J Korean Assoc Oral Maxillofac Surg.  2017 Apr;43(2):138-143. 10.5125/jkaoms.2017.43.2.138.

Malignant lymphoma on parotid gland: a clinical case

• Lee HG
• Lee JY
• Song JM

• KMID: 2377019
• DOI: http://doi.org/10.5125/jkaoms.2017.43.2.138

Abstract

Non-Hodgkin's lymphoma on the parotid gland is a relatively rare occurrence among head and neck tumors. The mass of parotid gland lymphoma cannot be distinguished from other benign masses of the parotid gland; therefore, it is important to consider lymphoma in the differential diagnosis when examining parotid swellings and masses. Parotid gland lymphoma is most likely to be B-cell, non-Hodgkin's lymphoma of one of three types, which include follicular, marginal zone, and diffuse large B-cell, although other histologic patterns have been described. We present a review of a patient with diffuse large B-cell lymphoma (DLBCL) who presented to the Department of Oral and Maxillofacial Surgery of Pusan National University Hospital (Yangsan, Korea).

Keyword

Lymphoma; Diffuse large B-cell lymphoma; Parotid gland

MeSH Terms

B-Lymphocytes
Busan
Diagnosis, Differential
Head
Humans
Lymphoma*
Lymphoma, B-Cell
Lymphoma, Non-Hodgkin
Neck
Parotid Gland*
Surgery, Oral

Figure

• 

  Fig. 1 Computed tomography on face and neck before the surgery.

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  Fig. 2 A. Exposed facial nerve trunk. B. The lesion lied scattered on and beneath the nerve and enlarged lymph node (arrows). C. Fibrous tissue around the Stensen's duct. D. Main mass and enlarged lymph node.

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  Fig. 3 H&E staining (A: ×40, B: ×400).

• 

  Fig. 4 Immunohistochemistry was positive for bcl6 (×200; A), CD20 (×200; B), and MUM1 (×200; C).

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  Fig. 5 Positron emission tomographycomputed tomography.

Reference

1. Huh J. Epidemiologic overview of malignant lymphoma. Korean J Hematol. 2012; 47:92–104. PMID: 22783355.

2. Campo E, Swerdlow SH, Harris NL, Pileri S, Stein H, Jaffe ES. The 2008 WHO classification of lymphoid neoplasms and beyond: evolving concepts and practical applications. Blood. 2011; 117:5019–5032. PMID: 21300984.

3. Swerdlow SH, Campo E, Harris NL, Jaffe ES, Pileri SA, Thiele J, et al. WHO classification of tumours of haematopoietic and lymphoid tissues. 4th ed. Lyon: IARC;2008. p. 9–32.

4. Wolvius EB, van der Valk P, van der Wal JE, van Diest PJ, Huijgens PC, van der Waal I, et al. Primary extranodal non-Hodgkin lymphoma of the oral cavity. An analysis of 34 cases. Eur J Cancer B Oral Oncol. 1994; 30B:121–125. PMID: 8032301.

5. Boring CC, Squires TS, Tong T. Cancer statistics, 1993. CA Cancer J Clin. 1993; 43:7–26. PMID: 8422609.

6. Iguchi H, Wada T, Matsushita N, Oishi M, Yamane H. Anatomic distribution of hematolymphoid malignancies in the head and neck: 7 years of experience with 122 patients in a single institution. Acta Otolaryngol. 2012; 132:1224–1231. PMID: 23025415.

7. Zapater E, Bagán JV, Carbonell F, Basterra J. Malignant lymphoma of the head and neck. Oral Dis. 2010; 16:119–128. PMID: 20374502.

8. Mehle ME, Kraus DH, Wood BG, Tubbs R, Tucker HM, Lavertu P. Lymphoma of the parotid gland. Laryngoscope. 1993; 103:17–21.

9. Loggins JP, Urquhart A. Preoperative distinction of parotid lymphomas. J Am Coll Surg. 2004; 199:58–61. PMID: 15217631.

10. Dispenza F, Cicero G, Mortellaro G, Marchese D, Kulamarva G, Dispenza C. Primary non-Hodgkins lymphoma of the parotid gland. Braz J Otorhinolaryngol. 2011; 77:639–644. PMID: 22030974.

11. Abbaszadeh-Bidokhty H, Mohtasham N, Pazouki M, Babakoohi S. Primary diffuse large B-cell lymphoma of the mandible: a case report. J Oral Maxillofac Surg Med Pathol. 2014; 26:98–100.

12. Eisenbud L, Sciubba J, Mir R, Sachs SA. Oral presentations in non-Hodgkin's lymphoma: a review of thirty-one cases. Part II. Fourteen cases arising in bone. Oral Surg Oral Med Oral Pathol. 1984; 57:272–280. PMID: 6584818.

13. Barnes L, Myers EN, Prokopakis EP. Primary malignant lymphoma of the parotid gland. Arch Otolaryngol Head Neck Surg. 1998; 124:573–577. PMID: 9604985.

14. Shum JW, Emmerling M, Lubek JE, Ord RA. Parotid lymphoma: a review of clinical presentation and management. Oral Surg Oral Med Oral Pathol Oral Radiol. 2014; 118:e1–e5. PMID: 24405648.

15. Ekström Smedby K, Vajdic CM, Falster M, Engels EA, Martínez-Maza O, Turner J, et al. Autoimmune disorders and risk of non-Hodgkin lymphoma subtypes: a pooled analysis within the Inter-Lymph Consortium. Blood. 2008; 111:4029–4038. PMID: 18263783.

16. Feinstein AJ, Ciarleglio MM, Cong X, Otremba MD, Judson BL. Parotid gland lymphoma: prognostic analysis of 2140 patients. Laryngoscope. 2013; 123:1199–1203. PMID: 23576299.

17. Koyuncu M, Seşen T, Akan H, Ismailoglu AA, Tanyeri Y, Tekat A, et al. Comparison of computed tomography and magnetic resonance imaging in the diagnosis of parotid tumors. Otolaryngol Head Neck Surg. 2003; 129:726–732. PMID: 14663442.

18. Shankland KR, Armitage JO, Hancock BW. Non-Hodgkin lymphoma. Lancet. 2012; 380:848–857. PMID: 22835603.

19. Coiffier B, Lepage E, Briere J, Herbrecht R, Tilly H, Bouabdallah R, et al. CHOP chemotherapy plus rituximab compared with CHOP alone in elderly patients with diffuse large-B-cell lymphoma. N Engl J Med. 2002; 346:235–242. PMID: 11807147.

20. Chernoff WG, Lampe HB, Cramer H, Banerjee D. The potential clinical impact of the fine needle aspiration/flow cytometric diagnosis of malignant lymphoma. J Otolaryngol. 1992; 21(Suppl 1):1–15.