Hodgkin's disease in the Waldeyer's ring

Area of Science:

• Oncology
• Otorhinolaryngology
• Pathology

Background:

• Hodgkin's disease (HD) is a malignant lymphoma.
• Waldeyer's ring, a ring of lymphoid tissue in the pharynx, can be affected by HD.
• Diagnosing HD involvement in the nasopharynx presents challenges.

Purpose of the Study:

• To investigate the incidence and characteristics of Waldeyer's ring involvement in Hodgkin's disease.
• To highlight diagnostic challenges, particularly for nasopharyngealHD.
• To discuss radiotherapy principles and propose improved diagnostic strategies for nasopharyngeal HD.

Main Methods:

• Retrospective analysis of 128 patients with Hodgkin's disease.
• Review of cases with Waldeyer's ring involvement (tonsil and nasopharynx).
• Correlation of histological findings with clinical presentation and imaging (roentgentomography).

Main Results:

• Six out of 128 patients (4.7%) had Waldeyer's ring involvement.
• Nasopharyngeal involvement was observed in five patients; tonsillar involvement in one.
• Three cases had direct Waldeyer's ring biopsies; three had cervical lymph node histology only.
• Five patients had disease limited to the head and neck; one had widespread disease.
• Roentgentomography is crucial for diagnosing nasopharyngeal involvement.

Conclusions:

• Waldeyer's ring involvement in Hodgkin's disease is uncommon but occurs.
• Nasopharyngeal HD poses diagnostic difficulties, necessitating advanced imaging.
• A more thorough search for nasopharyngeal disease and specific radiotherapy approaches are recommended.