顎口腔領域に発生した悪性リンパ腫の臨床的検討

DOI
  • 今城 育美
    九州大学歯学研究院口腔顎顔面病態学講座口腔顎顔面外科学分野
  • 山田 朋弘
    九州大学歯学研究院口腔顎顔面病態学講座口腔顎顔面外科学分野
  • 大山 順子
    九州大学歯学研究院口腔顎顔面病態学講座口腔顎顔面外科学分野
  • 石井 広太郎
    九州大学歯学研究院口腔顎顔面病態学講座口腔顎顔面外科学分野
  • 森 悦秀
    九州大学歯学研究院口腔顎顔面病態学講座口腔顎顔面外科学分野

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  • A clinical study of malignant lymphoma arising in the oral and maxillofacial region

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We examined the clinical characteristics of 68 malignant lymphomas （MLs）, which arose in the oral and maxillofacial region and were diagnosed at the Department of Oral and Maxillofacial Surgery of Kyushu University Hospital from 1986 to 2016. The patients consisted of 42 males and 26 females （mean age: 64.0 years）. <br>The MLs comprised 26 intranodal （38.2％） and 42 extranodal （61.8％） types. The primary sites of the extranodal type were the upper gingiva in 14 cases （33.3％）, lower gingiva in 11 cases （26.2％）, buccal in 8 cases （19.0％）, and others in 9 cases （21.4％）. Most of the intranodal tumors were in cervical lymph nodes （24 cases; 92.3％）. The chief complaints were tumor mass or swelling in 54 cases （79.4％）, paresthesia in 9 cases （13.2％）, and pain in 7 cases （10.3％）. <br>MLs were often recognized as well-defined uniformly enhanced masses on computed tomography （CT） （51.1％）. Apparent diffusion coefficient （ADC） values were characteristically low on magnetic resonance imaging （MRI）. Furthermore, the more malignant, the higher the FDG uptake tended to be in PET-CT. The initial clinical diagnoses were suspected MLs in 23 cases （35.9％）, malignant tumor in 13 cases （20.3％）, benign tumor in 12 cases （18.8％）, inflammation in 11 cases （17.2％）, and others. <br>The most common histopathological classification was diffuse large B-cell lymphoma （DLBCL） （57.1％）, according to the WHO classification of 2016. According to the Ann Arbor staging classification, 24 cases （61.5％） were in stage Ⅰ. As treatments, chemoradiotherapy was performed in 23 cases （47.9％）, chemotherapy alone in 14 cases （29.2％）, and radiotherapy alone in 7 cases （14.6％）.

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