Korean J Otolaryngol-Head Neck Surg.  2003 Jun;46(6):524-527.

A Case of Malignant Lymphoma of Parapharyngeal Space

• Lee BJ
• Cho KS
• Wang SG
• Park DY

Abstract

We report a case of primary extranodal non-Hodgkin's lymphoma of the parapharyngeal space. A 47-year-old female patient presented with a rapidly increasing right infraauricular firm mass. Oropharyngeal examination revealed a medially displaced right lateral oropharyngeal wall and tonsil. Parotid CT and MR scans showed a huge dumbbell-shaped mass in Rt. parotid gland and parapharyngeal space with carotid artery and internal jugular vein displacement. Fine needle aspiration cytology of Rt. Infraauricular mass was taken and reported as reactive hyperplasia, predominantly polymorphous lymphoid cells. Under general anestheisa, transparotid and transcervical approach was done and huge mass in Rt. parapharyngeal space was removed completely. The mass was confirmed as an extranodal marginal zone B-cell lymphoma (Stage IIAE). The patient received a combination chemotherapy (cytoxan, adriamycin, oncovin, prednisolone) and no evidence of recurrence was noted during a 7-month follow-up period. This condition especially required communication between the surgeon and the pathologist, as it was essential to prevent an incorrect or delayed diagnosis. Although extranodal non-Hogkin's lymphoma of the parapharyngeal space is rare and difficult to diagnose pre-operatively, an accurate early diagnosis and proper surgical intervention may result in good prognosis.

Keyword

Neck; Non-Hodgkin's lymphoma

MeSH Terms

Biopsy, Fine-Needle
Carotid Arteries
Delayed Diagnosis
Doxorubicin
Drug Therapy, Combination
Early Diagnosis
Female
Follow-Up Studies
Humans
Hyperplasia
Jugular Veins
Lymphocytes
Lymphoma*
Lymphoma, B-Cell, Marginal Zone
Lymphoma, Non-Hodgkin
Middle Aged
Neck
Palatine Tonsil
Parotid Gland
Prognosis
Recurrence
Vincristine
Doxorubicin
Vincristine