Linfoma não-Hodgkin com envolvimento oral e maxilofacial: estudo retrospectivo de 10 anos em um centro de referência oncológico do Amazonas

Abstract

Introduction: Non-Hodgkin lymphomas (NHL) are malignant diseases of the lymphoid tissue, which can affect both lymph nodes and extra-nodal sites. In the mouth, NHL are always extra-nodal and represents the third most prevalent malignancy of head and neck, especially by the subtypes: Diffuse Large B-cell (DLBCL), Burkitt, Follicular and the mucosa-associated lymphoid tissue (MALT). Epidemiological studies on extranodal NHL in the oral and maxillofacial region (OMF) are rare in Amazonas. Objectives: Evaluate the prevalence of NHL with emphasis on those diagnosed in the Oral and Maxillofacial region (OMF), from the Fundação Centro de Controle de Oncologia do Estado do Amazonas (FCECON), as well as to characterize these patients by the clinical-pathological profile. Methods: A cross-sectional, retrospective study of patients diagnosed with NHL from January 1, 2008 to December 31, 2017, in which information regarding their gender, age, clinical manifestations, histological diagnosis of the lesion was collected from their medical / dental records, also treatment protocol and patient survival. Results: Of the 301 NHL charts collected, only 4.6% (n = 14) occurred in the OMF region, corresponding to 16.28% of the cases of extra-nodal location (n = 86). Of these, 64.29% (n = 9) of them occurred in male patients, mixed race called “pardo” (57.14%; n = 8), with a higher incidence from the sixth decade of life (50%; n = 7), followed by the fourth decade (28.57%, n = 4), mainly located in the mandible (42.86%, n = 6). As for the histological type, there was a prevalence for cases derived from "B" cells (92.86%; n = 13), especially the DGCB subtype (50%, n = 7). A single treatment was performed in half of the cases (50%; n = 7) and combined in the other half (50%; n = 7). Survival data from these patients were insufficient for analysis.On the other hand, the OMF region showed a slightly higher percentage of survival than those diagnosed on other sites, however statistically irrelevant. As for NHL in general, it was possible to analyze the survival rate in a 5-year follow-up just for 34.88% of the patients (n=105/301), with lower survival rate for males at more advanced ages and with histological DGCB subtype, with no significant survival rates to race and origin cells (“B”, “T/NK”). Conclusion: NHL in the OMF region are similar from the epidemiological point of view in relation to those that affect other regions of the body, especially in relation to gender and histological subtype, but there may be peculiarities regarding the age range of the disease, showing an higher prevalence for the fourth decade of life, unlike for the others NHL that had increasing peaks starting from the fifth decade.