The management of extranodal head and neck lymphomas

The results from 156 patients with extranodal head and neck lymphomas treated at Stanford (Calif) University School of Medicine are combined with the experience of other investigators to recommend the management of these lymphomas. The tonsil and sinuses were the most common sites of presentation, and the most common histology was diffuse histiocytic lymphoma. The histologic classification systems are described as well as the use of immunohistochemistry in diagnosis. The appropriate staging procedures and the Ann Arbor staging system are discussed. Following the staging of 948 patients, 66% were found to have stage I or stage II disease and 34% had more widespread disease. Treatment with radiotherapy is discussed. Patterns of relapse following local radiotherapy for 360 relapsing patients with stage I and II disease showed a 73% distal relapse rate. Various treatment programs are recommended based on site, stage, and histology.