Imaging Sci Dent.  2013 Mar;43(1):59-62. 10.5624/isd.2013.43.1.59.

Disseminated non-Hodgkin's lymphoma presenting as bilateral salivary gland enlargement: a case report

• Revanappa
• Sattur AP
• Naikmasur
• Thakur AR

• KMID: 2167449
• DOI: http://doi.org/10.5624/isd.2013.43.1.59

Abstract

Non-Hodgkin's lymphoma (NHL) constitutes a group of malignancies those arises from cellular components of lymphoid or extranodal tissues. The head and neck is the most common area for the presentation of these lymphoproliferative disorders. Primary involvement of salivary glands is uncommon. This report described a case of a 73-year-old female patient who presented with involvement of both nodal and extranodal sites, with predominant involvement of salivary glands. The tumor staging worked up along with imaging, histopathological, and immunohistochemical findings were discussed. Computed tomographic images showed the involvement of Waldeyer's ring, larynx, orbit, and spleen. This report described imaging and prognostic tumor markers in diagnosing, treatment planning, and prognosis.

Keyword

Lymphoma, Non-Hodgkin; Diffuse, Large B-Cell, Lymphoma; Salivary Glands

MeSH Terms

Biomarkers, Tumor
Female
Head
Humans
Larynx
Lymphoma, Large B-Cell, Diffuse
Lymphoma, Non-Hodgkin
Lymphoproliferative Disorders
Neck
Neoplasm Staging
Orbit
Prognosis
Salivary Glands
Spleen

Figure

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  Fig. 1 A. Bilateral enlargements of parotid and submandibular glands are seen. B. Two swellings measuring 2 cm×3 cm are seen in the buccal vestibule in the region of the upper and lower second molar.

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  Fig. 2 A. A high resolution ultrasonographic image shows the gross enlargement of the right parotid gland measuring 79 mm×31 mm and the involvement of both deep and superficial lobes by hypoechoic areas with a few echogenic septae traversing in between is evident. B. A high resolution ultrasonographic image shows the enlargement of the submandibular glands showing heterogeneous echogenicity with distorted architecture.

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  Fig. 3 A. Contrast-enhanced computed tomography shows diffuse symmetrical enlargement of the parotid gland with heterogeneous moderate enhancement. B. Contrast-enhanced computed tomography shows diffuse symmetrical enlargement of the submandibular gland with heterogeneous moderate enhancement.

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  Fig. 4 A. Histopathological examination shows diffuse large B-cells with moderate cytoplasm and large round vesicular nuclei having prominent nucleoli (H&E stain, ×20). B. Immunohistochemical staining shows positive staining for CD20 (IHC, ×40).

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