Department of Otorhinolaryngology, Centro Hospitalar Universitário S. João, EPE, Porto, Portugal.
Unit of Otorhinolaryngology - Department of Surgery and Physiology, Faculty of Medicine, University of Porto, Porto, Portugal.
Head Neck Pathol. 2021 Jun;15(2):588-592. doi: 10.1007/s12105-020-01238-9. Epub 2020 Oct 22.
Head and neck lymphomas can present with a wide range of symptoms. Timely and accurate diagnosis is often challenging. The blastoid variant of mantle cell lymphoma (MCL) accounts for less than one-third of all MCL cases. Isolated primary presentation on the palatine tonsils is rare, and prognosis and outcome are seemingly unfavorable. An 81-year-old man presented with persistent odynophagia, dysphagia, and obstructive hypertrophic palatine tonsils with purulent exudate. The signs and symptoms were non-responsive to antibiotic therapy, and the tonsils were biopsied. The cellular morphology, immunophenotype, and genotype supported a diagnosis of the blastoid variant of MCL. After staging, the patient underwent chemotherapy with Rituximab-Bendamustine (R-Benda). The patient is in clinical remission more than two years after therapy. We report an exceedingly rare case of blastoid MCL that is prone to be misdiagnosed as tonsillitis. We review the literature and discuss treatment options of this uncommon malignancy.
头颈部淋巴瘤可表现出多种症状。及时准确的诊断往往具有挑战性。套细胞淋巴瘤（MCL）的母细胞样变体占所有 MCL 病例的不到三分之一。孤立性原发性腭扁桃体表现罕见，预后和结局似乎不佳。一名 81 岁男性因持续性咽痛、吞咽困难和肥大性阻塞性腭扁桃体伴有脓性渗出物而就诊。这些症状和体征对抗生素治疗无反应，且对扁桃体进行了活检。细胞形态、免疫表型和基因型支持母细胞样变体 MCL 的诊断。分期后，患者接受了利妥昔单抗-苯达莫司汀（R-Benda）化疗。治疗后两年多，患者处于临床缓解期。我们报告了一例极其罕见的母细胞样 MCL 病例，易误诊为扁桃体炎。我们回顾了文献并讨论了这种罕见恶性肿瘤的治疗选择。
