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Ley-Tomas JDJ, Perez-Delgadillo GM, Espinosa-Arce C, Ramirez-Gil LS. Laryngotracheal Stenosis Secondary to Mantle Cell Lymphoma. Cureus 2024; 16:e61900. [PMID: 38978894 PMCID: PMC11228407 DOI: 10.7759/cureus.61900] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/07/2024] [Indexed: 07/10/2024] Open
Abstract
Acute laryngeal dyspnea is a life-threatening emergency often attributed to laryngeal tumors or inflammatory edema in adults. Primary laryngeal lymphomas are especially infrequent. As an aggressive subtype of B-cell non-Hodgkin lymphoma (NHL), mantle cell lymphoma (MCL) cases are particularly complex. Herein, we present a case of laryngotracheal stenosis secondary to primary MCL. A comprehensive assessment, including in-office flexible laryngoscopy, revealed distinct findings within the supraglottis and subglottis. In the supraglottis, a submucosal lesion with well-defined, rounded edges was observed, while the subglottis exhibited a friable tumor occupying approximately 90% of the airway. This necessitated immediate intervention, leading to microlaryngoscopy, biopsy, and open tracheostomy. Due to the rarity of primary laryngeal lymphomas, they present a significant diagnostic challenge. Timely diagnosis is crucial to enable tailored therapeutic strategies and improved patient outcomes. This case highlights the importance of considering lymphomatous etiologies in the management of laryngotracheal stenosis and emphasizes the need for a multidisciplinary approach to optimize patient care.
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Affiliation(s)
- Jose de Jesus Ley-Tomas
- Otolaryngology - Head and Neck Surgery, Instituto Nacional de Enfermedades Respiratorias, Mexico City, MEX
| | | | - Cecilia Espinosa-Arce
- Otolaryngology - Head and Neck Surgery, Hospital Angeles Metropolitano, Mexico City, MEX
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Bernstein JD, Marcus S, Wang HY, Vahabzadeh-Hagh AM. Suspicious Laryngeal Mass: A Case Of Recurrent Mantle Cell Lymphoma. EAR, NOSE & THROAT JOURNAL 2023:1455613231170085. [PMID: 37056056 DOI: 10.1177/01455613231170085] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/15/2023] Open
Affiliation(s)
- Jeffrey D Bernstein
- Department of Otolaryngology - Head and Neck Surgery, University of California-San Diego, La Jolla, CA, USA
| | - Samuel Marcus
- University of California-San Diego, La Jolla, CA, USA
| | - Huan-You Wang
- Department Medicine, Division of Anatomic Pathology, University of California-San Diego, La Jolla, CA, USA
| | - Andrew M Vahabzadeh-Hagh
- Department of Otolaryngology - Head and Neck Surgery, University of California-San Diego, La Jolla, CA, USA
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Acute Laryngeal Dyspnea as the First Presentation of Mantle Cell Lymphoma: A Case Report and Review of the Literature. Case Rep Hematol 2020; 2020:8818270. [PMID: 32963850 PMCID: PMC7499331 DOI: 10.1155/2020/8818270] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2020] [Revised: 08/23/2020] [Accepted: 09/02/2020] [Indexed: 11/17/2022] Open
Abstract
Introduction Acute laryngeal dyspnea is a life-threatening emergency, and the causes in adults are most often laryngeal tumors or inflammatory edema. Lymphoma of the larynx and especially the mantle cell type is extremely rare. Case Presentation. We report a case of a 43-year-old woman with no particular pathological history. She presented with progressive dyspnea which has evolved towards an inspiratory bradypnea that worsened until she ultimately required an emergency tracheotomy. Biopsies revealed mantle cell lymphoma. The patient has been staged IVB MIPI 6, and she was treated by immunochemotherapy followed by ASCT. The therapeutic evaluation shows a complete remission, 18 months after, and the patient was always disease free. Conclusion The laryngeal localization of the mantle cell lymphoma is extremely rare; it may present catastrophically with acute airway obstruction. The diagnosis is mostly histological, hence the interest of deep biopsy. Given its rarity, the therapeutic strategy must be discussed case by case in a multidisciplinary consultation meeting.
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Tabet P, Saydy N, Letourneau-Guillon L, Gologan O, Bissada É, Ayad T, Tabet JC, Guertin L, Nguyen-Tan PF, Christopoulos A. Cystic masses of the lateral neck: Diagnostic value comparison between fine-needle aspiration, core-needle biopsy, and frozen section. Head Neck 2019; 41:2696-2703. [PMID: 30945785 DOI: 10.1002/hed.25755] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2017] [Revised: 02/09/2019] [Accepted: 03/12/2019] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND The usefulness of fine-needle aspiration (FNA), core-needle biopsy (CNB), and frozen section (FS) for assessing lateral cystic neck masses (LCNM) remains unclear. METHODS A retrospective review of patients presenting with a LCNM was undertaken. RESULTS In total, 135 patients were included. FNA had a lower sensitivity then CNB (59% vs 83%; P = .036) and FS (59% vs 93%; P = .01). FS had a better negative predictive value (NPV) when compared to FNA (92% vs 40%; P < .001) and CNB (92% vs 50%; P = .062). Positive predictive values (PPV) and sensitivities were similar among all groups. CONCLUSION Given its adequate PPV (92%), FNA should be used initially on LCNM. Because of its high sensitivity, CNB should be considered if FNA is not diagnostic of malignancy. FS should always follow a CNB indicative of malignancy, because of low NPV. A diagnosis of malignancy on FNA, CNB, or FS strongly indicates presence of malignancy.
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Affiliation(s)
- Paul Tabet
- Division of Otolaryngology - Head & Neck Surgery, Centre de Recherche du Centre Hospitalier de l'Université de Montréal (CRCHUM), Montreal, Québec, Canada.,Division of Otolaryngology - Head & Neck Surgery, Centre Hospitalier de l'Université de Montréal (CHUM), Montreal, Québec, Canada
| | - Nadim Saydy
- Division of Otolaryngology - Head & Neck Surgery, Centre de Recherche du Centre Hospitalier de l'Université de Montréal (CRCHUM), Montreal, Québec, Canada.,Division of Otolaryngology - Head & Neck Surgery, Centre Hospitalier de l'Université de Montréal (CHUM), Montreal, Québec, Canada
| | - Laurent Letourneau-Guillon
- Division of Otolaryngology - Head & Neck Surgery, Centre de Recherche du Centre Hospitalier de l'Université de Montréal (CRCHUM), Montreal, Québec, Canada.,Division of Otolaryngology - Head & Neck Surgery, Centre Hospitalier de l'Université de Montréal (CHUM), Montreal, Québec, Canada
| | - Olga Gologan
- Division of Otolaryngology - Head & Neck Surgery, Centre de Recherche du Centre Hospitalier de l'Université de Montréal (CRCHUM), Montreal, Québec, Canada.,Division of Otolaryngology - Head & Neck Surgery, Centre Hospitalier de l'Université de Montréal (CHUM), Montreal, Québec, Canada
| | - Éric Bissada
- Division of Otolaryngology - Head & Neck Surgery, Centre de Recherche du Centre Hospitalier de l'Université de Montréal (CRCHUM), Montreal, Québec, Canada.,Division of Otolaryngology - Head & Neck Surgery, Centre Hospitalier de l'Université de Montréal (CHUM), Montreal, Québec, Canada
| | - Tareck Ayad
- Division of Otolaryngology - Head & Neck Surgery, Centre de Recherche du Centre Hospitalier de l'Université de Montréal (CRCHUM), Montreal, Québec, Canada.,Division of Otolaryngology - Head & Neck Surgery, Centre Hospitalier de l'Université de Montréal (CHUM), Montreal, Québec, Canada
| | - Jean-Claude Tabet
- Division of Otolaryngology - Head & Neck Surgery, Centre de Recherche du Centre Hospitalier de l'Université de Montréal (CRCHUM), Montreal, Québec, Canada.,Division of Otolaryngology - Head & Neck Surgery, Centre Hospitalier de l'Université de Montréal (CHUM), Montreal, Québec, Canada
| | - Louis Guertin
- Division of Otolaryngology - Head & Neck Surgery, Centre de Recherche du Centre Hospitalier de l'Université de Montréal (CRCHUM), Montreal, Québec, Canada.,Division of Otolaryngology - Head & Neck Surgery, Centre Hospitalier de l'Université de Montréal (CHUM), Montreal, Québec, Canada
| | - Phuc Félix Nguyen-Tan
- Division of Otolaryngology - Head & Neck Surgery, Centre de Recherche du Centre Hospitalier de l'Université de Montréal (CRCHUM), Montreal, Québec, Canada.,Division of Otolaryngology - Head & Neck Surgery, Centre Hospitalier de l'Université de Montréal (CHUM), Montreal, Québec, Canada
| | - Apostolos Christopoulos
- Division of Otolaryngology - Head & Neck Surgery, Centre de Recherche du Centre Hospitalier de l'Université de Montréal (CRCHUM), Montreal, Québec, Canada.,Division of Otolaryngology - Head & Neck Surgery, Centre Hospitalier de l'Université de Montréal (CHUM), Montreal, Québec, Canada
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