Lymphoma

Adult Burkitt lymphoma originating in the sphenoid sinus: Case report and review of the literature

June 30, 2009     Sri Kiran Chennupati, MD, Satish Govindaraj, MD, Gavin Setzen, MD, and Alexander G. Chiu, MD
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Abstract

Burkitt lymphoma is a high-grade B-cell non-Hodgkin lymphoma. The endemic form of this malignancy occurs primarily in children aged 5 to 7 years, and it presents with jaw and facial bone involvement. The sporadic form affects older children (mean age: 12.2 yr) and often manifests as an abdominal mass; it rarely involves the head and neck. The presence of any type of lymphoma in the paranasal sinuses is rare. We report a case of Burkitt lymphoma that originated in the sphenoid sinus in a 66-year-old white woman. The patient presented with hypoesthesia in the left V1 and V2 distributions and frequent left-sided headaches. Imaging revealed that the destructive lesion had spread into the cavernous sinus and infratemporal fossa. Repeat imaging showed progression of the lesion in just 1 month. An endoscopic sphenoidotomy was performed to obtain a tissue specimen, and a diagnosis of sporadic Burkitt lymphoma was established on the basis of its clinical, morphologic, and immunohistochemical characteristics. The patient underwent chemotherapy and radiation. Short-term follow-up imaging showed that the lesion had disappeared, and the patient remained disease-free at 3 years of follow-up. This case is one of the few reported cases of true adult Burkitt lymphoma originating in the sphenoid sinus. We discuss the rapid progression of the disease and the considerable amount of invasion that can occur with minimal symptoms.

Lymphoma in the Waldeyer ring: A great masquerader

May 31, 2009     Ryan F. Osborne, MD, FACS, Jason S. Hamilton, MD, FACS, and Sofia Avitiaz, MD
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Angiogenic non-Hodgkin T/natural killer (NK)-cell lymphoma: Report of three cases

September 25, 2008     Rubens A. Martins-Filho, MD, Ricardo C. Demarco, MD, Fabiana C.P. Valera, MD, Catarina Shaletich, MD, Paulo R. Félix, MD, Giovana B. Badiale, MD, and Wilma T. Anselmo-Lima, MD, PhD
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Abstract

Angiogenic T/natural killer (NK)-cell lymphoma is a non-Hodgkin lymphoma characterized by necrosis and vascular destruction that is strongly associated with Epstein-Barr virus and AIDS. Early diagnosis is essential to improve the chances of patient survival, but severe local inflammatory infiltrate impairs histologic diagnosis by obscuring neoplastic cells. The most common markers are CD2, CD56, cytoplasmic CD3, and CD43 EBV. We describe 3 cases of angiogenic T/NK-cell lymphoma that show the diverse presentation of the same disease. Patient 1 was HIV positive and had nasal obstruction, facial edema, and ulceration of the nasal mucosa. Patient 2 had fever, a sore throat, and weight loss. Patient 3 had facial edema, fever, proptosis, and rapid development of neurologic alterations. Several biopsies were needed for histologic confirmation in these patients, despite positivity for the CD3 and CD56 markers.

Trigeminal ganglion dysfunction secondary to lymphoma

December 1, 2007     Juan Gómez, MD, Jagan Gupta, MD, and Enrique Palacios, MD, FACR
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Burkitt's lymphoma of the base of the tongue: A case report and review of the literature

May 31, 2007     Steven M. Feinberg, MD; S.H. Ignatius Ou, MD, PhD; Mai Gu, MD, PhD; Terry Y. Shibuya, MD
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Malignancy in asymmetrical but otherwise normal palatine tonsils

September 30, 2006     Adenike F. Oluwasanmi, FRCS; Stephen J. Wood, FRCS; David L. Baldwin, FRCS; Fabian Sipaul, MRCS
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Abstract
An abnormally large tonsil may be a sign of malignancy. We retrospectively analyzed the case files of 87 patients who had asymmetrically sized but otherwise normal tonsils and no risk factors for cancer to determine if asymmetry is associated with a higher incidence of malignancy. We found 2 cases (2.3%) of malignancy among these patients. One patient had high-grade non-Hodgkin's lymphoma in the larger tonsil, and the other had lymphocyte-rich Hodgkin's lymphoma. Both patients were older than 50 years, and neither had a history of recurrent tonsillitis. We believe that although the incidence of cancer in our series was small, it is significant. Therefore, we recommend routine excision of abnormally large tonsils. Moreover, when making such a recommendation to a patient, it is essential that the patient have a clear understanding of the risk and benefit of having a tonsil removed solely because of asymmetry.

Follicular lymphoma

September 30, 2006     Liron Pantanowitz, MD; Lester D.R. Thompson, MD, FASCP
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Primary B cell lymphoma of the external auditory canal

August 31, 2006     Sheldon P. Hersh, MD; Winston G. Harrison, MD; David J. Hersh, MD
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Abstract
Temporal bone lymphomas are rare and typically metastatic neoplasms. We describe a case of primary B cell lymphoma that originated in the external auditory canal of an elderly woman. The diagnosis was based on histopathologic examination supplemented by immunophenotypic analysis. The patient was treated with external-beam radiation and remained disease-free throughout 9 years of follow-up. We also point out that the presence of non-Hodgkin's lymphoma in an unusual site may be an indication that the patient has an acquired immunodeficiency syndrome.

Sinonasal lymphoma: A case report

April 30, 2006     M. Panduranga Kamath, MS; Gurudath Kamath, MS; Kiran Bhojwani, MS; Mukhta Pai, MD; Ahamed Shameem, MBBS; Salil Agarwal, MBBS
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Abstract
Sinonasal lymphomas are uncommon malignancies. They are difficult to differentiate from carcinomas, and immunohistochemistry is needed to make the diagnosis. We describe an unusual case of a T cell lymphoma that involved only the paranasal sinuses in a middle-aged man. The patient presented with a complete loss of vision in one eye and lateral rectus muscle palsy, but no nasal symptoms.

Unusual paratracheal masses presenting with vocal fold paralysis

February 1, 2006     Evan R. Reiter, MD; Michael O. Idowu, MD; Celeste N. Powers, MD, PhD
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Abstract
Most paratracheal masses are of thyroid origin. We describe two cases of vocal fold paralysis that were caused by unusual paratracheal masses. In one case, a 35-year-old man was found to have a malignant lymphoma that originated in the mediastinum and extended above the clavicle. The other patient was a 53-year-old man with an enlarged left thyroid lobe, tumor invasion of the adjacent larynx and trachea, and multiple pulmonary nodules all due to adenoid cystic carcinoma. Unusual paratracheal masses presenting with vocal fold paralysis may mimic thyroid malignancies, thereby posing both diagnostic and therapeutic challenges. Fine-needle aspiration cytology is often helpful in making a definitive diagnosis, but incisional biopsy is necessary in some cases.

Primary laryngeal lymphoma: Case report

February 1, 2006     Ronnie Word, MD; Andrew C. Urquhart, MD; Victor S. Ejercito, MD
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Abstract
Extranodal laryngeal lymphoma is extremely rare. We report a case of primary laryngeal lymphoma in a 76-year-old man who had presented with a 7-week history of progressive hoarseness. Laryngoscopy revealed asymmetry of the right false vocal fold. Pathology of a deep biopsy specimen identified a malignant, diffuse, CD20-positive, B-cell lymphoma. The stage 1E lymphoma completely resolved after treatment with CHOP (cyclophosphamide, doxorubicin, vincristine, and prednisone) and rituximab. Despite its relative rarity, the consequences of a missed diagnosis warrant vigilance for this type of laryngeal tumor.

Primary lymphoma of the parotid gland

April 1, 2005     Andres Eraso, MD; Giovanni Lorusso, MD; Enrique Palacios, MD, FACR
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