title: Minimally invasive procedure for accurate diagnosis of mucosa-associated lymphoid tissue lymphoma of the head and neck.
abstract: Sonography-guided cutting needle biopsy for the diagnosis of malignant lymphoma has recently come into wide use. However, surgery is sometimes unavoidable for the diagnosis of malignant lymphoma, particularly for low-grade malignant lymphoma such as extranodal marginal zone B-cell lymphoma of mucosa-associated lymphoid tissue, because cutting needle biopsy offers limited diagnostic accuracy for low-grade malignant lymphoma. Of course, unnecessary invasive procedures like open biopsy should be avoided wherever possible, given the cosmetic problems and burden on the patient. We tried to diagnose malignant lymphoma using the combination of cutting needle biopsy, flow cytometry and polymerase chain reaction to identify monoclonal rearrangement of immunoglobulin heavy chain genes. We have used this method in two cases in whom malignant lymphoma was suspected in the head and neck region, allowing diagnosis of mucosa-associated lymphoid tissue lymphoma in both cases. One case involved a 23-year-old woman with mucosa-associated lymphoid tissue lymphoma in the parotid glands, and the other involved a 77-year-old man with mucosa-associated lymphoid tissue lymphoma in the thyroid. The combination of cutting needle biopsy, flow cytometry and immunoglobulin heavy chain gene rearrangement testing might offer a useful alternative to open biopsy for the diagnosis of mucosa-associated lymphoid tissue lymphoma. We recommend this procedure, particularly for young women or patients with poor performance status in whom malignant lymphoma is suspected.
authors.affiliation: Department of Otolaryngology, Head and Neck Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences. 2-5-1 Shikata-Cho, Kita-Ku, Okayama 700-8558, Japan. y.orita@live.jp
authors.forename: Yorihisa
authors.initials: Y
authors.lastname: Orita
authors.forename: Yasuharu
authors.initials: Y
authors.lastname: Sato
authors.forename: Eisei
authors.initials: E
authors.lastname: Kondo
authors.forename: Hisashi
authors.initials: H
authors.lastname: Ishihara
authors.forename: Haruka
authors.initials: H
authors.lastname: Hirai
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Hanakawa
authors.forename: Tomoo
authors.initials: T
authors.lastname: Onoda
authors.forename: Takuro
authors.initials: T
authors.lastname: Igawa
authors.forename: Ryusuke
authors.initials: R
authors.lastname: Saito
authors.forename: Kazunori
authors.initials: K
authors.lastname: Nishizaki
authors.forename: Tadashi
authors.initials: T
authors.lastname: Yoshino
mesh_terms: D000328:Adult; D000368:Aged; D001707:Biopsy, Needle; D005260:Female; D005434:Flow Cytometry; D050438:Genes, Immunoglobulin Heavy Chain; D006258:Head and Neck Neoplasms / Q000175:diagnosis*; D006801:Humans; D018442:Lymphoma, B-Cell, Marginal Zone / Q000175:diagnosis; D008297:Male; D016133:Polymerase Chain Reaction