Qin You, Lu Lijuan, Lu Yanwei, Yang Kunyu
Cancer Center, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan Department of Molecular Medicine, Zhongshan School of Medicine, Sun Yat-Sen University, Guangzhou, Guangdong, China.
Medicine (Baltimore). 2018 Feb;97(7):e9761. doi: 10.1097/MD.0000000000009761.
Primary Hodgkin lymphoma (HL) involving the tonsil is extremely rare. Only about 20 such cases with verification of biopsy and immunohistochemistry have been reported. Because of its rarity and unremarkable clinical presentation, a timely correct diagnosis is very challenging.
A 43-year-old man complained left tonsillar enlargement and painless masses in left neck, with night sweat. The clinical examination found a marked tonsillar asymmetry, with an enlarged left tonsil and ipsilateral cervical lymphadenopathy and a normal right tonsil.
The patient was initially regarded as tonsillar lymphoepithelial carcinoma.
The patient received a resection of left tonsil and left cervical masses and then was definitively diagnosed as HL (IIEB). He was managed by 6 cycles of chemotherapy (adriamycin, bleomycin, vinblastine, and dacarbazine) and radiotherapy to the Waldeyer ring.
The patient has been disease free for more than 3 years after diagnosis.
As the reason of an extreme rare occurrence of HL involving the tonsil, doctors can easily misdiagnose the disease as tonsillar lymphoepithelial carcinoma. This case serves as a reminder important role of biopsy.
原发性霍奇金淋巴瘤（HL）累及扁桃体极为罕见。仅有约20例经活检及免疫组化证实的此类病例被报道。因其罕见且临床表现不显著，及时做出正确诊断极具挑战性。
一名43岁男性主诉左侧扁桃体肿大及左侧颈部无痛性肿块，伴有盗汗。临床检查发现明显的扁桃体不对称，左侧扁桃体肿大且同侧颈部淋巴结肿大，右侧扁桃体正常。
患者最初被诊断为扁桃体淋巴上皮癌。
患者接受了左侧扁桃体及左侧颈部肿块切除术，随后被确诊为HL（IIEB期）。他接受了6个周期的化疗（阿霉素、博来霉素、长春花碱和达卡巴嗪）及对韦氏环的放疗。
患者诊断后已无病生存超过3年。
由于HL累及扁桃体极为罕见，医生很容易将该病误诊为扁桃体淋巴上皮癌。该病例提醒了活检的重要作用。
