Abstract
Primary lymphomas of the salivary glands are rare tumors seen in the head and neck. We report the case of a 52-year-old woman with an extranodal marginal cell lymphoma of her submandibular gland, whose primary presenting symptom was a slow swelling of her neck. Fine-needle aspiration of the mass was performed, followed by CT imaging studies, and both tests showed inconclusive results. The tumor was excised and the patient has been monitored with no recurrence to date. This case adds to the diverse differential diagnoses of primary tumors in the head and neck, as early consideration, identification, and management of this etiology is essential for the clinician to ensure the best patient outcomes.
Highlights
Final pathology post-excision showed normal salivary gland tissue contrasted with abnormal salivary gland tissue with significant lymphoid infiltrate (Figure 1)
While the entity of extranodal marginal cell lymphoma has been well-described, studies regarding the presentation, clinical course, and treatment outcomes of this disease presenting in the submandibular gland as the primary tumor site are sparse in the literature
The treatment protocol for submandibular gland marginal cell lymphoma remains a matter of minimizing long-term treatment-related complications and should be individualized to the patient’s specific clinical picture
Summary
Neoplasms of the salivary gland are rare entities, representing 10% of head and neck tumors [1]. A 52-year-old woman presented with an asymptomatic, slowly growing swelling of the left neck She had undergone an ultrasound, which showed a 1.5 x 0.7 x 1.1 cm hyperechoic mass inside of the left submandibular gland, prompting her to visit an otolaryngologist. Fine-needle aspiration of the mass was performed in the office, which revealed lymphocytes and benign epithelium Given these results, the differentials for the mass included sialadenitis and lymphoid lesions. The tumor consisted of atypical lymphoid infiltrate of mixed T-cells and Bcells with lambda light-chain predominance and focal granulomatous inflammation (Figures 2, 3). These overall findings favored an extranodal B-cell marginal lymphoma.
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