Primary Parotid Gland Hodgkin's Lymphoma

Abstract

Hodgkin's lymphoma with its primary manifestation in the parotid gland is an exceedingly rare entity and is not usually suspected in the initial evaluation of a parotid mass. Because it is not suspected, the results of fine-needle aspiration cytology are often misleading, and parotidectomy is needed for a definitive diagnosis. The most common subtype encountered is lymphocyte-predominant. The prognosis is favorable; the 5-year survival rate exceeds 90%. Treatment consists of chemotherapy, radiotherapy, or both. A case of primary parotid gland Hodgkin's lymphoma is presented along with a review of the literature and a discussion of the evaluation and management of this rare entity.

An exceedingly rare entity: Mixed cellular type primary Hodgkin

“…4 WHO defines a lymphoma of the salivary gland as primary only if the bulk of the tumor is in the gland and the parenchyma is involved.…”

“…Criteria used to define primary parotid gland lymphoma. 4,6 • Any lymphoma originating in either glandular lymph nodes or glandular parenchyma, regardless of its association with autoimmune disease or its subsequent stage: must be initial clinical manifestation of lymhoma …”

“…The vast majority of parotid gland lymphomas are NHL. Incidence of primary Hodgkin's lymphoma of the parotid gland is extremely rare [1][2][3][4][5] and most of the reported cases are of lymphocyte predominant subtype. 5 On the other hand, mixed cellularity type Hodgkin's lymphoma is exceptional with only seven cases reported up to date.…”

“…5 On the other hand, mixed cellularity type Hodgkin's lymphoma is exceptional with only seven cases reported up to date. [1][2][3][4] We report here, to the best of our knowledge, the eighth primary, mixed cellularity type Hodgkin's lymphoma of the parotid gland to contribute in part to a better understanding of the disease.…”

“…Among the reports, in which the subtype of the Hodgkin's lymphoma was mentioned, we were able to determine only seven cases, with our case being the eighth one. [1][2][3][4] The diagnostic accuracy of FNA in parotid gland masses is around 85-93.5%; However, due to the rarity of lymphomas in this region 3 and the possibility of not being able to see the classical ReedSternberg cells in FNA biopsies, the diagnostic accuracy of FNA in lymphomas is only 66%. 4 Some cases are overlooked and diagnosed as reactive lymph nodes in parotid gland or as Warthin's tumor.…”