Hodgkin Lymphoma of the Nasopharynx: Case Report with Review of the Literature

Abstract

We report an uncommon case and histopathologic work-up of Hodgkin lymphoma of the nasopharynx in a 49-year old female patient who presented with a 2-year complaint of bilateral nasal congestion. Histologic study revealed a lymphocyte rich subtype of classic Hodgkin lymphoma. Immunohistochemical analysis revealed CD15, CD30, OCT-2, BOB.1, and MUM-1 expression by the neoplastic cells and a lack of expression of CD45, CD20, CD3, EMA, and EBER. The review of the literature showed that Hodgkin lymphoma of the nasopharynx is rare, the most common reported subtype is the mixed cellularity, and Hodgkin lymphoma of the nasopharynx has a favorable prognosis.

Primary Nasopharyngeal Hodgkin Lymphoma

“…These epidemiologic data seem constant in time, since they are substantially in accordance with the ones previously reported by other authors [3][4][5]. Despite its rarity, primary nasopharynx CHL has a favourable clinical course and it is usually well managed with a combined approach, as reported by the authors and by Johnson and colleagues, too [1,6]. In particular, we share the opinion that the best therapeutic option in this setting is represented by few cycles of doxorubicin, bleomycin, vinblastine and dacarbazine (ABVD) followed by attenuated dose involved-field radiotherapy (IF-RT), since we successfully treated 4 years ago a 50-year-old male patient with this modality.…”

“…We read with great interest the paper by Owosho et al [1], showing a case of nasopharyngeal classical Hodgkin lymphoma (CHL) in a 49-year-old woman presenting with nasal congestion and post nasal drainage and we have a similar case managed at our institution.…”

“…Only 35 cases have been identified to date and the most recent, homogeneous and large cohort reported in the literature comes from a retrospective analysis published by Iyengar and colleagues from the MD Anderson Cancer center, in which they showed that among more than 3.500 HL patients registered during a 40 years period , only 34 had a primary head-neck classic variant; notably nasopharynx localization is a true rarity since only 9 of them had an exclusive involvement at that level [1,2]. These epidemiologic data seem constant in time, since they are substantially in accordance with the ones previously reported by other authors [3][4][5].…”

Nasopharyngeal Lymphoma: A 22-Year Review of 35 Cases

“…There are only few studies reporting the clinical characteristics and prognosis of NP lymphomas, and most of them studied T-cell and B-cell lymphomas as a single group [2,3,4,6,8,9]. Very few studies have specifically addressed the clinical disparities of NP-DLBCL and NP-NKTCL.…”

“…Lymphoma, the most common non-epithelial malignancy of the head and neck region, can be classified into two types, Hodgkin’s lymphoma (HL) and non-Hodgkin’s lymphoma (NHL) [1]. Among them, primary nasopharyngeal (NP) lymphoma is a very rare tumor, with only limited studies found in the literatures [2,3,4,5,6,7,8,9,10]. Waldeyer-Hartz firstly described the lymphoid tissues within the nasopharynx, oropharyngeal wall, base of the tongue, palatine tonsils, and soft palate, known today as Waldeyer’s ring (WR) [7].…”