• Radiation Oncology Journal
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• v.12 no.1
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• pp.33-42
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• 1994

From 1982 to 1991, sixteen Patients with primary non-Hodgkin's lymphoma of the central nervous system(CNS) were seen at Kyung Hee University Hospital. The most common subtypes were large, noncleaved cell lymphoma and immunoblastic lymphoma of B cells. Lesions most commonly involved were the parietal lobes and/or deep nuclei. Positive cerebrospinal fluid cytology was rare at initial presentation. Sixteen patients were treated with surgical biopsy or resection followed by whole brain radiotherapy at a median dose of 40 Gy(range=30-50 Gy) with variable boost doses. Of 16 patients who underwent surgery and postoperative radiotherapy, fourteen patients died between 2 and 49 months following treatment, and two are alive with no evidence of disease at 8 and 22 months. The 1-and 2-year survival rates were 55.6$ \% $ and 34.7$ \% $, respectively with 12 months of median survival. Patterns of failure were analyzed in eleven patients of total 16 patients. Failure at the original site of involvement was uncommon after radiotherapy treatment. In contrast, failure in the brain at sites other than those originally invovled was common in spite of the use of whole brain irradiation. Failure occurred in the brain 11/16(68.7$ \% $), in spinal axis 4/16(25.0$ \% $). The age, sex, location of involvement within CNS, numbers of lesion, or radiation dose did not influence on survival. The authors conclude that Primary CNS lymphoma is a locally aggressive disease that is poorly controlled with conventional radiation therapy. The limitation of current therapy for this disease are discussed, and certain promising modality should be made in regarding the management of future patients with this disease.

• Journal of Korean Neurosurgical Society
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• v.29 no.10
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• pp.1365-1371
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• 2000

Objectives : Spinal cord compression is a rare presentation of non-Hodgkin's lymphoma(NHL), occurring in 0.1% to 10.2% of patients. Primary spinal extradural NHL, i.e. occurring in the absence of any detectable extraspinal lymphoproliferative disorder, has a potentially favourable outcome if diagnosed and treated early. The authors describe two patients with a clinical picture of acute spinal cord compression as the first presentation of NHL. Methods : The patients were 48-year-old female and 27-year-old female. Both presented with back pain followed by acute paraparesis and voiding difficulty. One patient was diabetic. Plain radiographs of the spine were not specific. Thoracic spine magnetic resonance imaging(MRI) revealed evidence of extradural soft tissue mass extending multiple vertebral segments. Results : The patients underwent emergency laminectomy for decompression and tissue diagnosis. Histological and immunohistochemical study revealed B-cell lymphoma, intermediate grade in both patients. Postoperative staging did not reveal any additional lesions other than extradural manifestation of the malignant lymphoma. Surgery with additional chemotherapy and radiotherapy allowed the clinical improvement of both patients. Conclusion : The authors report two patients with a clinical picture of acute spinal cord compression as the first presentation of NHL, and stress that primary spinal epidural NHL should be a diagnostic consideration in the patient without prior history of malignancy who presents with a prodrome of back pain followed by a rapid neurological deterioration.

• Radiation Oncology Journal
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• v.3 no.2
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• pp.113-121
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• 1985

This is a retrospective analysis of 54 patients with stage I or II Non-Hodgkin's lymphoma involving the head and neck region treated with curative radiotherapy in the Department of Therapeutic Radiology, Seoul National University Hospital during the period of February 1979 through September 1982. The minimum follow-up period was 24 months. The review of histologic slides was available in 36 cases. Waldeyer's ring was the most common extranodal sites $(40\%)$. $41\%$ of patients were in the stage 1 and $59\%$ in the stage II by Ann Arbor classification. Of the 44 patients who responded after radiotherapy, 24 patients$(54.4\%)$subsequently relapsed. Regional recurrence rate was $29\%$, distant metastasis was $54\%$ and simultaneous regional recurrence and distant metastasis was $17\%$. The survival rate and disease free survival at 2 years were $57\%\;and\;45\%$ respectively. Those patients with a large primary lesion (over 6cm in diameter), multiple conglomerated, extranodal site and diffuse ceil type, experienced a high rate of distant metastasis. Therefore it seems desirable to study the use of adjuvant chemotherapy in those patients with a high probability of distant metastasis.

• Radiation Oncology Journal
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• v.5 no.1
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• pp.23-30
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• 1987

Thirty eight patients with stage I and II primary gastrointestinal non-Hodgkin's lymphoma were treated in the Department of Therapeutic Radiology, Seoul National University Hospital between 1979 and 1984. There were 6 systemic disseminations during radiotherapy, and the overall failure rate were $31\%$ in the cases with tumor bulk less than 5cm in diameter before radiotherapy and $75\%$ in the cases with tumor bulk greater than 5cm in diameter (p <0,05). The overall 5 year survival rate were $69.2\%$ in 28 patients who completed radiotherpay and $72\%$ in 24 patients with tumor bulk less than 5cm in diameter (small or no tumor bulk). The 5 year disease free survival rate were $71\%$ in cases with tumor bulk less than 5cm in diameter and $25\%$ in cases with tumor bulk greater than 5cm in diameter (p<0.01). But the intitial stage was not related with treatment result in all cases or subgroups of cases. Thus the cases with small or no tumor bulk were shown to be curable with combined surgery and postoperative radiotherapy, but for the control of the cases with large tumor bulk that had a guarded prognosis combined radiotherapy and chemotherapy should be tried.

• Radiation Oncology Journal
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• v.3 no.1
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• pp.65-68
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• 1985

Primary lymphoid tumors of orbit are rare. Sometimes they pose difficulty in differentiating malignant non-Hodgkin's lymphoma of the orbit from benign lymphoid hyperplasia or pseudotumor of the orbit by growth characteristics and histologic examination of a biopsy specimen. Consequently, systemic work-up for staging of the disease before the initiation of treatment is essential. All lymphoid tumors of the orbit are radiosensitive and the response to radiotherapy is rapid and complete. Radiation dose for permanent control varies from 2,400 to 4,500rads in $2.5\~4$ weeks depending on extent and location of the disease. A case of localized lymphoma of the orbit was treated with radiotherapy. For the following 15 months, the patient was clinically free of disease without any evidence of side effects of radiation treatment.

• Journal of Korean Neurosurgical Society
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• v.51 no.6
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• pp.377-379
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• 2012

Mucosa-associated lymphoid tissue (MALT) lymphoma is one of the most common lymphomas and accounts for about 7% of all newly diagnosed non-Hodgkin's lymphoma (NHL). The clinical course of MALT lymphoma is relatively indolent and, in the majority of cases (50%), the lymphoma arises within the stomach. Primary central nervous system lymphoma (PCNSL), an uncommon variant of extranodal NHL, can affect any part of the neuraxis, including the eyes, brain, leptomeninges, or spinal cord. Herein, we present a rare case of PCNSL, which occurred one year after radiochemotherapy of gastric MALT lymphoma. A 62-year-old man presented with a 3-day history of left facial palsy. One year ago, he underwent antibiotic eradication therapy of Helicobacter pylori, local stomach fractional radiotherapy, and chemotherapy for gastric MALT lymphoma. Magnetic resonance imaging revealed a strong enhancing solid mass in the right frontal lobe. The tumor was completely removed, and the histological diagnosis of PCNSL developing from diffuse large B-cell lymphoma was made. Although elucidating the correlation between the first gastric MALT lymphoma and the second PCNSL seemed difficult, we have postulated and discussed some possible pathogeneses, together with a review of literature.

• Radiation Oncology Journal
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• v.9 no.1
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• pp.103-109
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• 1991

Radiotherapy result of 162 patients with stage I, II intermediate grade non-Hodgkin's Iymphoma was analyzed to clarify the role and limit of radiotherapy. Of 68 initial failures, 38.2% occurred in field and 61.8% occurred out of field. Proportion of in-field and out-of-field failures in stage I was 30.0% and 70.0%, respectively with involved field treatment and was 43.8% and 56.2% with extended field treatment, respectively; in stage ll , was 16.7% and 83.3%, 41.7% and 58.3%, respectively. The disease free suwival rate at S years was 48.1% for all patients and was 50.3% and 40.4% for patients with stage I and II, respectively. The survival was significantly different by stage. Bulky tumors (${\geq}10$ cm) and B symptoms didn't influence prognosis significantly. The 5 year disease free suwival with extended or wide field was better than that with involved field especially in stage I. Overall survival rates for all patients, patients with stage 1, and ll disease were 57.7%, 65.3% and 52.2% , respectively, after survival gain of the salvage chemotherapy was combined. But the overall survival of stage I disease was not better than that of stage II disease. Thus, extended field was required to achieve better disease free survival and relapsed cases might gain with chemotherapy.

• Journal of Gastric Cancer
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• v.1 no.4
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• pp.215-220
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• 2001

Purpose: The aim of the study was to obtain data on the anatomic and histologic distributions, the clinical features, and the treatment results for patients with primary gastric non-Hodgkin's lymphoma. Materials and Methods: One hundred thirty-two patients who were treated at 8 university hospitals and 2 general hospitals between January 1991 and December 2000 were enrolled to evaluate clinico-pathologic features. Results: The lower one-third of the stomach was the most frequent site ($42\%$), and the most frequent chief complaint was epigastric pain ($54\%$). Gastric resection was performed in 114 cases. Pathologic findings of preoperative endoscopic biopsy specimens from the 114 patients that underwent surgery were a gastric lymphoma in 94 cases ($82\%$), a carcinoma in 15 cases ($13\%$), an ulcer in 4 cases ($4\%$), and a gastrointestinal stromal tumor in 1 case ($1\%$). The stage distributions by Musshoff's criteria were 71 cases ($54\%$) of stage IE, 36 cases ($27\%$) of stage $II_{1}E$, 8 cases ($6\%$) of stage $II_{2}E$, 2 cases ($2\%$) of stage IIIE, and 15 cases ($11\%$) of stage IVE. Histologic gradings by the Working Formulation in were 31 cases ($23\%$) of low grade, 96 cases ($73\%$) of intermediate grade, and 5 cases ($4\%$) of high grade. Chemotherapy-related complications occurred in 25 cases ($22\%$) while operation-related complications occurred in 6 cases ($5\%$). Seventeen patients ($13\%$) only underwent surgery, 19 ($14\%$) had chemotherapy (CTx) and/or radiotherapy (RTx) only, and 96 patients ($73\%$) received surgery and CTx and/or RTx. No substantial differences in survival were found in relation to the different histologic grades and different treatments. The five-year survival was $85\%$ in stage I or II and $47\%$ in stage III or IV (P=0.0000). Conclusion: Pathologic stage appears to be the single most important prognostic indicator. Survival differences according to treatment modalities were not statistically significant. However, the low number of patients treated with various approaches over a long period precludes a firm conclusion.

• Korean Journal of Head & Neck Oncology
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• v.17 no.1
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• pp.26-31
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• 2001

Background: Primary malignant lymphoma of the parotid gland is a rare disease and defined as any malignant lymphoma that first manifests in the parotid gland, regardless of the subsequent stage of the diseases, whether it arises in the parenchyma or intraglandular lymph nodes. This study was performed to review the clinicopathological characteristics of primary parotid lymphoma and identify its optimal treatment modality. Materials and Methods: Six cases with parotid mass as first presentation of malignant lymphoma between 1988 and 2000, were studied on the basis of clinical features, diagnostic tools, treatment modality, treatment outcomes, and clinical stage by Ann Arbor Criteria. All were microscopically reevaluated and classified by NCI working formulation. Results: All patients were males and mean age was 36.7 years (2-66 years). Rapid growing non-tender mass was presented in all the cases and cervical lymphnodes were palpated in 4 cases. However, there was not any evidence of concurrent autoimmune disease such as Sjogren's syndrom or Rheumatoid arthritis. One case was confirmed by surgical specimen after superficial parotidectomy, 2 by excisional biopsy, and 3 by incisional biopsy. The stage of disease by NCI working formulation was IE in 1 patient, IIE in 4 and IV in 1. All were classified into non-Hodgkin' lymphoma, of which there were 5 cases of B-cell type and 1 case of T-cell type. There were 3 diffuse large cell lymphomas, 1 Burkitt lymphoma, 1 MALT lymphoma and 1 T-lymphoblastic lymphoma. Three cases were treated by chemotherapy only, 2 by radiotherapy only and 1 by chemo-radiotherapy. One case with Burkitt lymphoma was died from the disease and one case was lost to follow-up. The others are alive with no evidence of recurrence. Conclusions: Although primary parotid lymphoma is rare and difficult to diagnose preoperatively, most were detected in early stage and showed a relatively good response to the chemotherapy or radiotherapy like other types of extranodal malignant lymphoma.

• The Korean Journal of Cytopathology
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• v.13 no.1
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• pp.33-37
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• 2002

We report two different types of thyroid lymphoma associated with Hashimoto's thyroiditis. Both showed autoantibodies and were compatible with Hashimoto's thyroiditis according to their clinical backgrounds. A 76-year-old female noted a painless, rapidly growing mass in her neck which was diagnosed as diffuse non-Hodgkin's lymphoma, large cell type, after the fine needle aspiration cytology of the thyroid. She underwent chemo-radiotherapy and is free of the disease 10 months after diagnosis. The other patient, a 73-year-old female with a diffuse golfer, was diagnosed on fine needle aspiration cytology as having Hashimoto's thyroiditis. Three years later she developed a hard nodular growth in the both lobes of the thyroid. This was subjected to fine needle aspiration cytology and needle biopsy and was diagnosed as a MALT lymphoma. She refused any treatment and died 12 months after the diagnosis.