title: Waldeyer ring lymphoma: a case series.
abstract: We encountered a patient with a tongue base lymphoma that we initially diagnosed as a lingual tonsil in view of its benign appearance. We established the correct diagnosis of Waldeyer ring lymphoma by histology. This case led us to conduct a study of all cases of Waldeyer ring lymphoma that had been treated at our center during a 10-year period. We retrospectively examined our case records and found 35 such cases. From this group, we excluded 5 cases because of incomplete data. Thus our final study group was made up of 30 patients-14 males and 16 females, aged 14 to 76 years (mean: 51.6; median 54). The primary presenting signs and symptoms were dysphagia (n = 17 [57%]), a neck mass (n = 7 [23%]), nasal symptoms (n = 5 [17%]), and pain (n = 1 [3%]). Only 4 patients (13%) had B symptoms. A total of 20 patients (67%) presented with tonsillar involvement, 8 (27%) with nasopharyngeal involvement, 1 (3%) with tongue base lymphoma, and 1 with anterior tongue involvement. Most patients (77%) presented at an early stage. Histologically, 25 patients (83%) had high-grade diffuse large B-cell lymphoma, 4 (13%) had T-cell lymphoblastic lymphoma, and 1 (3%) had follicular lymphoma. Twenty-one patients (70%) were treated with chemotherapy, 4 (13%) received adjuvant chemotherapy with either radiotherapy or surgery, 3 (10%) resorted to other forms of treatment (primarily traditional remedies), and 2 (7%) declined treatment altogether. There were 14 patients (47%) alive at the end of the study period.
authors.affiliation: Department of Otorhinolaryngology, Sungai Buloh Hospital, Sungai Buloh, 47000 Selangor, Malaysia. carren_teh@hotmail.com.
authors.forename: Carren S
authors.initials: CS
authors.lastname: Teh
authors.forename: Pailoor
authors.initials: P
authors.lastname: Jayalakshmi
authors.forename: Sheldon Y
authors.initials: SY
authors.lastname: Chong
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D008221:Lymphoid Tissue / Q000473:pathology; D008223:Lymphoma / Q000175:diagnosis* / Q000473:pathology; D008224:Lymphoma, Follicular / Q000175:diagnosis / Q000473:pathology; D016403:Lymphoma, Large B-Cell, Diffuse / Q000175:diagnosis / Q000473:pathology; D016399:Lymphoma, T-Cell / Q000175:diagnosis / Q000473:pathology; D008297:Male; D008875:Middle Aged; D009303:Nasopharyngeal Neoplasms / Q000175:diagnosis* / Q000473:pathology; D009367:Neoplasm Staging; D014062:Tongue Neoplasms / Q000175:diagnosis* / Q000473:pathology; D014067:Tonsillar Neoplasms / Q000175:diagnosis* / Q000473:pathology; D055815:Young Adult