Diffuse Swelling of Salivary and Lacrimal Glands as a First and only Manifestation of Non-Hodgkin B-Cell Lymphoma: A Case Report

Abstract

Lymphoma is the third most common cancer worldwide. Oral cavity Lymphoma forms 3% of all lymphomas in the general population. This is a case report of non Hodgkin B-cell lymphoma in 60 -year-old black male who was diagnosed earlier as having benign lympho-epithelial lesions of salivary and lacrimal glands. The patient was complaining of painless symmetrical facial swelling of the parotid, submandibular and lacrimal glands. Serological findings were negative for antinuclear antibody (ANA), anti-SS-A and anti-SS-B antibodies. Bilateral surgical excision of disfiguring buccal swollen salivary gland revealed a B-cell lymphoma. Chemotherapy started and dramatic response was noticed with total disappearance of all lacrimal and salivary gland swelling.

Follicular Lymphoma Mimicking a Benign Submandibular Gland Tumor

“…As for slowly progressing or lowgrade NHL, 40% where follicular lymphoma (FL) being the most frequent type of indolent NHL [15]. Follicular lymphoma is a slow-growing NHL from B-lymphocytes and accounts for one-third of all NHL [6]. The definitive diagnosis requires haematoxylin and eosin staining of the histological specimen, immunostaining for B cell markers (CD20), T cell marker (CD3), and proliferative marker (Ki67).…”

“…According to their origin within or outside the lymph nodes, they can be subdivided into intranodal and extranodal types. Non-Hodgkin's lymphoma accounts for 2-4% of head and neck lymphatic tumors, 4-5% of all cancers [6,7,8], and 86% of lymphoma cases [9].…”

“…They are predominantly nodal and primarily found in the nasal cavity, paranasal sinuses, Waldeyer's ring, oral cavity, and salivary glands [7]. A salivary gland NHL is rare, most effective 5-10%, and represents 1.7% -3.1% of all salivary gland malignant tumors [2,3,6,7,9,10,11,12]. Rzepakowska et al reported 73.2% of nodal type lymphomas and 26.8% of extra-nodal type, which covered: submandibular glands, parotid glands, parapharyngeal space, hypopharynx, and larynx [13].…”