2023 Volume 69 Issue 6 Pages 419-426
Malignant lymphoma is a general term for malignant tumors of lymphoid cells that develop in lymphoid tissue. It may show clinical symptoms similar to other malignant tumors of the head and neck and inflammatory diseases, and it may also cause airway obstruction, so a prompt and appropriate diagnosis and treatment are necessary. To clarify the clinical picture of malignant lymphoma and enact more appropriate decisions on treatment policy, a clinicopathological study was conducted among 163 patients with symptoms in the head and neck region and a pathological diagnosis of malignant lymphoma was made in those patients who visited our department over a 6-year period from 2016 to 2021. The median age of the patients was 71 years old, 74 were male, and 89 were female. The biopsy sites included the nasopharynx, mid-pharynx and other Waldeyer's pharyngeal rings in 42 cases, cervical lymph nodes in 103 cases, nasal cavity, and paranasal sinuses in 10 cases, salivary glands in 2 cases, thyroid gland in 2 cases and hypopharynx and larynx in 3 cases. The median soluble IL-2R value was 1,956 U/㎖, and the median LDH value was 258 U/ℓ, both of which were above the normal upper limit. Two cases with respiratory distress at initial presentation were also reported, both with airway stenosis due to lesions, and therefore it was considered that starting treatment after a definitive diagnosis was made could thus be fatal. After consultations with the Department of Hematology, steroid therapy was started before a definitive diagnosis was made after the collection of histopathological specimens, which thereafter led to a definitive diagnosis and treatment. Malignant lymphoma in the head and neck region progresses quickly, and in some cases it can be fatal due to airway obstruction. For a prompt diagnosis and treatment decision, it is important to perform not only a tissue diagnosis, but also tests, such as sIL-2R and LDH evaluations, and cooperate closely with other departments.
