Dergiler / Balıkesir Sağlık Bilimleri Dergisi / 2026 / Volume: 12 Issue: 1

Waldeyer Halkası Lenfomalarının Klinikopatolojik İncelenmesi: Türkiye’de Kesitsel Bir Çalışma

Clinicopatological Examination of Waldeyer’s Ring Lymphomas: A Cross-Sectional Study in Turkey

Çiğdem Özdemir(AFYONKARAHISAR HEALTH SCIENCES UNIVERSITY, SCHOOL OF MEDICINE, DEPARTMENT OF SURGICAL MEDICAL SCIENCES, DEPARTMENT OF PATHOLOGY)0000-0001-8500-0744
Nilhan Eryeğen(Balikesir Ataturk City Hospital, Department of Pathology)0000-0001-8509-3442
Filiz Yavaşoğlu(ESKISEHIR OSMANGAZI UNIVERSITY, SCHOOL OF MEDICINE, DEPARTMENT OF INTERNAL MEDICINE, DEPARTMENT OF INTERNAL MEDICINE, HEMATOLOGY)0000-0002-4017-4668
Mehmet Olgun Ak(AFYONKARAHISAR HEALTH SCIENCES UNIVERSITY, SCHOOL OF MEDICINE, DEPARTMENT OF SURGICAL MEDICAL SCIENCES, DEPARTMENT OF PATHOLOGY)0000-0003-1845-1849
Selçuk Kuzu(AFYONKARAHISAR HEALTH SCIENCES UNIVERSITY, SCHOOL OF MEDICINE, DEPARTMENT OF SURGICAL MEDICAL SCIENCES, DEPARTMENT OF OTORHİNOLARYNGOLOGIC DISEASES)0000-0002-0511-9874
Mustafa Duran(AFYONKARAHISAR HEALTH SCIENCES UNIVERSITY, SCHOOL OF MEDICINE, DEPARTMENT OF INTERNAL MEDICINE, DEPARTMENT OF INTERNAL MEDICINE, HEMATOLOGY)0000-0001-9158-8214
Burcu Belen Aydoğmuş(AFYONKARAHISAR HEALTH SCIENCES UNIVERSITY, SCHOOL OF MEDICINE, DEPARTMENT OF SURGICAL MEDICAL SCIENCES, DEPARTMENT OF PATHOLOGY)0000-0002-1837-1892
Büşra Çetinkaya(AFYONKARAHISAR HEALTH SCIENCES UNIVERSITY, SCHOOL OF MEDICINE, DEPARTMENT OF SURGICAL MEDICAL SCIENCES, DEPARTMENT OF PATHOLOGY)0000-0002-7065-8380
Abdulkadir Bucak(AFYONKARAHISAR HEALTH SCIENCES UNIVERSITY, SCHOOL OF MEDICINE, DEPARTMENT OF SURGICAL MEDICAL SCIENCES, DEPARTMENT OF OTORHİNOLARYNGOLOGIC DISEASES)0000-0003-3031-3465
Yiğit Şenol(AFYONKARAHISAR HEALTH SCIENCES UNIVERSITY, SCHOOL OF MEDICINE, DEPARTMENT OF INTERNAL MEDICINE, DEPARTMENT OF PUBLIC HEALTH)0000-0002-2220-4595
Sayfa
—
Yayın Tarihi
2023-03-15
🏛️Bu makalenin bibliyografik verileri ve tam metin bağlantısı DergiPark üzerinden sağlanmıştır.
DergiPark Kaydı ↗
✨

Yapay Zeka Hızlı Bakış & Çıkarımlar

AI Insight
⚡ TL;DR(1 Cümlede Hızlı Çıkarım)

Bu çalışmada WH lenfomalarının histopatolojik ve klinik bulgularını, Epstein-Barr virüsü (EBV) varlığını, genel sağ kalım verilerini değerlendirdik.

📌 3 Maddede Bu Makale

🎯
Amaç & Hipotez:ÖZ Amaç: Waldeyer halkası (WH), ekstranodal lenfomaların ikinci sıklıkta görüldüğü yerdir.
📊
Temel Bulgular & Veri:Bu çalışmada WH lenfomalarının histopatolojik ve klinik bulgularını, Epstein-Barr virüsü (EBV) varlığını, genel sağ kalım verilerini değerlendirdik.
💡
Sonuç & Katkı:Nazofarenksten kaynaklanan lenfomalarda sağ kalım daha düşüktür.
🔬Tür:Research Article
📍Kapsam:32 hasta
⚙️Değişkenler:Non-Hodgkin Lymphoma · Tonsil · Hodgkin Lymphoma

Özet

ÖZ Amaç: Waldeyer halkası (WH), ekstranodal lenfomaların ikinci sıklıkta görüldüğü yerdir. Klinik seyri nodal lenfomalara benzeyebilmektedir. Bu çalışmada WH lenfomalarının histopatolojik ve klinik bulgularını, Epstein-Barr virüsü (EBV) varlığını, genel sağ kalım verilerini değerlendirdik. Gereç ve yöntem: Çalışmamız retrospektiftir. WH lenfoma tanılı 32 hastaya ait demografik, klinik veriler, lenfoma tipleri ve kromojenik in-situ hibridizasyon yöntemi (KİSH) ile EBV (EBER) varlığı incelendi. Tanımlayıcı istatistikler yapıldı. Hayatta kalma oranı için Kaplan-Meier analizi kullanıldı. P değerinin 0.05'ten küçük olması anlamlı kabul edildi. Bulgular: Çalışmamızdaki 32 vakanın 23’ü erkek, 9’u kadın olup, hastaların yaş ortalaması 57.97±16.15’di. Vakaların %46.9’unda klinik ön tanı karsinomdu. Lenfoma yerleşimi tonsil ve nazofarenkste eşitti. Vakaların sadece 3’ü klasik hodgkin lenfoma (KHL), diğerleri Non-Hodgkin lenfoma (NHL) tanılıydı. NHL tanılı olguların 16’sı diffüz büyük B hücreli lenfoma (DBBHL) idi. DBBHL’ların %50.0’si germinal merkez B (GMB) hücre kökenli iken, %50.0’si non-GMB’kökenli idi. EBER pozitifliği sadece tonsil KHL vakalarında izlendi. Ann Arbor evreleme sistemine göre vakaların %58.3’ünün evresi I-II idi. Nazofaringeal kaynaklı lenfoma hastalarının sağ kalımı tonsil kaynaklı olanlardan anlamlı olarak kısa idi (p=0.037). Sonuç: WH lenfomaları klinik olarak en sık karsinomlar ile karıştırılmaktadır. Tonsil ve nazofarenks kaynaklı olanlar oranca birbirine yakındır. EBER pozitifliği sadece KHL’larda tespit edilmiştir. Nazofarenksten kaynaklanan lenfomalarda sağ kalım daha düşüktür.

Abstract

Objective: Waldeyer's ring (WR) is the second most common site of extranodal lymphomas. Its clinical course may resemble those of nodal lymphomas. We evaluated the histopathological and clinical findings, Epstein-Barr virus (EBV) presence, and overall survival of WR lymphomas diagnosed in our department. Materials and Methods: Retrospectively, 32 patients were included. The demographic and clinical data of the patients and lymphoma types, the presence of EBV [EBV early RNAs (EBER)] by chromogenic in-situ hybridization (CISH) method were examined. Kaplan-Meier analysis was used for the survival rate. A P value less than 0.05 was considered statistically significant. Results: 23 of 32 cases were male. The mean age was 57.97±16.15 years. The preliminary clinical diagnosis was carcinoma in 46.9% of the cases. Tonsil and nasopharynx had equal proportions as lymphoma origin. Only 3 (9.4%) cases are classic Hodgkin lymphoma (CHL). 16 cases (50.0%) were diffuse large B-cell lymphoma (DLBCL). EBER was detected only in tonsillar CHL cases. The survival of patients with nasopharyngeal lymphoma was shorter than those of tonsillar origin (p=0.037). Conclusion: DLBCL is the most common lymphoma type of this localization. EBER positivity has been detected only in CHL. Survival is lower in lymphomas originating from the nasopharynx

🔖

Bu Makaleye Atıf Yap

Özdemir, Ç., Eryeğen, N., Yavaşoğlu, F., Ak, M. O., Kuzu, S., Duran, M., Aydoğmuş, B. B., Çetinkaya, B., Bucak, A., Şenol, Y. (2023). Waldeyer Halkası Lenfomalarının Klinikopatolojik İncelenmesi: Türkiye’de Kesitsel Bir Çalışma. Balıkesir Sağlık Bilimleri Dergisi, Volume: 12 Issue: 1. https://doi.org/10.53424/balikesirsbd.1241429

📄 Tam Metin PDF Okuyucu

📄

PDF görüntüleyici hazırlanıyor...

Kaynakça (21)

  1. REFERENCES Alaggio, R., Amador, C., Anagnostopoulos, I., Attygalle, A. D., Araujo, I. B. O., Berti, E., Bhagat, G., Borges, A. M., Boyer, D., Calaminici, M., Chadburn, A., Chan, J. K. C., Cheuk, W., Chng, W. J., Choi, J. K., Chuang, S. S., Coupland, S. E., Czader, M., Dave, S. S.,. Xiao, W. (2022). The 5th edition of the World Health Organization Classification of Haematolymphoid Tumours: Lymphoid Neoplasms. Leukemia, 36(7), 1720-1748. https://doi.org/10.1038/s41375-022-01620-2
  2. Clarke, J., Medford, S., Islam, S., Ramsingh, C., & Christopher, M. (2019). Extranodal lymphoma of the tongue, a very rare entity-report of two cases with literature review. International journal of surgery case reports, 54, 70-74.
  3. d'Amore, F., Christensen, B. E., Brincker, H., Pedersen, N. T., Thorling, K., Hastrup, J., Pedersen, M., Jensen, M. K., Johansen, P., Andersen, E., & et al. (1991). Clinicopathological features and prognostic factors in extranodal non-Hodgkin lymphomas. Danish LYFO Study Group. Eur J Cancer, 27(10), 1201-1208. https://doi.org/10.1016/0277-5379(91)90081-n
  4. de Leval, L., Bonnet, C., Copie-Bergman, C., Seidel, L., Baia, M., Brière, J., Molina, T. J., Fabiani, B., Petrella, T., Bosq, J., Gisselbrecht, C., Siebert, R., Tilly, H., Haioun, C., Fillet, G., & Gaulard, P. (2012). Diffuse large B-cell lymphoma of Waldeyer's ring has distinct clinicopathologic features: a GELA study. Ann Oncol, 23(12), 3143-3151. https://doi.org/10.1093/annonc/mds150 Hans, C. P., Weisenburger, D. D., Greiner, T. C., Gascoyne, R. D., Delabie, J., Ott, G., Müller-Hermelink, H. K., Campo, E., Braziel, R. M., Jaffe, E. S., Pan, Z., Farinha, P., Smith, L. M., Falini, B., Banham, A. H., Rosenwald, A., Staudt, L. M., Connors, J. M., Armitage, J. O., & Chan, W. C. (2004). Confirmation of the molecular classification of diffuse large B-cell lymphoma by immunohistochemistry using a tissue microarray. Blood, 103(1), 275-282. https://doi.org/10.1182/blood-2003-05-1545
  5. Herbst, H., Steinbrecher, E., Niedobitek, G., Young, L. S., Brooks, L., Müller-Lantzsch, N., & Stein, H. (1992). Distribution and phenotype of Epstein-Barr virus-harboring cells in Hodgkin's disease. Blood, 80(2), 484-491. Hoppe, R. T., Burke, J. S., Glatstein, E., & Kaplan, H. S. (1978). Non-Hodgkin's lymphoma: involvement of Waldeyer's ring. Cancer, 42(3), 1096-1104. https://doi.org/10.1002/1097-0142(197809)42:3 3.0.co;2-z
  6. Iyengar, P., Mazloom, A., Shihadeh, F., Berjawi, G., & Dabaja, B. (2010). Hodgkin lymphoma involving extranodal and nodal head and neck sites: characteristics and outcomes. Cancer, 116(16), 3825-3829. KAYGUSUZ, G., CANSIZ, C., KUZU, I., & SAK, D. S. (2008). Tonsil maligniteleri arasında lenfoproliferatif hastalıkların dağılımı. Türk Patoloji Dergisi, 24(3), 166-173.
  7. Ma, Z., Shi, Y., Pang, X., Li, X., Cui, W., & Zhang, W. (2020). Clinicopathologic features and prognostic analysis of Waldeyer ring B-cell lymphoma. Medicine (Baltimore), 99(2), e18670. https://doi.org/10.1097/md.0000000000018670
  8. Mian, M., Capello, D., Ventre, M. B., Grazio, D., Svaldi, M., Rossi, A., Tsang, R., Gospodarowicz, M. K., Oldani, E., Federico, M., Luminari, S., Marcheselli, L., Pogliani, E. M., Rossini, F., Cabrera, M. E., Martelli, M., Gutierrez-Garcia, G., Busetto, M., Visco, C.,. Cortelazzo, S. (2014). Early-stage diffuse large B cell lymphoma of the head and neck: clinico-biologicalcharacterizationn and 18 year follow-up of 488 patients (IELSG 23 study). Ann Hematol, 93(2), 221-231. https://doi.org/10.1007/s00277-013-1856-4
  9. Monabati, A., Safaei, A., Noori, S., Mokhtari, M., & Vahedi, A. (2016). Subtype distribution of lymphomas in South of Iran, analysis of 1085 cases based on World Health Organization classification. Ann Hematol, 95(4), 613-618. https://doi.org/10.1007/s00277-016-2590-5
  10. O'Malley, D. P., Dogan, A., Fedoriw, Y., Medeiros, L. J., Ok, C. Y., & Salama, M. E. (2019). American Registry of Pathology Expert Opinions: Immunohistochemical evaluation of classic Hodgkin lymphoma. Ann Diagn Pathol, 39, 105-110. https://doi.org/10.1016/j.anndiagpath.2019.02.001
  11. Qin, Y., Lu, L., Lu, Y., & Yang, K. (2018). Hodgkin lymphoma involving the tonsil misdiagnosed as tonsillar carcinoma: A case report and review of the literature. Medicine (Baltimore), 97(7), e9761. https://doi.org/10.1097/md.0000000000009761
  12. Quiñones-Avila, M. d. P., Gonzalez-Longoria, A. A., Admirand, J. H., & Medeiros, L. J. (2005). Hodgkin lymphoma involving Waldeyer ring: a clinicopathologic study of 22 cases. American journal of clinical pathology, 123(5), 651-656.
  13. Shi, Y., Han, Y., Yang, J., Liu, P., He, X., Zhang, C., Zhou, S., Zhou, L., Qin, Y., Song, Y., Liu, Y., Wang, S., Jin, J., Gui, L., & Sun, Y. (2019). Clinical features and outcomes of diffuse large B-cell lymphoma based on nodal or extranodal primary sites of origin: Analysis of 1,085 WHO classified cases in a single institution in China. Chin J Cancer Res, 31(1), 152-161. https://doi.org/10.21147/j.issn.1000-9604.2019.01.10
  14. Sun, J., Yang, Q., Lu, Z., He, M., Gao, L., Zhu, M., Sun, L., Wei, L., Li, M., Liu, C., Zheng, J., Liu, W., Li, G., & Chen, J. (2012). Distribution of lymphoid neoplasms in China: analysis of 4,638 cases according to the World Health Organization classification. Am J Clin Pathol, 138(3), 429-434. https://doi.org/10.1309/ajcp7yltqpusdq5c
  15. Swerdlow SH, C. E., Harris NL, Jaffe ES, Pileri SA, Stein H, Thit Rele J, Arber DA, Hasserjian RP, Le Beau MM, Orazi A, Sieber. (2017). WHO Classification of Tumours of Haematopoietic and Lymphoid Tissues (C. E. Swerdlow SH, Harris NL, Jaffe ES, Pileri SA, Stein H, Thit Rele J, Ed. Revised 4th ed.). International Agency for Research on Cancer.
  16. Teh, C. S., Jayalakshmi, P., & Chong, S. Y. (2014). Waldeyer ring lymphoma: a case series. Ear Nose Throat J, 93(9), E22-25. https://doi.org/10.1177/014556131409300905
  17. Völker, H., Becker, E., Müller-Hermelink, H., & Scheich, M. (2020). Extranodal manifestation of classical Hodgkin lymphoma in the head and neck region. HNO, 68(1), 32-39.
  18. Völker, H. U., Becker, E., Müller-Hermelink, H. K., & Scheich, M. (2020). [Extranodal manifestation of classical Hodgkin lymphoma in the head and neck region]. HNO, 68(1), 32-39. https://doi.org/10.1007/s00106-019-00781-4 (Extranodale Manifestation klassischer Hodgkin-Lymphome im HNO-Bereich.)
  19. Wang, J., Tang, W., Zhang, W., Wang, J., Chen, F., Zhong, L., Chen, Y., & Chen, G. (2021). Clinicopathologicalcharacterizationn of follicular helper T-cell-derived peripheral T-cell lymphoma involving Waldeyer's ring. Virchows Arch, 479(2), 355-363. https://doi.org/10.1007/s00428-021-03071-z
  20. REFERENCES Alaggio, R., Amador, C., Anagnostopoulos, I., Attygalle, A. D., Araujo, I. B. O., Berti, E., Bhagat, G., Borges, A. M., Boyer, D., Calaminici, M., Chadburn, A., Chan, J. K. C., Cheuk, W., Chng, W. J., Choi, J. K., Chuang, S. S., Coupland, S. E., Czader, M., Dave, S. S.,. Xiao, W. (2022). The 5th edition of the World Health Organization Classification of Haematolymphoid Tumours: Lymphoid Neoplasms. Leukemia, 36(7), 1720-1748. https://doi.org/10.1038/s41375-022-01620-2
  21. Mian, M., Capello, D., Ventre, M. B., Grazio, D., Svaldi, M., Rossi, A., Tsang, R., Gospodarowicz, M. K., Oldani, E., Federico, M., Luminari, S., Marcheselli, L., Pogliani, E. M., Rossini, F., Cabrera, M. E., Martelli, M., Gutierrez-Garcia, G., Busetto, M., Visco, C.,. Cortelazzo, S. (2014). Early-stage diffuse large B cell lymphoma of the head and neck: clinico-biologicalcharacterizationn and 18 year follow-up of 488 patients (IELSG 23 study). Ann Hematol, 93(2), 221-231. https://doi.org/10.1007/s00277-013-1856-4