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| Importance of extensive staging in patients with mucosa-associated lymphoid tissue (MALT)-type lymphoma |
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| Author(s): Raderer M, Vorbeck F, Formanek M, Osterreicher C, Valencak J, Penz M, Kornek G, Hamilton G, Dragosics B, Chott A |
| Source: BRITISH JOURNAL OF CANCER Volume: 83 Issue: 4 Pages: 454-457 Published: AUG 2000 |
| Times Cited: 75 References: 22 |
| Abstract: Lymphoma of the mucosa-associated lymphoid tissue (MALT) type usually arises in MALT acquired through chronic antigenic stimulation triggered by persistent infection and/or autoimmune processes. Due to specific ligand-receptor interactions between lymphoid cells and high-endothelial venules of MALT, both normal and neoplastic lymphoid cells display a pronounced homing tendency to MALT throughout the body. In the case of neoplastic disease these homing properties may be responsible for lymphoma dissemination among various MALT-sites. According to this concept, we have standardized staging procedures in all patients diagnosed with MALT-type lymphoma. All patients with MALT-type lymphoma underwent standardized staging procedures before treatment. Staging included ophthalmologic examination, otolaryngologic investigation, gastroscopy with multiple biopsies, endosonography of the upper gastrointestinal tract, enteroclysis, colonoscopy, computed tomography of thorax and abdomen and bone marrow biopsy. Biopsy was performed in all lesions suggestive for lymphomatous involvement, and evaluation of all biopsy specimens was performed by a reference pathologist. 35 consecutive patients with histologically verified MALT-type lymphoma were admitted to our department. Twenty-four patients (68%) had primary involvement of the stomach, five (15%) had lymphoma of the ocular adnexa, three (8.5%) had lymphoma of the parotid, and three (8,5%) of the lung. Lymphnode involvement corresponding to stage EII disease was found in 13 patients (37%), only one patient with primary gastric lymphoma had local and supradiaphragmatic lymph-node involvement (stage Bill). Bone marrow biopsies were negative in all patients. Overall, eight of 35 patients (23%) had simultaneous biopsy-proven involvement of two MALT-sites: one patient each had lymphoma of parotid and lacrimal gland, conjunctiva and hypopharynx, conjunctiva and skin, lacrimal gland and lung, stomach and colon, and stomach and lung. The remaining two patients had bilateral parotideal lymphoma. Staging work-up was negative for lymph-node involvement in all of these eight patients, The importance of extensive staging in MALT-type lymphoma is emphasized by the demonstration of multiorgan involvement in almost a quarter of patients. In addition, our data suggest that extra-gastrointestinal MALT-type lymphoma more frequently occurs simultaneously at different anatomic sites than MALT-type lymphoma involving the GI-tract. (C) 2000 Cancer Research Campaign. |
| Document Type: Article |
| Language: English |
| Reprint Address: Raderer, M (reprint author), Univ Vienna, Dept Internal Med 1, Div Oncol, Waehringer Guertel 18-20, A-1090 Vienna, Austria |
Addresses:
1. Univ Vienna, Dept Internal Med 1, Div Oncol, A-1090 Vienna, Austria
2. Univ Vienna, Dept Internal Med 1, Div Radiol, A-1090 Vienna, Austria
3. Univ Vienna, Dept Internal Med 1, Div Otolaryngol, A-1090 Vienna, Austria
4. Univ Vienna, Dept Internal Med 1, Div Internal Med 4, A-1090 Vienna, Austria
5. Univ Vienna, Dept Internal Med 1, Div Clin Pathol, A-1090 Vienna, Austria |
| Publisher: CHURCHILL LIVINGSTONE, JOURNAL PRODUCTION DEPT, ROBERT STEVENSON HOUSE, 1-3 BAXTERS PLACE, LEITH WALK, EDINBURGH EH1 3AF, MIDLOTHIAN, SCOTLAND |
| Subject Category: Oncology |
| IDS Number: 342UH |
| ISSN: 0007-0920 |
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