Department of Otorhinolaryngology, Head and Neck Surgery, Juntendo University, Urayasu Hospital, 2-1-1 Tomioka, Urayasu-city, Chiba, Japan.
Department of Otorhinolaryngology, Head and Neck Surgery, Juntendo University, Urayasu Hospital, 2-1-1 Tomioka, Urayasu-city, Chiba, Japan.
Auris Nasus Larynx. 2023 Aug;50(4):632-636. doi: 10.1016/j.anl.2022.07.001. Epub 2022 Jul 18.
The larynx is a rare site of extranodal non-Hodgkin lymphoma (NHL), accounting for less than 1% of all primary laryngeal neoplasms. We report a rare case of laryngeal diffuse large B-cell lymphoma (DLBCL) in an 85-year-old female patient, which was difficult to diagnose even after several biopsies from the primary laryngeal lesion, both under local and general anesthesia, and the diagnosis of DLBCL was obtained from the lymph node biopsy, which appeared in the proximity of the larynx 2 months after the first biopsy from the larynx. Since the diagnosis of laryngeal NHL is sometimes difficult when sufficient samples cannot be obtained, repeated biopsies may be required. Due to the small number of cases, there is no definite consensus regarding the best management of laryngeal NHL. Thus, a standard treatment option for DLBCL, such as 3 courses of R-CHOP (rituximab + cyclophosphamide, doxorubicin, vincristine and prednisone) followed by Involved-field radiation therapy, or 6∼8 course of R-CHOP, are also applied for the treatment of laryngeal DLBCL. For this case, doxorubicin was not adopted and 8 courses of R-COP (rituximab + cyclophosphamide, vincristine and prednisone) at a decreased dose were chosen because of her age (85-year-old) and cardiac hypofunction.
喉是结外非霍奇金淋巴瘤（NHL）的罕见部位，占所有原发性喉肿瘤的不到 1%。我们报告了一例罕见的 85 岁女性喉弥漫性大 B 细胞淋巴瘤（DLBCL）病例，即使在局部和全身麻醉下对原发性喉病变进行了多次活检，也难以诊断，并且在第一次喉活检后 2 个月出现的靠近喉部的淋巴结活检中获得了 DLBCL 的诊断。由于当无法获得足够的样本时，喉 NHL 的诊断有时较为困难，因此可能需要重复进行活检。由于病例数量较少，对于喉 NHL 的最佳治疗方法尚无明确共识。因此，也适用于 DLBCL 的标准治疗选择，例如 3 个周期的 R-CHOP（利妥昔单抗+环磷酰胺、多柔比星、长春新碱和泼尼松），随后进行受累野放射治疗，或 6∼8 个周期的 R-CHOP。对于该病例，由于患者年龄（85 岁）和心脏功能低下，未采用多柔比星，选择了 8 个周期的 R-COP（利妥昔单抗+环磷酰胺、长春新碱和泼尼松），剂量降低。
