For unclear reasons, the incidence of NHL continues to rise. Only a small component of the increase relates to HIV-associated lymphomas. The incidence increases with older age. For HL, the peak incidence is in the second to third decade. A smaller peak occurs in the sixth decade. In the United States, approximately 64,000 cases of lymphoma occurred in 2005. Of these, approximately 7000 are HL. Of the NHL, 40% are indolent and 60% are aggressive. Nodal-based lymphomas very frequently present with lymphadenopathy involving head and neck locations. Anterior and posterior cervical, submandibular, and supraclavicular nodes are most commonly affected.
Approximately 25% of extranodal lymphomas affect head and neck sites. Almost always, these are NHL. In North America, sinonasal lymphomas comprise the single most frequent group, accounting for 25% of the cases. Waldeyer's ring sites as a group comprise 38% of patients with nasopharyngeal, tonsillar, and base-of-tongue involvement, accounting for 18%, 12%, and 8%, respectively (1). The aggressive natural killer (NK)-/T-celI NHL is rare in North America but occurs with an increased frequency in Southeast Asia. It is strongly associated with the Epstein-Barr virus (EBV). Burkitt's lymphoma is an aggressive malignancy that occurs in two forms. The endemic form frequently involves the jaw, orbit, and central nervous system (CNS) in addition to the abdomen and paraspinal region and accounts for approximately 50% of malignancies in parts of equatorial Africa. It is also strongly associated with EBV. The sporadic form occurs in North America and Western Europe and more frequently affects the nasopharynx in addition to nodal sites, often intraabdominal.
MM accounts for 10% of hematological malignancies. It has an annual incidence of 4/100,000. It occurs at a similar rate in both males and females but affects blacks up to twice as often as whites.
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