Research Paper Volume 16, Issue 8 pp 6796—6808

Clinical characteristics and prognostic analysis of primary extranodal non-Hodgkin lymphoma of the head and neck

Jiamu Lv1, , Yining Jiang2, , Tingting Yu1, , Shengrui Gao1, , Wanzhong Yin1, ,

  • 1 Department of Otolaryngology Head and Neck Surgery, First Hospital of Jilin University, Changchun, China
  • 2 Department of Neurosurgery, First Hospital of Jilin University, Changchun, China

Received: July 6, 2023       Accepted: February 29, 2024       Published: April 5, 2024
How to Cite

Copyright: © 2024 Lv et al. This is an open access article distributed under the terms of the Creative Commons Attribution License (CC BY 4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.


Objective: Primary extranodal non-Hodgkin’s lymphoma (PE-NHL) of the head and neck is the second common site of extranodal lymphoma, accounting for approximately one-third of all extranodal non-Hodgkin’s lymphoma (E-NHL). However, in recent years, large-scale PE-NHL case studies in China and worldwide are rare and not comprehensive enough. This work analyzed the clinical manifestations, pathological features, immunophenotypes and diagnosis of PE-NHL, as well as the factors affecting the treatment and prognosis.

Methods: A retrospective study was performed on 74 patients who were diagnosed with head and neck PE-NHL and treated for the first time. The clinical manifestations, pathological features, and immunophenotypes were summarized, and the factors related to the treatment and prognosis were analyzed.

Results: The most common site of this disease was the Waldeyer’s ring, followed by the nasal cavity. Diffuse large B-cell lymphoma was the most common type, followed by extranodal NK T-cell lymphoma nasal type. The 1-year, 2-year, and 5-year progression-free survival (PFS) rates were 76.4%, 67.9%, and 59.3%. The 1-year, 2-year, and 5-year overall survival (OS) rates were 89.4%, 85.6%, and 63.2%. ECOG score ≥ 2, Ann Arbor stage III or IV and IPI risk stratification identifying patients as the high-risk group were independent risk factors affecting the OS of patients with PE-NHL of the head and neck.

Conclusions: The most common site of PE-NHL in these Chinese patients was the Waldeyer’s ring, but the incidence in the nasal cavity was higher than that reported in Western countries. Radiotherapy combined with chemotherapy had better efficacy than chemotherapy alone, and the prognosis depended on the ECOG score and clinical stage. IPI had a better prognostic value in patients in the high-risk group of head and neck PE-NHL.


AITL: Angioimmunoblastic T-cell lymphoma; BL: Burkitt lymphoma; CR: Complete response; DLBCL: Diffused large B-cell lymphoma; ECOG: Eastern Cooperative Oncology Group; ENKTCL-NT: Extranodal NK T-cell lymphoma nasal type; E-NHL: Extranodal non-Hodgkin’s lymphoma; FL: Follicular lymphoma; GCB: Germinal center B-cell like; IPI: International prognostic index; LDH: Lactate dehydrogenase; MALT: Mucosa associated lymphoid tissue lymphoma; MCL: Mantle cell lymphoma; NHL: Non-Hodgkin’s lymphoma; Non-GCB: Non-germinal center B-cell like; ORR: Objective response rate; OS: Overall survival; PE-NHL: Primary extranodal non-Hodgkin’s lymphoma; PFS: Progression-free survival; PR: Partial response; PTCL-NOS: Peripheral T-cell lymphoma, not otherwise specified; SPTCL: Subcutaneous panniculitis T-cell lymphoma; WHO: World Health Organization.