Comparison of Primary B/NKT Non-Hodgkin Lymphomas in Nasopharynx, Nasal Cavity, and Paranasal Sinuses

OBJECTIVE

We aimed to compare clinical and survival differences between B-cell (B-NHL) and NKT-cell non-Hodgkin lymphomas (NKT-NHL) located in the nasal cavity (NC), nasopharynx, and paranasal sinuses, which are always categorized as one sinonasal type.

STUDY DESIGN

Patients diagnosed with primary B-NHL and NKT-NHL in the nasal cavity, nasopharynx, and paranasal sinuses from Surveillance, Epidemiology, and End Results (SEER) database were included (1975-2017).

SETTING

Population-based cohort study.

METHODS

We conducted univariate and multivariate Cox regressions and Kaplan-Meier analysis to examine survival outcomes of B/NKT-NHL in the nasal cavity, nasopharynx, and paranasal sinuses, respectively.

RESULTS

Overall, most B-NHL cases originated from the nasopharynx, while the majority of NKT-NHL cases occurred in the nasal cavity. Notably, the cancer-special survival (CSS) outcomes improved significantly in all sinonasal B-NHL cases over time, whereas no such improvement trend was observed in each sinonasal NKT-NHL type. Additionally, increasing age was linked with an elevated risk of death in B-NHL, particularly in the nasal cavity (Hazard ratio [HR]: 3.37), rather than in NKT-NHL. Compared with B-NHL, the adverse effect of a higher stage on CSS was more evident in NKT-NHL, particularly in its nasopharynx site (HR: 5.12). Furthermore, radiotherapy was beneficial for survival in patients with sinonasal B-NHL and NKT-NHL, except in the nasopharynx NKT-NHL. However, chemotherapy has only been beneficial for CSS in patients with paranasal sinuses B-NHL (HR: 0.42) since 2010, rather than in other types of B/NKT-NHL.

CONCLUSION

Although B-NHL and NKT-NHL in the nasal cavity, nasopharynx and paranasal sinuses have similar anatomical locations, their clinicodemographics and prognoses are largely different and should be treated and studied as distinct diseases.

Quantitative dynamic contrast-enhanced and diffusion-weighted MRI for differentiation between nasopharyngeal carcinoma and lymphoma at the primary site

OBJECTIVES

To investigate the value of quantitative dynamic contrast-enhanced MRI (QDCE-MRI) and diffusion-weighted MRI (DW-MRI) in differentiating nasopharyngeal carcinoma (NPC) from lymphoma.

METHODS

We retrospectively analysed the data from 102 patients (82 with NPC and 20 with lymphoma) who underwent pre-treatment QDCE-MRI and DW-MRI on a 1.5-T MR unit. QDEC-MRI parameters [influx transfer constant (K(trans)), efflux rate constant (Kep), fractional volume of extravascular extracellular space (Ve) and fractional volume of plasma (fPV)] based on pharmacokinetic model and apparent diffusion coefficient (ADC) were compared between the two nasopharyngeal malignancies.

RESULTS

The K(trans), Kep, Ve, fPV and ADC values (mean ± standard deviation) for NPC were 0.366 ± 0.155 min(-1), 1.353 ± 0.468 min(-1), 0.292 ± 0.117, 0.027 ± 0.024 and 0.981 ± 0.184 × 10(-3) mm(2) s(-1), respectively. The K(trans), Kep, Ve, fPV and ADC values (mean ± standard deviation) for lymphoma were 0.212 ± 0.059 min(-1), 1.073 ± 0.238 min(-1), 0.213 ± 0.104, 0.008 ± 0.007 and 0.760 ± 0.182 × 10(-3) mm(2) s(-1), respectively. Optimal cut-off values (area under the curve, sensitivity, specificity) for distinguishing the two tumours were as follows: K(trans) = 0.262 min(-1) (0.866, 80.49%, 85.00%), Kep = 1.401 min(-1) (0.681, 43.90%, 100.00%), Ve = 0.211 (0.784, 76.83%, 85.00%), fPV = 0.012 (0.779, 60.98%, 85.00%), ADC = 0.761 × 10(-3) mm(2) s(-1) (0.781, 93.90%, 55.00%).

CONCLUSIONS

QDCE-MRI together with DW-MRI is useful for differentiation between NPC and lymphoma.

Enhanced Autophagy and Reduced Expression of Cathepsin D Are Related to Autophagic Cell Death in Epstein-Barr Virus-Associated Nasal Natural Killer/T-Cell Lymphomas: An Immunohistochemical Analysis of Beclin-1, LC3, Mitochondria (AE-1), and Cathepsin D in Nasopharyngeal Lymphomas

This study investigated autophagy in 37 cases of nasopharyngeal lymphomas including 23 nasal natural killer (NK)/T-cell lymphomas (NKTCL), 3 cytotoxic T-cell lymphomas (cytotoxic-TML) and 9 B-cell lymphomas (BML) by means of antigen-retrieval immunohistochemistry of beclin-1, LC3, mitochondria (AE-1) and cathepsin D. Peculiar necrosis was noted in EBV⁺ lymphomas comprising 21 NKTCL, 2 cytotoxic-TML and 1 BML. Lymphomas without peculiar necrosis showed high expression of beclin-1, macrogranular cytoplasmal stain of LC3 with sporadic nuclear stain, a hallmark of autophagic cell death (ACD), some aggregated mitochondria and high expression of cathepsin D, suggesting a state of growth with enhanced autophagy with sporadic ACD. EBV⁺ NKTCL with the peculiar necrosis, showed significantly low level of macrogranular staining of LC3, aggregated mitochondria and low expression of cathepsin D in the cellular areas when degenerative lymphoma cells showed decreased beclin-1, significantly advanced LC3-labeled autophagy, residual aggregated mitochondria and significantly reduced expression of cathepsin D, suggesting advanced autophagy with regional ACD. Consequently it was suggested that enhanced autophagy and reduced expression of lysosomal enzymes induced regional ACD under EBV infection in NKTCL.