Primary Extra-Nodal DLBCL of Glands: Our Experiences outside Guidelines of Treatment

Abstract

Lymphomas usually involve lymph nodes and other lymphoid tissues, but sometimes occur in non-lymphoid organs, called extra-nodal sites. Primary diffuse extra-lymph node large B-cell lymphoma (DLBCL) of the thyroid and parotid gland have been observed rarely. According to the most accredited guidelines, primary extra-nodal DLBCL of the parotid and thyroid glands should be treated with three cycles of R-CHOP followed by radiotherapy of the involved site (ISRT). Surgery alone is not enough to treat DLBCL. We describe two unusual cases of primary extra-nodal DLBCL in elderly patients treated exclusively with surgical resection, given the inability to apply chemotherapy. Both patients achieved clinical recovery, which was maintained after a follow-up of more than 18 months, despite not having performed the indicated chemotherapy protocol. The two cases presented here, and a few others reported in the literature, should be considered exceptions to the rule, and do not allow the conclusion that surgery alone might be sufficient for complete remission.

Ultrasound-Guided Anterior Mediastinotomy: A Feasible Tool for Critical Lymphoma Patients

“…One of the most frequent etiologies discovered in these masses is lymphoma, with an average incidence of 25%. Although FNAC is a valuable tool for the diagnosis of lymphoma, thanks to the minimally invasive approach, it is not considered as first choice by the recent guidelines; the pathologic diagnosis of lymphoma can be difficult; therefore, a surgical biopsy is often preferred to obtain an adequate amount of tissue for diagnosis and definition of lymphoma subtypes [ 5 , 6 , 7 , 8 , 9 , 10 , 11 , 12 , 13 , 14 ].…”