Clinical Profile And Histological Characteristics Of Head And Neck Lymphomas In Patients Seen At Two Referral Centres In Nairobi, Kenya

Abstract

Background Head and neck malignancies continue to be a challenge to patients due to the associated morbidity and mortality. The most common malignancies in the head and neck are squamous cell carcinomas, lymphomas and others. Lymphomas are lymphoproliferative neoplasms which are classified as Hodgkin’s and Non-Hodgkin. They may either be nodal or extra nodal lymphomas. Extra nodal lymphomas are mainly the NHL and account for 5% all head and neck neoplasms. They may present with painless swellings which may be non- ulcerated. In addition these lesions may invade the local structures resulting in obstruction of oral and nasal passages. The common presenting complaints include facial asymmetry, dysphagia, dysphonia, nasal obstruction, blindness, proptosis and epiphora amongst others. This study was to determine the common types of head and neck lymphomas, their location, clinical and histopathological characteristics, and compare these with studies done elsewhere Objective: To describe the clinical characteristics and histological types of lymphomas manifesting in the head and neck among patients presenting for treatment at Kenyatta National Referral and Teaching Hospital (KNH) and University of Nairobi Dental Hospital (UNDH). Materials and methods: This study was a retrospective, cross-sectional descriptive study carried out on patients with lymphomas of the head and neck. It was conducted at KNH and UNDH registry with data from patient records between January 2010 and May 2019, duration of 8 years and 5 months. The patient files with histopathology and immunohistochemistry or both were included in the study. A pre-designed data collection tool (Appendix 1) was used to record patient information obtained from the records. The data was then coded and entered into the statistical package for social sciences (SPSS) software version 25 for analysis. The study was approved by KNH/UON- ERC on 02 October 2018 with study number P432/06/2018. Results: A total of 82 patients with head and neck lymphomas presented in the two centres and met the inclusion criteria. The age distribution ranged between 3 and 77 years with mean age of 26.5 (SD =19), while the median age was 18.5 years. There were 57 (69.5%) males and 25 (30.5%) females with male to female ratio of 2.3: 1. 52% of the lymphomas were seen in the first and second decades. Out of the 82 patients, a total of sixty patients knew their HIV status with 51 being negative and nine being positive. There ratio of HL to NHL was