Non Hodgkin lymphoma

Primary non-Hodgkin lymphomas (NHL) of the hypopharynx, larynx or trachea are very rare. They account for 1% of all primary extranodal NHL {809}. By contrast, secondary laryngeal lymphomas are more common and represent spread from cervical and mediastinal lymph nodes, and thyroid gland. Patients present with hoarseness, foreign body sensation, or mild airway obstruction. Supraglottic tumours are more frequent, but all regions of the larynx can be involved.

Most primary laryngeal NHL are B-cell lymphomas, especially diffuse large B-cell lymphoma (DLBCL) and extranodal marginal zone B-cell lymphoma of MALT type {63,601,1285,1771}. Rare cases of extranodal NK/T cell lymphoma of nasaltype {371,1761} and peripheral T-cell lymphoma {1285,1632,1761} have also been reported. Most patients (>90%) present with low clinical stage (Stage IE/IIE) {63,1285,1771}, but occasional patients can succumb to acute laryngeal obstruction {1771}. NK/T cell lymphomas and peripheral T-cell lymphomas have a poorer outcome as compared to B-cell lymphomas {63,1285,1761,1771}.

nucleoli, 4) greater than 2 mitoses per 10 high power fields at 200X magnification,

5) high nuclear to cytoplasmic ratio, and

6) pleomorphism. Neoplasms that meet 3 or more of these criteria are classified as malignant. Those that meet only one or two criteria are regarded as atypical while those that show only focal pleomorphism but none of the other features are classified as benign.

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