gms | German Medical Science

Introduction: Globus sensation and frequent coughing can be caused by a multitude of benign and malignant lesions in the pharynx. In the head and neck area lymphomas often originate from the pharyngeal lymphoid ring. Highly proliferative tumors can generate such indistinct symptoms quickly.

Methods: case report and literature review

Results: A 74-year old female presented with globus sensation and coughing that had developed over a period of six weeks. Dyspnea, weight-loss, fever or night sweats were not reported. The patient did not have a history of smoking or alcohol abuse. During transnasal videolaryngopharyngoscopy a solitary, pediculated tumor originating from the lympoid tissue of the left tonsil and tongue base was documented. The tumor with an even surface compressed the epiglottis and obstructed the pharynx subtotally. Reclination of the neck triggered the cough reflex by irritation of the glottic mucosa. Vocal chord mobility was not impaired. During panendoscopy the tumor was removed and referred to pathohistologic examination. A highly proliferative, malignant b-cell lymphoma was diagnosed and polychemotherapy was initiated.

Conclusion: Lymphomas originating from the pharyngeal lymphoid ring can cause indistinct symptoms and present in a variety of shapes. Due to high proliferative capacity an adequate therapy chemotherapy needs to be initiated immediately.