Huge cervical lymphadenopathy revealing nasopharyngeal non-Hodgkin's lymphoma

Abstract

Non-Hodgkin's lymphoma is a rare histological type of nasopharyngeal cancer. Most of these cancers are undifferentiated carcinomas or undifferentiated nasopharyngeal carcinomas (UNC). We report a case of nasopharyngeal non-Hodgkin's lymphoma. Immunohistochemical examination showed B-cell non-Hodgkin's lymphoma. The study involved a 47-year old patient with no particular past medical history presenting with right laterocervical swelling associated with right nasal obstruction and rhinorrhea that had persisted for 6 months. Clinical examination showed right voluminous painless adherent laterocervicale lymphadenopathy without signs of inflammation. Endoscopic examination of the nasopharynx showed enormous process extending to the posterior nares. Anatomo-pathologic study of the biopsy with immunohistochemical study showed B-cell non-Hodgkin's lymphoma. Patient's outcome was favorable under chemotherapy with no relapse during 6-month follow-up period. Primary non-Hodgkin's lymphoma of the nasopharynx is a rare localization of lymphomas. It occurs in less than 10% of patients with lymphoma of the head and of the neck. It often poses a problem in positive clinical and histological diagnosis. Symptoms are generally little specific. Peripheral lymphadenopathies occur in 50% of cases. Diagnosis is based on biopsy with immunohistochemical examination. Therapeutic progress have been achieved through the more frequent use of chemotherapy associated with radiotherapy.