Primary malignant lymphoma of mucosa‐associated lymphoid tissue of larynx

Abstract

Non-Hodgkin's lymphoma (NHL) is rarely encountered in the larynx. We report another case of malignant lymphoma of larynx arising from mucosa-associated lymphoid tissue (MALT). CASE REPORTA 58-year-old Taiwanese woman was admitted to our hospital in August 1996 because of persistent hoarseness and a sensation of a lump in the throat for 2 months. Under indirect laryngoscopy, a right supraglottic, nonulcerative mass that was fish-flesh colored and about 1.5 cm in diameter was noted arising from the right aryepiglottic fold. Biopsy specimens revealed a nonulcerative mucosa infiltrated by a few atypical lymphocytes. The tumor persisted after supportive treatment, so direct laryngoscopy was performed again. Deep incision was done, and 6 pieces of tissue were taken, which revealed a submucosal tumor composed of small cleaved cells and large lymphoid cells with plasmacytoid differentiation. A thin grenz zone separated the main tumor from the overlying epithelium, but some atypical lymphoid cells infiltrated the overlying epithelium (Fig 1).Immunohistochemistry study demonstrated B-cell lineage. CT scan showed a laryngeal mass at right aryepiglottic fold, and 1 enlarged regional lymph node was noted. No other foci of lymphoma were found. A primary, diffuse, small cleaved and large cell laryngeal lymphoma was diagnosed. The patient was treated with a total dose of 3000 cGy of radiation. After 2000 cGy was given, the symptoms disappeared. Follow-up laryngoscopy was performed 6 months later; no recurrent tumor was seen. The patient was alive and well without symptoms of recurrence 1 year after treatment.

Imaging Characteristics of Primary Laryngeal Lymphoma

“…5,21,24 Our study was consistent with this finding, demonstrating a B-cell phenotype to NK/T-cell phenotype ratio of 6:1. 25 We found that the diffuse large B-cell lymphoma was the most common immunophenotype, consistent with prior reports, 25 followed by the MALT. As previously noted, the major imaging and pathologic distinction between the B-cell phenotype and the NK/T-cell phenotype was the involvement of the submucosa in all the cases with B-cell phenotype.…”

Subglottic stenosis induced by extranodal mucosa-associated lymphoid tissue lymphoma

“…14 Local radiation therapy has been advocated as the most appropriate treatment in this area due to highly sensitivity to MALT lymphoma over larynx. 15 . In general, patients with MALT lymphoma respond well to local therapy and have high survival rate.…”

Primary mucosa-associated lymphoid tissue (MALT) lymphoma of the larynx

“…Most MALT lymphomas of the larynx have been treated with radiation therapy when the disease was localized and with chemotherapy in cases of recurrent or disseminated disease (Table 1). Local radiation therapy has been advocated as the most appropriate treatment, in that other lymphomas are highly sensitive to this treatment 21. Radiation therapy is generally moderate‐dose radiotherapy (30–50 Gy) 18.…”