Varied Presentations of Non-Hodgkin Lymphoma in Head and Neck Region

Abstract

Introduction
 Majority of lymphomas involving the head and neck are Non-Hodgkin lymphoma (NHL). Most of them present as cervical lymphadenopathy. The objectives of this study are to present the problems encountered in the diagnosis of extra-nodal NHL in head and neck region and show the importance of thorough clinical examination and proper investigation.
 Materials and Methods
 A prospective study was done in the department of ENT in a tertiary care hospital of West Bengal from July 2015 to June 2018. Patients diagnosed as NHL on the basis of histopathology and immunohistochemistry were included in this study. Patients who were lost in follow up were excluded from the study. Patients were treated with chemotherapy and radiotherapy by Oncologist. All patients were followed up routinely both by Otorhinolaryngologist and Oncologist. 
 Results
 There were 26 male and 11 female patients in this study. Patients were between 22 years to 76 years of age with highest incidence in 6th decade of life. Patients presented with only cervical lymphadenopathy; asymmetrical tonsillar enlargement with cervical lymphadenopathy; unilateral tonsillar enlargement only; huge inta-oral mass with stridor; parotid gland swelling; thyroid swelling with multiple cervical lymphadenopathy; epistaxis, palatal ulcer and cheek swelling; severe trismus with inconspicuous retro-mandibular mass. Majority of patients did well with chemoradiotherapy. Two patients succumbed to death, one with huge intra-oral NHL and another with nasal T/NK-cell lymphoma. 
 Conclusion
 Good knowledge of the clinical characteristics of extra-nodal NHL and the methods to establish the diagnosis are essential for a correct and timely therapy of the disease.