Malignant Lymphomas of Waldeyers ring

This section gives a brief overview of lymphomas of Waldeyer's ring. For a more detailed description, including genetic characteristics of these lymphomas see the WHO classification and the revised European-American classification of lymphoid neoplasms [74, 95]. Extranodal lymphomas of Waldeyer's ring constitute about 5-10% of all lymphomas in the USA and Europe, about 15% in Hong Kong and about 10-20% in Japan. Of all lymphomas involving Waldeyer's ring, 80% are primary to this site and the tonsillar fossa is the most common location, followed by the nasopharynx and the base of the tongue. Up to 20% of patients with tonsillar lymphoma have an associated gastrointestinal involvement. Clinical presentation is that of a localised neoplasm, sore throat, dysphagias, and in cases of nasopharyngeal involvement cranial nerve, auditory and nasal symptoms. Between 85 and 90% of all non-Hodgkin's lymphomas in Waldeyer's ring are of the B-cell phenotype, the remainder are of the T-cell type, but regional differences have been reported [146, 150]. The vast majority of Waldeyer's ring lymphomas are high-grade lymphomas, with only less than 15% being of low grade [113]. The majority of AIDS-related extranodal head and neck lymphomas are aggressive B-cell lymphomas of the Burkitt type or immunoblas-tic diffuse large B-cell lymphomas [207].

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