Primary extranodal non-Hodgkin's malignant lymphoma of the oral region: analysis of 11 autopsy cases.

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 IE, and one was IIE. 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 radiotherapy. 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.