Lymphoma

Primary diffuse large B-cell lymphoma of the ethmoid sinus: A case report

August 27, 2014     Jing-pu Yang, MD; Lian-ji Wen, MD; Chun-shun Jin, MD; Yan Liu, MD
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Abstract

B-cell lymphoma of the paranasal sinuses is rare. We present the case of a 42-year-old woman who presented with proptosis, diplopia, and vision disturbances in the right eye. She was diagnosed with diffuse large B-cell lymphoma of the ethmoid sinus. We describe the general clinical presentation, diagnosis, and differential diagnosis of this entity, and we review the pathology of diffuse large B-cell lymphoma.

Primary Burkitt lymphoma of the thyroid

December 20, 2013     Samuel Albert, MD
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Abstract

Primary Burkitt lymphoma of the thyroid is extremely rare. The author describes a new case in a 15-year-old boy who presented with a rapidly enlarging thyroid mass and dyspnea.

Secondary lymphoma of the parotid gland: Clinical experience

February 25, 2013     Lorraine Williams-Smith, MD, FACS; Reena Gupta, MD, FACS; and Ryan F. Osborne, MD, FACS
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 It is important to remember that parotid lymphomas do occur and should be considered in the differential diagnosis for parotid masses.

Primary cutaneous CD30-positive anaplastic large-cell lymphoma of the external auditory canal

December 31, 2012     Nuno Marcal, MD; Sofia Campelos, MD; Luis Dias, MD; Matos Goncalves, MD; Gabriel Pereira, MD; Tiago Godinho, MD
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Abstract

Primary cutaneous T-cell lymphoma is rare. Cutaneous lymphoma is defined as primary when there is an absence of nodal or systemic disease during the first 6 months following diagnosis. We report what we believe to be the first documented case of a primary cutaneous CD30-positive anaplastic large-cell lymphoma of the external auditory canal. The patient was an elderly woman who presented with progressively worsening right otalgia and hypoacusis. Otoscopy revealed an erythematic, ulcerative, nonbleeding, localized lesion in the anterosuperior area of the external auditory canal. The patient underwent an excisional biopsy, and after the diagnosis was established, she underwent 22 sessions of radiotherapy. During follow-up, she exhibited no evidence of recurrence.

Primary laryngeal NK/T-cell non-Hodgkin lymphoma: A case report

July 5, 2012     Draško Cikojević, MD, PhD; Ivo Glunčić, MD, PhD; Valdi Pešutić-Pisac, MD, PhD; Marisa Klančnik, MD, PhD; Zaviša Čolović, MD
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Abstract

The estimated prevalence of extranodal non-Hodgkin lymphoma ranges from 10 to 35% of all cases; a finding in the larynx is extremely rare. We describe the case of a 77-year-old man who presented for evaluation of a 1-month history of minor swallowing difficulty, cough, and a foreign-body sensation in the throat. Fiberoptic endoscopy detected a tumor mass on the left aryepiglottic fold. Vocal fold mobility was normal. A biopsy specimen was obtained, and microscopic analysis revealed that the stratified squamous epithelium was partially eroded by abundant infiltrate that had occupied the entire submucosa. The submucosal infiltration consisted of lymphatic cells, including small, medium-sized, and large cells with an anaplastic appearance. On immunohistochemical analysis, the lymphoma cell population stained positive for CD3 and CD2, focally positive for CD56, and negative for CD4, CD5, and CD7. In addition, tumor cells expressed TIA-1, perforin, and granzyme B. A complete radiologic, pulmonologic, and hematologic workup found no other tumor. The patient underwent two cycles of chemotherapy followed by radiotherapy, and he experienced complete tumor regression. At the 1-year follow-up, findings on fiberoptic endoscopy of the larynx were normal, and positron-emission tomography found no evidence of a recurrence. The prognosis for this type of tumor is good when the diagnosis is made in the early phase of the disease. Long-termfollow-up is advisable for the timely detection of possible local or distant recurrences, which are common.

Diffuse large B-cell lymphoma of the nasopharynx

April 30, 2012     Lester D.R. Thompson, MD
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Diffuse large B-cell lymphoma accounts for more than 50% of all Waldeyer ring lymphomas, which in turn account for about 15% of all head and neck lymphomas and about 50% of all extranodal head and neck lymphomas.

Primary NK/T-cell lymphoma of the larynx

April 30, 2012     Nechama Uri, MD; Yaakov Schindler, MD; Miriam Quitt, MD; Olga Valkovsky, MD; Geva Barzilai, MD
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Abstract

Laryngeal extranodal non-Hodgkin lymphoma is uncommon, accounting for less than 1% of all laryngeal neoplasms; the B-cell phenotype is predominant. Lymphomas outside the nasal cavity are rare and highly aggressive. We present a case of primary natural killer T-cell (NK/T-cell) lymphoma of the larynx that arose in a 45-year-old man. Because only a limited amount of data is available on laryngeal NK/T-cell lymphoma, the mainstay of treatment remains unclear, although some data suggest that radiotherapy alone is the best option. Our patient was treated with chemotherapy and radiotherapy, and he remained in remission 2 years later.

Hodgkin lymphoma of the maxillary sinus: An unusual occurrence

January 25, 2012     Jennifer L. Peterson, MD, Cherie J. Hayostek, MD, Christopher Garvey, MD, David M. Menke, MD, and Candido E. Rivera, MD
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Abstract

The maxillary sinus is a rare anatomic site for Hodgkin lymphoma, as only 1 such case has been previously reported in the literature. Nevertheless, we recommend that lymphoma be considered in the differential diagnosis of a mass that involves the maxillary sinus or any other unusual extranodal site in the head and neck. Lymphoma in a patient who presents with disease in an unusual site and without lymphadenopathy is difficult to diagnose. We report the case of a 60-year-old woman who presented with nasal congestion and obstruction. Examination revealed an abnormal-appearing mucosa involving the maxillary sinus. Subsequent evaluation led to a diagnosis of Hodgkin lymphoma. Because making such a diagnosis is difficult, close attention to radiologic and pathologic findings is important. Our review of the literature revealed that treatment commonly includes chemotherapy and radiotherapy, which yield excellent outcomes. The current standard of care for patients with similar-stage Hodgkin lymphoma at other sites can guide the treatment course for patients with extranodal Hodgkin lymphoma.

Primary extranodal T-cell non-Hodgkin lymphoma of the tongue

January 25, 2012     J. Madana, MS, DNB, Deeke Yolmo, MS, Sunil Kumar Saxena, MS, and S. Gopalakrishnan, MS
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Abstract

The most common sites of extranodal non-Hodgkin lymphoma (NHL) are the gastrointestinal tract and the head and neck region. Head and neck involvement accounts for 8 to 13% of all extranodal lymphomas. Primary NHLs of the oral cavity, especially in the tongue, are extremely rare, which makes it difficult to understand their biologic behavior. Extranodal NHLs of the tongue usually present as a nodular lesion of the B-cell type. The T-cell variant of tongue NHL with an ulcerated exophytic presentation is extremely rare. We report such a case in a 37-year-old woman.

Neck masses confined to the submental space: Our experience with 24 cases

November 22, 2011     Ahmet Ural, MD, Mehmet İmamoğlu, MD, Abdülcemal Ümit Işık, MD, Osman Bahadır, MD, Devrim Bektaş, MD, Bengü Çobanoğlu, MD, and Ümit Çobanoğlu, MD
article

Abstract

We conducted a study to identify the clinical and histopathologic features of masses confined to the submental space and to outline an approach to the diagnosis and treatment of these lesions. Our study population was made up of 24 patients-17 males and 7 females, aged 13 to 68 years (mean: 45.88 ± 8.48)-who had undergone surgery at our tertiary care center for the treatment of masses of the submental triangle. Our findings were based on a retrospective review of demographic data, signs and symptoms, diagnostic and therapeutic methods, histopathologic outcomes, and recurrences. Fine-needle aspiration biopsy and ultrasonography were performed on all patients as standard diagnostic procedures. Surgical excision was the mainstay of treatment, although abscesses were treated with local drainage and systemic antibiotics. Histopathology identified a wide variety of entities, including reactive lymphoid hyperplasia (n = 12), non-Hodgkin lymphoma (n = 3), dermoid cyst (n = 3), abscess (n = 3), sarcoidosis (n = 1), hemangioma (n = 1), and lipoma (n = 1). The clinical picture was complicated by dental problems in 9 patients and by cheilitis in 2. During a follow-up of up to 74 months, no local recurrences were detected. We conclude that lesions of the submental space are most likely to occur secondary to local and benign pathologies of the head and neck. However, malignancies or systemic diseases must also be ruled out. Careful assessment of the oral cavity and nose is important, and treatment must be based on the underlying etiology.

Primary lymphoma of the temporal bone presenting as XIIth cranial nerve weakness

March 1, 2011     Zi Yang Jiang, MD and Miriam I. Saadia-Redleaf, MD
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Abstract

Primary lymphoma of the temporal bone is an extremely rare finding in clinical practice. Although it is treated as a type of non-Hodgkin lymphoma, the absence of systemic signs and symptoms makes detection dependent on the tumor's local mass effect. In this article, we report a case of temporal bone lymphoma that caused XIIth nerve palsy. We also discuss the clinical manifestations of temporal bone lymphoma and the importance of imaging the head and neck when any idiopathic cranial nerve palsy develops.

Primary diffuse large B-cell lymphoma of the skull mimicking osteomyelitis

January 1, 2011     Egambaram Senthilvel, MD, Shanmugam Subbiah, MD, Vikas Jain, MD, and Michael Seidman, MD
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Abstract

Primary lymphomas of the skull are extremely rare, as fewer than 20 cases have been reported in the literature. We describe the case of a 51-year-old woman with Huntington chorea who presented with forehead swelling. Imaging studies detected an enhancing mass in the skull with some destruction of the underlying bone. These features were suggestive of osteomyelitis. Surgical excision was performed, and the mass was found to be a primary diffuse large B-cell lymphoma. The patient was administered postoperative chemotherapy, and she was in complete remission at the 1-year follow-up.

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