The authors describe autopsy cases of primary extranodal non–Hodgkin's lymphoma of the oral regions in 11 (8%) of 134 patients: 10 were clinical stage I E , and one was II E . Histologic subtypes of each lymphoma included the diffuse large cell type (8 cases), diffuse mixed type (2 cases) and Burkitt's type (1 case) according to the Japanese Lymphoma Study Group (JLSG) classification. All patients received anti‐lymphomatous chemotherapy and/or radiotheraphy. Nine cases had active disease, 3/9 manifesting leukemia. Nodes were involved. There was involvement of cervical lymph nodes in 7 (64%). Viscera most commonly involved were, in order of decreasing frequency: lung, kidney, pancreas, liver, spleen, heart, gastrointestinal tract, bone marrow, and adrenal gland. It is apparent that primary extranodal non‐Hodgkin's lymphomas of the oral region arise in a single focus, and extensions of the disease are not random. The primary lesions spread to regional lymph nodes by way of lymphatic channels, and to extranodal organs of the intrathoracic and intraabdominal regions by contiguous direct invasion of adjacent organs and by blood‐borne metastases. Wide spread dissemination at the time of death was found in 6 cases and 3 modes of spreading were observed.
The relationship between the silver-stained proteins of the nucleolar organizer regions (AgNORs) and proliferative activity was studied in 30 patients with lymphoproliferative disorders of the major salivary gland. The salivary gland lesions were microscopically and immunohistochemically differentiated into myoepithelial sialadenitis (MESA, n = 6), low-grade B-cell lymphoma (n = 16), high-grade B-cell lymphoma (n = 5), and T-cell lymphoma (n = 3). The mean AgNOR count per nucleus for MESA was 2.48; for low-grade B-cell lymphoma, 2.19; for high-grade B-cell lymphoma, 6.37; and for T-cell lymphoma, 5.46. There was no significant difference in AgNOR counts per nucleus between the MESA and low-grade B-cell lymphoma, whereas the high-grade B-cell lymphomas exhibited significantly increased mean AgNOR number. Furthermore, the mean numbers of AgNOR were compared with cellular types of lymphoproliferative disorders. A statistically significant difference did exist among AgNOR counts of centroblasts, centrocytes and mantle zone lymphocytes or interfollicular lymphocytes in MESA. There was no significant difference in AgNOR counts per nucleus among the centroblasts of MESA, neoplastic centroblasts of centroblastic/centrocytic lymphoma, and centroblastic lymphoma. It was shown that AgNOR enumeration of tumor cells in mucosa-associated lymphoid tissue (MALT) lymphoma was similar to those seen in mantle zone and interfollicular lymphocytes of MESA. Therefore, we propose that MALT lymphoma may represent a mucosal counterpart of mantle zone lymphocyte- or interfollicular lymphocyte-related low-grade B-cell lymphomas.
There are relatively few paraesophageal bronchogenic and esophageal cysts in mediastinal tumors. It is often difficult to distinguish between these cysts. Case 1: 11 year old, male with no symptoms. An abnormal tumor shadow was revealed by chest roentgenogram. Before operating, CT, MRI and other laboratory tests were suggested that the tumor was neurogenic. A cyst with a pedicle connected to the esophageal muscle layer was found during the operation. Pathological examination confirmed a bronchogenic cyst lined with cartilage. Case 2: 38 year old female with epigastralgia. Upper gastrointestinal series revealed that the thoracic esophagus was smoothly compressed from the outside. CT and MRI showed a well-defined cystic mass in the posterior mediastinum. The cyst bordered the esophagus, but there was no direct communication between them. The pathological findings showed the presence of a double layer of smooth muscle without cartilage which was diagnosed as an esophageal cyst.
