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Ominato H, Komabayashi Y, Suzuki S, Kunibe I, Kumai T, Takahara M. Hypopharyngeal Diffuse Large B-Cell Lymphoma in a 74-Year-Old Man Presenting with Dysphagia: A Case Report. AMERICAN JOURNAL OF CASE REPORTS 2023; 24:e942070. [PMID: 38140723 PMCID: PMC10756395 DOI: 10.12659/ajcr.942070] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2023] [Revised: 11/23/2023] [Accepted: 11/07/2023] [Indexed: 12/24/2023]
Abstract
BACKGROUND Malignant lymphomas can occur at various sites. Hypopharyngeal tumors are at risk for airway obstruction and require rapid diagnosis and treatment. Most hypopharyngeal malignancies are squamous cell carcinomas; other tumors are rare. To date, only a few cases of malignant hypopharyngeal lymphoma have been reported, and its specific characteristics are unknown. Herein, we report a case of right hypopharyngeal diffuse large B-cell lymphoma (DLBCL) in a 74-year-old man with dysphagia. CASE REPORT A 74-year-old man presented to our hospital with dysphagia. He had no relevant medical history. Endoscopic examination revealed a right hypopharyngeal tumor. The surface of the tumor was smooth, with no evidence of hemorrhage. Computed tomography revealed a 40-mm mass located in the hypopharynx. We performed a tracheotomy and biopsy of the tumor. Histopathological examination revealed a diffuse proliferation of large atypical B cells with negative staining for Epstein-Barr virus by in situ hybridization. Immunohistochemical staining was positive for CD20 but negative for CD3 and CD10. The patient was administered chemotherapy. The tumor reduced in size, and the patient recovered completely. During the two-year follow up, no recurrence of cancer was observed. CONCLUSIONS Although most hypopharyngeal tumors are squamous cell carcinomas (SCCs), the possibility of other types of tumors should also be considered. Malignant lymphoma of the hypopharynx is rare, and more cases need to be studied and reported in the future.
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Affiliation(s)
- Hisataka Ominato
- Department of Otolaryngology – Head and Neck Surgery, Sapporo Higashi Tokushukai Hospital, Sapporo, Hokkaido, Japan
- Department of Otolaryngology – Head & Neck Surgery, Asahikawa Medical University, Asahikawa, Kamikawa, Japan
| | - Yuki Komabayashi
- Department of Otolaryngology – Head and Neck Surgery, Sapporo Higashi Tokushukai Hospital, Sapporo, Hokkaido, Japan
| | - Shiori Suzuki
- Department of Otolaryngology – Head and Neck Surgery, Sapporo Higashi Tokushukai Hospital, Sapporo, Hokkaido, Japan
| | - Isamu Kunibe
- Department of Otolaryngology – Head and Neck Surgery, Sapporo Higashi Tokushukai Hospital, Sapporo, Hokkaido, Japan
| | - Takumi Kumai
- Department of Otolaryngology – Head & Neck Surgery, Asahikawa Medical University, Asahikawa, Kamikawa, Japan
| | - Miki Takahara
- Department of Otolaryngology – Head & Neck Surgery, Asahikawa Medical University, Asahikawa, Kamikawa, Japan
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Varghese SS, Varghese A, Paul PAM, Dhawan K, Gupta P. Laryngeal Anaplastic Lymphoma Kinase-Positive B-cell Lymphoma: Case Report and Review. Indian J Otolaryngol Head Neck Surg 2023; 75:2328-2333. [PMID: 37636644 PMCID: PMC10447305 DOI: 10.1007/s12070-023-03640-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Accepted: 02/23/2023] [Indexed: 03/07/2023] Open
Abstract
Larynx is an uncommon extranodal site for non-Hodgkin lymphoma (NHL). Anaplastic lymphoma kinase (ALK)-positive B-cell lymphoma is a rare and aggressive form of NHL. A 19-year-old male presented to the ENT department with globus sensation, hoarseness, cervical lymphadenopathy and weight loss. A 70-degree rigid endoscopic examination of the larynx showed a vascular, irregular, submucosal mass arising from the right aryepiglottic fold causing near complete obstruction of the laryngeal airway. PET-CT showed hypermetabolic lesions in the supraglottis, cervical lymph nodes, cervical spine, ribs and abdominal lymph nodes. Biopsy was taken from the supraglottic mass as well as the enlarged cervical lymph nodes, which revealed ALK-positive large B-cell NHL. In this report, we present a rare case of ALK-positive large B-cell NHL of the larynx, discussing its clinical, radiological and pathological features. A limited review of literature is also presented. There is a need to develop a database for the description of lymphomas affecting the larynx and this case report adds to the existing knowledge of this rare entity.
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Affiliation(s)
- Sunil Sam Varghese
- Department of ENT, Christian Medical College, Ludhiana, Punjab 141008 India
| | - Ashish Varghese
- Department of ENT, Christian Medical College, Ludhiana, Punjab 141008 India
| | | | - Kaffy Dhawan
- Department of ENT, Christian Medical College, Ludhiana, Punjab 141008 India
| | - Pulkit Gupta
- Department of ENT, Christian Medical College, Ludhiana, Punjab 141008 India
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Higo R, Kojima M, Itoh S, Noguchi M, Izumi H, Takeuchi K. Primary diffuse large B-cell lymphoma of the Larynx. Auris Nasus Larynx 2022:S0385-8146(22)00187-0. [PMID: 35863932 DOI: 10.1016/j.anl.2022.07.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2022] [Revised: 06/14/2022] [Accepted: 07/05/2022] [Indexed: 11/15/2022]
Abstract
The larynx is a rare site of extranodal non-Hodgkin lymphoma (NHL), accounting for less than 1% of all primary laryngeal neoplasms. We report a rare case of laryngeal diffuse large B-cell lymphoma (DLBCL) in an 85-year-old female patient, which was difficult to diagnose even after several biopsies from the primary laryngeal lesion, both under local and general anesthesia, and the diagnosis of DLBCL was obtained from the lymph node biopsy, which appeared in the proximity of the larynx 2 months after the first biopsy from the larynx. Since the diagnosis of laryngeal NHL is sometimes difficult when sufficient samples cannot be obtained, repeated biopsies may be required. Due to the small number of cases, there is no definite consensus regarding the best management of laryngeal NHL. Thus, a standard treatment option for DLBCL, such as 3 courses of R-CHOP (rituximab + cyclophosphamide, doxorubicin, vincristine and prednisone) followed by Involved-field radiation therapy, or 6∼8 course of R-CHOP, are also applied for the treatment of laryngeal DLBCL. For this case, doxorubicin was not adopted and 8 courses of R-COP (rituximab + cyclophosphamide, vincristine and prednisone) at a decreased dose were chosen because of her age (85-year-old) and cardiac hypofunction.
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Affiliation(s)
- Ryuzaburo Higo
- Department of Otorhinolaryngology, Head and Neck Surgery, Juntendo University, Urayasu Hospital, 2-1-1 Tomioka, Urayasu-city, Chiba, Japan.
| | - Masataka Kojima
- Department of Otorhinolaryngology, Head and Neck Surgery, Juntendo University, Urayasu Hospital, 2-1-1 Tomioka, Urayasu-city, Chiba, Japan
| | - Shin Itoh
- Department of Otorhinolaryngology, Head and Neck Surgery, Juntendo University, Urayasu Hospital, 2-1-1 Tomioka, Urayasu-city, Chiba, Japan
| | - Masaki Noguchi
- Department of Hematology, Juntendo University, Urayasu Hospital, 2-1-1 Tomioka, Urayasu-city, Chiba, Japan
| | - Hirosi Izumi
- Department of Pathology, Juntendo University, Urayasu Hospital, 2-1-1 Tomioka, Urayasu-city, Chiba, Japan
| | - Kengo Takeuchi
- Pathology Project for Molecular Targets, The Cancer Institute, Japanese Foundation for Cancer Research, 3-8-31 Ariake, Koto, Tokyo, Japan
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