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Thyroid
Published in Pat Price, Karol Sikora, Treatment of Cancer, 2020
Lymphoma of the thyroid is rare, representing 2% of thyroid malignancies and 2% of extra-nodal lymphomas. Chronic autoimmune stimulation, as in Hashimoto’s thyroiditis, is a predisposing factor. There is a strong female predominance, and the median age at diagnosis is in the seventh decade, similar to that of anaplastic cancer, from which it must be distinguished (Figure 4.1e). An analysis of the U.S. National Cancer Database published in 2019 identified 3466 patients between 2004 and 2015. The median all-cause survival was 11.6 years (CI: 11.1 to 12.1 years). The majority were diffuse large B cell lymphoma (DLBCL, 59.5%), with marginal zone lymphoma (18.3%) and follicular and Burkitt lymphoma (8% and 1.9%, respectively) making up the rest.38 Mucosa-associated lymphoid tissue (MALT) is a form of marginal zone lymphoma and is characterized by a low grade of malignancy, slow growth rate, and a tendency for late relapse or second lymphomas in other MALT sites.37
Lymphoma
Published in Anju Sahdev, Sarah J. Vinnicombe, Husband & Reznek's Imaging in Oncology, 2020
Sarah J Vinnicombe, Rodney J Hicks
MALT lymphomas arise from epithelial and mucosal sites that normally have no organized lymphoid tissue, within which lymphoid tissue has arisen as a result of chronic inflammation or autoimmunity. Examples include Hashimoto's thyroiditis, Sjögren's syndrome and Helicobacter-induced chronic follicular gastritis. The association between gastric MALT lymphoma and H. pylori infection was established in 1991 by Wotherspoon et al. (137), who found the organism in over 90% of cases and demonstrated remission in response to antibiotic treatment for H. pylori. More recent studies suggest that the incidence of gastric MALT lymphoma is decreasing as a result of widespread eradication therapy for H. pylori. Consequently, fewer cases are associated with H. pylori at diagnosis (138).
Inflammation and the Immune System
Published in Jeremy R. Jass, Understanding Pathology, 2020
Tumours may include secondary deposits of carcinoma or melanoma, or primary neoplasms such as Hodgkin’s disease or non-Hodgkin’s lymphoma. Lymphomas of MALT (MALTomas) are biologically different to nodal lymphomas and are being diagnosed with increasing frequency. Diagnosis of these conditions requires knowledge of the limits of normal lymph node architecture and cytology. Diagnosis of non-Hodgkin’s lymphoma has been aided by developments in new immunology. These include monoclonal antibodies to T and B cell markers and the molecular demonstration of gene rearrangement to prove both clonality (indicative of neoplasia) and cell lineage. Whilst diagnosis of lymphoma is precise, reflects the biological complexity of the immune system and carries prognostic significance, treatment options are still relatively limited.
Mucosa-associated lymphoid tissue lymphoma in thymus: a SEER analysis
Published in Expert Review of Anticancer Therapy, 2022
Meng-Xin Zhou, Ye-Ye Chen, Lei Liu, Gui-Ge Wang, Jia-Qi Zhang, Ke Zhao, Shan-Qing Li
Between 1 January 2000, and 31 December 2018, the present study retrieved patients diagnosed with thymic MALT lymphoma with treatment information from the SEER-18 Dataset. Data extraction was performed using SEER*Stat (version 8.3.9.2). First, all patients with diseases that developed from the thymus were searched by defining the primary site as the C37.9-thymus. After that, all MALT lymphoma cases, described as one of the subtypes of marginal-zone lymphomas (MZLS) – extranodal MZL of MALT – according to the World Health Organization (WHO) classification [9], were searched by the specific histology/behavior code of the International Classification of Diseases for Oncology, 3rd edition (ICD-O-3), 9699/3: Extranodal marginal zone lymphoma of mucosal-assoc. lymphoid tissue-MALT lymphoma. For identifying the missing cases, the cases with thymic MALT lymphoma were scanned from both search results. We did not set any exclusion criteria owing to the rarity of the disease. In addition, data regarding the following variables were retrieved: age, sex, year of diagnosis, race/ethnicity, Ann Arbor stage, surgery, radiotherapy, chemotherapy, survival months, and vital status. Finally, all extracted data were tabulated and presented in this study.
Epidemiology, outcomes, and prognostic factors of orbital lymphoma in the United States
Published in Orbit, 2020
Osama M. Ahmed, Anthony K. Ma, Taha M. Ahmed, Renelle Pointdujour-Lim
Table 2 provides data on cancer specific survival probabilities amongst various histologic subtypes. MALT lymphoma conferred the best prognosis (10-year cancer specific survival [CSS] 90.2%, 95% Confidence Interval [CI] 87.4% – 93.1%) and DLBCL conferred the worst prognosis (10-year CSS 68.6%, 95% CI 62.5% – 75.3%) (p < .001, log-rank test). Upon pair-wise comparisons, DLBCL conferred a significantly worse overall survival compared to every other histology, except for Mantle Cell lymphoma and lymphoplasmacytic lymphoma (p < .05, log-rank test). Not only did DLBCL confer the worst cancer specific survival, but also the worst overall survival at 10 years (disease specific survival 44.6%, 95% CI 38.5%-51.7%). Figure 1 shows Kaplan Meier plots of overall and cancer specific survival amongst the histologic subtypes.
Prognostic value of cryoglobulins, protein electrophoresis, and serum immunoglobulins for lymphoma development in patients with Sjögren’s syndrome. A retrospective cohort study
Published in Acta Clinica Belgica, 2018
Jesse Kimman, Xavier Bossuyt, Daniel Blockmans
The prevalence of lymphoma (8.9% with a median FU of 6 years) did not differ from earlier observations (4–11%) [5–9]. Also the median age at which lymphoma was diagnosed (53 years) was in accordance with previous observations [9,12], although our median time of FU before lymphoma diagnosis was slightly shorter (4.5 versus 7 years) [9,24]. Congruent to the literature [3,4,8,9,12,13,32,33], the most common subtypes were MZLs (44%) and DLBCLs (38%). In a multicenter European study of 33 malignant NHL in SS patients, a MZL was found most commonly (in 48.5%), being mostly extranodal (78.8%) and most often identified in the salivary glands (54.6%) [9]. In our study, six of seven MZLs (86%) were identified in the salivary glands (i.e. MALT-subtype): five in the parotid and one in the submandibular gland. MALT lymphomas are relatively indolent [32] and no difference in median survival for treated and untreated patients was found previously (median FU 6 years). In contrary, DLBCLs tend to be highly aggressive (median overall survival of only 1.8 years in SS patients) [9,12]. Five of our sixteen lymphoma patients (31%) died during a median FU of 6.5 years: 50% of patients with MALT-lymphoma and 17% of DLBCL-patients during a median FU of 12.5 and 3 years, respectively.