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B-Cell marginal zone lymphoma of the larynx. Diagnostic difficulties – case report

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Czak W. A., Czak W., Nowakowski J.
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2015
|
vol. 4(2)
75-77
EN
Marginal zone lymphomas are a group of slow-growing non-Hodgkin B-cell lymphomas. This type of lymphoid tissue tumors occur extremely rare in larynx. Since the first description by Diebold et al in 1990, less than 50 cases marginal zone lymphomas of the larynx have been reported [1, 2]. We present a case report of a 66-year-old woman, admitted in April 2012 to an ENT Ward in Polanica Zdroj hospital in order to perform a biopsy of lesion present in larynx since at least 2 years. Patient presented with hoarseness, mounting dyspnoea and history of recurrent inflammation of larynx and trachea. Histopathologic examination revealed B-Cell Marginal Zone Lymphoma. The patient was sent to undergo further hematological treatment (R-CHOP regimen chemotherapy), which was followed by a complete remission. It is important to emphasize that it was the 3rd biopsy of the lesion taken in 2 years time (since 2010) preceded by two such procedures in another clinical ENT Ward in Poland. The microscopic examination results of the previous biopsies were described as indicative more of an inflammatory lesion although both of them were said to be hard to evaluate. This shows the diagnostic difficulties that biopsy itself or its microscopic interpretation might bring.
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A manifestation of sarcoidosis in the neck region

88%
Stańska K. A., Rzepakowska A., Ewa O. W., Majszyk D., Niemczyk K.
Polski Przegląd Otorynolaryngologiczny
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2018
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vol. 7(2)
16-20
EN
Sarcoidosis is a systemic disease of unknown etiology. It is characterized by a formation of lumps known as noncaseating granulomas, which are not affected by necrosis. Typical collections of inflammatory cells may be found in any organ tissues but mainly in the lungs, skin or lymph nodes. Head and neck organs involvement is rare, although sarcoidosis can be found in lymph nodes, salivary glands, larynx and sinuses. A search was performed based on medical records of patients admitted to the Department of Otolaryngology within four previous years. We analyzed two cases of sarcoidosis of salivary glands (parotid and submandibular), two cases of larynx involvement and one case of lymphadenopathy due to sarcoidosis. Patients (4 women and 1 man), age range 26–76 years old, were directed to the Otolaryngology Department with neck lymphadenopathy or a suspicion of a neoplastic tumor of salivary gland or larynx. Only one patient had previous diagnosis of pulmonary sarcoidosis. Preoperative diagnostic procedures such as ultrasonography, biopsy, chest radiography did not suggest sarcoidosis on the initial assessment in other patients. Surgical removal of the pathological findings and histopathological examination confirmed extrapulmonary sarcoidosis. The computed tomography of lungs confirmed coexisting pulmonary sarcoidosis in only one patient.
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