Franzen A, Kurrer M O
Institut für Klinische Pathologie, Universitäts-Spital Zürich.
Laryngorhinootologie. 2000 Oct;79(10):579-83. doi: 10.1055/s-2000-7678.
Malignant lymphoma of the larynx are rare tumors and represent less than 1% of primary malignant laryngeal tumors.
In this case report we present a case of a diffuse large B-cell lymphoma of the larynx. Clinical presentation, diagnostic approach, staging and differential diagnosis as well as therapy and prognosis are discussed in relation to the available literature.
Lymphomas primary to the larynx are non-Hodgkin-lymphomas and are predominantly located in the supraglottic larynx. The presenting symptoms and signs include dysphagia, dysphonia, dyspnea which on occasion can be severe, and enlarged cervical lymphoma. B-symptoms are mostly not present. Indirect laryngoscopy reveals a globoid submucosal faintly pink tumor mass. The diagnosis rests on histological examination of a biopsy specimen. Benign tumors, squamous cell carcinoma and other lymphoproliferative diseases have to be excluded from the differential diagnosis. Extensive tumor staging is necessary before radiotherapy or chemotherapy. Surgery is not indicated, even in localized disease. Prognosis is good in the most often localized laryngeal non-Hodgkin-lymphomas (stage IE and IIE) and generalization is rare. Hence, supraglottic submucosal laryngeal tumors can represent non-Hodgkin-lymphomas. Biopsy and subsequent histological examination are essential for correct diagnosis.
喉恶性淋巴瘤是罕见肿瘤，占原发性喉恶性肿瘤的比例不到1%。
在本病例报告中，我们呈现了1例喉弥漫性大B细胞淋巴瘤。结合现有文献讨论了临床表现、诊断方法、分期及鉴别诊断以及治疗和预后。
原发性喉淋巴瘤是非霍奇金淋巴瘤，主要位于声门上区。呈现的症状和体征包括吞咽困难、声音嘶哑、呼吸困难（有时可能很严重）以及颈部淋巴结肿大。大多无B症状。间接喉镜检查可见球状黏膜下淡粉色肿瘤肿物。诊断依赖于活检标本的组织学检查。鉴别诊断必须排除良性肿瘤、鳞状细胞癌和其他淋巴增殖性疾病。在放疗或化疗前必须进行广泛的肿瘤分期。即使是局限性疾病也不建议手术。大多数常见的局限性喉非霍奇金淋巴瘤（IE期和IIE期）预后良好，很少发生转移。因此，声门上区喉黏膜下肿瘤可能为非霍奇金淋巴瘤。活检及后续组织学检查对正确诊断至关重要。
