Ryoo Hyun Jung, Lim Jin Soo, Kim Min Cheol
Department of Plastic and Reconstructive Surgery, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea, Suwon, Korea.
Arch Craniofac Surg. 2022 Jun;23(3):125-129. doi: 10.7181/acfs.2022.00136. Epub 2022 Jun 20.
Most malignant lymphomas of the head and neck region are non-Hodgkin lymphomas (NHL), and diffuse large B-cell lymphoma is the most common subtype. The prevalence of malignant lymphoma among parotid tumors is low, approximately 1% to 4%. The most common symptom of parotid lymphoma is a unilateral, non-tender, firm mass that slowly grows in size over time. As its clinical manifestations are non-specific, a comprehensive assessment is required for an accurate diagnosis. The initial work-up includes imaging tools, such as computed tomography and magnetic resonance imaging. However, NHL of the parotid gland is difficult to distinguish from other types of benign tumors prior to biopsy; histopathological evaluation and subsequent immunohistochemical staining are needed for the final diagnosis. Once a definitive diagnosis is established, patients should be referred to an oncologist for staging. Treatment is mainly based on systemic chemotherapy, whereas radiotherapy is indicated for certain cases. Here, we report the case of a 53-year-old man who presented with a progressively enlarging mass in the right parotid area, which was later diagnosed as malignant lymphoma of the parotid gland after superficial parotidectomy.
头颈部区域的大多数恶性淋巴瘤是非霍奇金淋巴瘤(NHL),弥漫性大B细胞淋巴瘤是最常见的亚型。腮腺肿瘤中恶性淋巴瘤的患病率较低,约为1%至4%。腮腺淋巴瘤最常见的症状是单侧、无压痛、质地坚硬的肿块,其大小会随时间缓慢增大。由于其临床表现不具有特异性,需要进行全面评估才能准确诊断。初步检查包括使用计算机断层扫描和磁共振成像等影像学工具。然而,在活检之前,腮腺NHL很难与其他类型的良性肿瘤区分开来;最终诊断需要进行组织病理学评估及后续的免疫组织化学染色。一旦确诊,患者应转诊至肿瘤学家处进行分期。治疗主要基于全身化疗,某些情况下则需要进行放疗。在此,我们报告一例53岁男性患者,其右侧腮腺区出现逐渐增大的肿块,在进行浅叶腮腺切除术后,该肿块后来被诊断为腮腺恶性淋巴瘤。