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81st Annual Meeting of the German Society of Oto-Rhino-Laryngology, Head and Neck Surgery

German Society of Oto-Rhino-Laryngology, Head and Neck Surgery

12.05. - 16.05.2010, Wiesbaden

Swelling of the parotid gland as a first symptom of a Non Hodgkin Lymphoma

Meeting Abstract

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  • corresponding author presenting/speaker Knut Bördner - HNO-Klinik, Bad Hersfeld, Germany
  • Timo Rother - HNO-Klinik, Bad Hersfeld, Germany
  • Peter Rolf Issing - HNO-Klinik, Bad Hersfeld, Germany

German Society of Oto-Rhino-Laryngology, Head and Neck Surgery. 81st Annual Meeting of the German Society of Oto-Rhino-Laryngology, Head and Neck Surgery. Wiesbaden, 12.-16.05.2010. Düsseldorf: German Medical Science GMS Publishing House; 2010. Doc10hno025

DOI: 10.3205/10hno025, URN: urn:nbn:de:0183-10hno0253

Published: July 6, 2010

© 2010 Bördner et al.
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Outline

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Introduction: Diagnostics and treatment of swellings of unknown origin in the head neck region is the daily routine of an ENT specialist. Causes can vary and range from infectious to potentially malignant diseases. In the following we want to report an unusual case in a young patient.

Casuistics: A 31-year old male presented with a progressive and solid enlargement of the parotideal and the submandibular gland in our ENT department. Ultrasound imaging revealed an additional hypertrophy of the lymphatic nodes in the cervical region. A systemic fibrosis was known. On clinical examination a 3x3 cm node inside the right parotideal gland was palpable, the further examination revealed no additional pathologic findings. Aspiration of cytologic material showed a minor inflammatory reaction including spindle cells, an image conformable consistent with scar tissue. Initially we assumed another manifestation of the known systemic fibrosis. To further ensure the histologic diagnosis we performed a subtotal parotidectomy and an extirpation of the submandibular gland as well as a selective neck dissection on the right side.

The postoperative course was uneventful. Histologic findings including immunohistochemical analysis showed a low malignant Non Hodgkin lymphoma. Subsequent radiation was performed and tolerated well.

Conclusion: A swelling of the parotideal gland needs to be examined by an ENT specialist, who should consider a histologically confirmed diagnosis. It remains unclear, whether the systemic fibrosis or the immunosuppressive treatment of this disease has induced malignant lymphoma.