Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0677930 (primary tumor)
 20,210 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

HTLV-I induced not only nodal but also primary extranodal lymphomas. In this report we describe 12 patients with HTLV-I induced extranodal T-cell lymphoma collected from the literature and our institute experience. There were 5 males and 7 female patients of middle age positive for HTLV-I antibody. The sites of primary tumor were gastrointestinal, Waldeyer's ring, skin, facial sinuses, and the pleura. All of these were histologically diffuse lymphomas and most of them were found to be a helper/inducer T-cell phenotype, showing integration of HTLV-I proviral DNA. Late leukemic changes and skin infiltration often occurred, but hypercalcemia was rare. Survival time varied from 4 to 35 months, and late organ infiltrations were common. These HTLV-I induced extranodal lymphomas were compared with HTLV-I unrelated extranodal lymphomas or HTLV-I induced nodal lymphomas (lymphoma type ATL). Between 1981 and 1990, we had 110 ATL patients and of these, 5 (4.6%) were HTLV-I induced primary extranodal lymphomas. The frequency of HTLV-I induced extranodal lymphoma might be much higher than expected because until now attention has not been paid to this entity. From the present review, it is suggested that HTLV-I could cause primary extranodal lymphoma which may have some different characteristics from other types of lymphoma. Therefore, patients with T-cell extranodal lymphomas should be investigated further for the presence of HTLV-I antibody and the tumor cells should be examined for the integration of HTLV-I proviral DNA using Southern blot analysis.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:HTLV-I induced extranodal lymphomas. 147 32

Whether to accept the report of the referring physician is often a stumbling block for many otolaryngologist-head and neck surgeons, especially when management of the case is changing hands. Thus, it is no surprise that all the consultants would repeat the examination of the upper aerodigestive tract under anesthesia. Drs. Robbins and Fried objected to the term "blind" biopsies and preferred "random-guided" and "directed" biopsies is that order. Yet, all 3 specialists agree that multiple biopsies of Waldeyer's ring should be obtained. They emphasize that palpation is an integral part of the endoscopy and may guide the surgeon in deciding where to biopsy. The surgeons agree that the base of tongue has the highest yield in cases like this one. Dr. Robbins stands alone in his use of ipsilateral tonsillectomy as a screening biopsy technique. Dr. Robbins believes imaging studies have a role prior to the initial panendoscopy and prefers an MRI of the head and neck. Drs. Gluckman and Fried use imaging studies if the primary tumor is in a clinically difficult area to evaluate. Faced with a normal repeat endoscopy and no other cervical adenopathy, Drs. Fried and Robbins would treat Waldeyer's ring and both sides of the neck with radiotherapy; Dr. Fried suggests 60 to 65 Gy over 6 weeks and Dr. Robbins suggests 65 to 70 Gy over 6 to 7 weeks to Waldeyer's ring and the upper neck but would treat the remaining nodal areas of the neck with 50 Gy over 5 weeks.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Cervical metastatic squamous carcinoma of unknown or occult primary source. 179 Nov 50

Gastrointestinal involvement occurs in a greater proportion of patients with malignant lymphoma of Waldeyer's ring than would be accounted for by change alone. In the absence of direct lymphatic connection between these two sites, the association of these tumors has prompted several hypotheses: that the gastrointestinal lymphoma is a concomitant primary tumor; or that it is related to the swallowing and implantation of tumor cells; or that it represents the homing tendency of the gut-associated lymphoid tissue. Five cases are described in which malignant lymphoma of Waldeyer's ring developed ten months to five and half years after an initial diagnosis of gastrointestinal lymphoma was made. All five patients were female, and the original tumors were of the nodular lymphoma, histiocytic type in 4, and Lennert's lymphoma in 1. The tumors of Waldeyer's ring had similar cytologic features. In 1 patient with small intestinal lymphoma and recurrent tonsillar tumor five and half years later, immunoperoxidase staining of the original and recurrent tumors was positive with anti-IgA and anti-kappa antisera, thus establishing the identity of the two tumors. The reverse pattern of involvement, i.e., Waldeyer's ring tumor following gastrointestinal lymphoma, provides evidence against the concomitant primary or swallowing theories. The homing tendencies of gut-associated lymphoid tissue may offer some explanations for this interesting coincidence.
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PMID:Malignant lymphoma of Waldeyer's ring following gastrointestinal lymphoma. 677 6

Nasopharyngeal carcinoma represents a morphologic spectrum of neoplasms localized to the nasopharynx and arising from nasopharyngeal epithelium. Nasopharyngeal carcinomas have rather unique clinical, epidemiologic, pathologic, and biologic features. The morphologic spectrum of nasopharyngeal carcinoma includes keratinizing, nonkeratinizing, and undifferentiated subtypes. The separation of these morphologic types is not an academic exercise, but has practical importance relative to differential diagnosis, management, and prognosis. A similar morphologic classification applies to carcinomas arising in the palatine tonsils and the base of tongue. The nasopharynx, palatine tonsils, and base of tongue are collectively designated as Waldeyer's tonsillar tissues. Awareness of the morphologic spectrum of Waldeyer's ring carcinomas may assist in suggesting the primary tumor site in the face of an occult metastatic carcinoma to cervical neck lymph nodes.
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PMID:Nasopharyngeal carcinoma. 1059 90

Most of the patients with nasal-paranasal and oropharyngeal-nasopharyngeal (NPONP) lymphomas had early-stage disease according to the Murphy system. But the survival rates are not correlated with the stages. Treatment results were analyzed to see the effects of the staging in NPONP lymphomas. Fifty-five children (median age 8 years, M/F: 4.5) with NPONP lymphoma were included in this study. The Murphy staging system was used at diagnosis and all cases were restaged according to the TNM system: primary tumor, regional lymph node, and metastasis. The survival rates were analyzed by grouping the patients according to the treatment and stages. The disease was located in Waldeyer's ring, the sinonasal region, and the nasopharynx in 45.4, 27.3, and 27.3% of patients, respectively. Thirty-nine patients had stage I or II disease according to the Murphy system. When the TNM system was used, 92% of these patients were upstaged to stage III-IV. Five-year overall and event-free survival rates were 52.1 and 50.4%, respectively, for the whole group. Five-year event-free survival rates for Murphy stage I, II, and III disease were 66.7, 56.9, and 45.4%, respectively. The rates for TNM stage III and IV patients were 64.3 and 43.8%. Treatment protocols were intensified in most of the early-stage disease treated with modified LSA2-L2 regimen and better survival rates were obtained in these patients. The intensification of the treatment by using intrathecal treatment and doxorubicin in patients with early-stage disease at NPONP location seems effective. In conclusion, the Murphy staging system is not suitable for the staging of NPONP lymphomas. It should be revised to predict the prognosis and decision-making for treatment.
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PMID:Nasal-paranasal-oronasopharyngeal lymphomas in childhood: the role of staging system on prognosis. 1103 25

Unknown primary carcinoma presenting as cervical lymph node metastasis accounts for approximately 5% of all head and neck malignancies. The typical presentation involves a middle-aged man with a painless neck mass that has been present for several months. Over 90% of these malignancies represent squamous cell carcinoma originating within Waldeyer's ring (lymphoid tissue of the nasopharynx, tonsil, and base of tongue). The remainder are comprised of adenocarcinoma, melanoma, and other rare histologic variants. The ability to identify the occult primary tumor is imperative because identification allows site-specific therapy and avoidance of wide-field radiation side effects. Following confirmation of metastatic cervical disease with fine-needle aspiration, all patients presenting with an unknown primary carcinoma require a thorough head and neck history and physical examination, radiographic imaging, panendoscopy with directed biopsies of Waldeyer's ring, and bilateral tonsillectomy. Positron emission tomography has proved helpful in identifying occult primary tumors of the head and neck region.
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PMID:Occult primary head and neck carcinoma. 1728 81

Human papillomavirus (HPV) is detected in a subset of patients with head and neck squamous cell carcinoma, most frequently in tumors in the Waldeyer's ring (palatine tonsil and base of tongue). Several studies suggest that patients with HPV-positive tumors have better survival with either concurrent chemoradiation therapy or surgery followed by radiation compared with HPV-negative patients. However, some possible confounding clinicopathologic variables may challenge the validity of this statement, for example, some authors used the TNM (tumor, node, metastasis) grouping stage while others used the primary tumor (T stage), and other studies have demonstrated that tumors with advanced T stage were less likely to be infected with HPV. A large clinical trial with stratification of patients according to all known tumor prognostic factors is crucial to solve the question.
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PMID:Recent advances in managing human papillomavirus-positive oropharyngeal tumors. 2094 69

Head and neck squamous cell carcinoma (HNSCC) often presents with cervical lymph node metastases and at times the primary tumor cannot be identified despite extensive workup. Lymphoma is the second most common neoplasm in the head and neck region but is seldom synchronous with HNSCC and rarely involves regional mucosal sites. We report herein a rare occurrence of tonsillar involvement by small lymphocytic lymphoma (SLL) incidentally detected during the workup for a cervical lymph node SCC metastasis of a 52-year-old non-smoker male. The microscopic human papillomavirus-positive SCC involving the tonsillar surface and crypts was obscured by SLL leading to the initial designation of 'unknown primary'. The occult HNSCC are likely explained by small tumor size, quality and quantity of sampling, thoroughness of endoscopic, radiological and pathological assessment or a combination of the above. The coexistence of another tumor such as lymphoma has not yet been reported as a confounding factor in the workup for cervical SCC metastasis. Since oropharyngeal SCC can be very small and Waldeyer's ring is a common site for lymphoma involvement, identification of such rare collision tumors requires pathologists' awareness, extensive sampling and occasionally ancillary studies for the accurate diagnosis and staging essential for the correct management.
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PMID:Small lymphocytic lymphoma obscuring microscopic tonsillar squamous cell carcinoma: an unknown occurrence with a known primary. 2112 Jul 10

While most cystic neck masses are cervical cleft cysts, it is known that lymph node metastasis from a squamous cell carcinoma in Waldeyer's ring may undergo cystic degeneration and can mimic cervical cysts, leading to a mistaken diagnosis. A 54-year-old male presented with features of a cervical cleft cyst, which later proved to be a lymph node metastasis from a supraglottic laryngeal carcinoma. A 47-year-old male presented with an abscessing lymphadenitis; this turned out to be a metastasis of an unknown primary tumor. Investigations should include ultrasound-guided FNA (fine-needle aspiration) performed by an experienced radiologist. However, FNA outcomes are often inconclusive. In patients who are highly suspected of having a malignancy (those with a history of smoking and alcohol abuse), a panendoscopy with biopsies and tonsillectomy, preferably conducted by an otolaryngologist specialised in head and neck cancer, should be considered.
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PMID:[Cystic neck mass. Cervical cleft cyst or lymph node metastasis?]. 2332 13