Diagnostic Challenge of a Primary Laryngeal Lymphoma Mimicking  Laryngeal Inflammation with no Sign of Malignancy: A Case Report

Azin   Kheradmand; Mahammad Amir Alizadeh Tabrizi; Sadra Amirpour  Haradasht; Sarina  Hassanpour  Dargah

doi:10.18502/jcr.v13i1.21483

Azin Kheradmand Department of Pathology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Mahammad Amir Alizadeh Tabrizi Department of Oral and Maxillofacial Surgery, School of Dentistry, Zahedan University of Medical Sciences, Zahedan, Iran.
Sadra Amirpour Haradasht Department of Oral and Maxillofacial Surgery, School of Dentistry, Zahedan University of Medical Sciences, Zahedan, Iran.
Sarina Hassanpour Dargah Department of Oral and Maxillofacial Surgery, School of Dentistry, Kerman University of Medical Sciences, Kerman, Iran.

DOI: https://doi.org/10.18502/jcr.v13i1.21483

Keywords: Laryngeal lymphoma; Inflammation; Malignancy

Abstract

Laryngeal lymphoma is an extremely rare condition. Symptoms are nonspecific and include hoarseness, dysphagia, and respiratory difficulty or airway obstruction. The initial presentation often mimics benign conditions such as inflammation or infection. Early diagnosis is crucial for optimal treatment. A 63-year-old man was admitted with a 1-month history of dysphonia, persistent hoarseness, odynophagia, and mild dyspnea. The patient did not report any fever, weight loss, or night sweats. Complete examination included: general physical examination, comprehensive ENT examination, oral cavity examination, neck examination, stroboscopy, flexible fibrolaryngoscopy, CT scan, MRI, and chest X-ray. Biopsy and IHC confirmed a diagnosis of diffuse large B-cell lymphoma (DLBCL). The patient underwent chemotherapy with the R-CHOP scheme, followed by involved-site radiotherapy (ISRT). After a 2-year follow-up, the patient remained in complete remission. This case emphasizes the importance of considering rare malignancies in patients with nonspecific laryngeal symptoms and the crucial role of a comprehensive diagnostic workup, even when symptoms are more commonly associated with benign conditions such as inflammation, and there is no sign of malignancy. Time is a critical factor for the management of laryngeal lymphoma, as Early diagnosis with appropriate treatment may significantly improve patients’ prognosis.