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Clinical Problem Solving: Pathology
February 15, 2010

Pathology Quiz Case 2: Diagnosis

Author Affiliations


Arch Otolaryngol Head Neck Surg. 2010;136(2):207-208. doi:10.1001/archoto.2009.228-b

Malignant lymphoma accounts for up to 5% of all malignant neoplasms of the head and neck.1Although most cases present with cervical adenopathy, approximately 13% of cases present with extranodal head and neck disease.2The most common extranodal site is composed of the structures of the Waldeyer ring, with less frequent locations including the nose, paranasal sinuses, salivary glands, larynx, thyroid, and conjuntiva.2Historically, reports of lymphoma presenting primarily as a hard palate lesion have been exceedingly rare.3This scarcity of cases in the literature is possibly a result of nomenclature that has disguised this entity behind terms such as lethal midline granuloma, polymorphic reticulosis, lymphomatoid granulomatosis, and midline malignant reticulosis. Currently, many of these diagnoses are thought to represent some form of a lymphomatous lesion and are most likely consistent with extranodal NK/T-cell lymphoma, nasal type.1,4,5

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