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Clinical Problem Solving: Pathology
May 16, 2011

Pathology Quiz Case 1: Diagnosis

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Copyright 2011 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Restrictions Apply to Government Use.2011

Arch Otolaryngol Head Neck Surg. 2011;137(5):528. doi:10.1001/archoto.2011.57-b

Diagnosis: Primary diffuse large B-cell lymphoma of the larynx

Nonepithelial tumors of the larynx are extremely rare, with most cases being reported as individual case reports or short case series. The most commonly reported nonepithelial neoplasms of the larynx include mesenchymal tumors such as chondrosarcoma and lymphoreticular neoplasms such as plasmacytomas and lymphomas.1While primary lymphoreticular neoplasms represent approximately 5% of all head and neck cancers, these neoplasms account for fewer than 1% of primary laryngeal malignant tumors, with fewer than 100 cases of primary lymphoma of the larynx reported in the literature.2Lymphomas of the head and neck most commonly occur in cervical lymph nodes and present as cervical adenopathy. Extranodal head and neck lymphoma occurs in 13% of cases, most commonly involving Waldeyer ring lymphoid tissue. Lymphomas may also present as lesions arising from the palate, nasal cavity, paranasal sinuses, salivary glands, thyroid, and conjunctiva.3,4Therefore, it is essential for the practicing otolaryngologist to include lymphoma in the differential diagnosis of both cervical and upper aerodigestive tract masses.

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