Non-Hodgkin's lymphomas in a southern prefecture in Japan: an analysis in 715 cases

As of March 1978, the prognosis was confirmed in 715 non-Hodgkin's lymphoma cases reported during the 12-year period from 1965 through 1976 in the Prefecture of Kagoshima. Included were 222 cases of extranodal lymphoma. Patients with the initial tumor site in the gastrointestinal tract and Waldeyer's ring had a relatively good probability of survival. Among the patients with cutaneous lymphomas, those with the mycosis fungoides type had a poor survival rate. In Kagoshima Prefecture, the survival curve for cases of nodal lymphomas is characteristically much poorer than those reported in the medical literature. Of the nodal lymphomas, the nodular type was found in 128 cases and the five-year survival rate was 15%, while the diffuse type accounted for 365 cases and the five-year survival rate was 8%. The paracortex type, considered to be of T-cell origin, accounted for 55 cases and the five-year survival rate was 0%. These differences were statistically significant. Based on our data, the classification of nodular lymphomas into subtypes according to the degree of nodularity was found to be useful since it was related to clinical stage and survival. Rappaport's cellular classification of diffuse lymphoma is related to prognosis and was found to be useful, but problems still remain in determining T- and B-cell types by means of cellular morphology and thus further study is warranted.