A rare case of an extranodal head and neck lymphoma primarily diagnosed as sarcoma
Abstract
Diffuse large B-cell lymphomas-not otherwise specified (DLBCL-NOS) are a common lymphoid malignancy, being the most common form of non-Hodgkin lymphoma (NHL). Typically, DLBCL-NOS arises in lymph nodes, however primarily extranodal involvement is possible, and it can present itself in various clinical and morphological types, posing a diagnostic challenge. In some cases, extranodal lymphomas may mimic non-lymphoid tumours, among them sarcomas. Treatment of DLBCL may involve chemotherapy, immunotherapy, radiotherapy and autologous stem cell transplant, while in the care of sarcomas surgery is an important modality of treatment. A-36-year-old male patient presented with a tumour of the left angle of the mandible which appeared a few days after a tooth extraction. It was first diagnosed as inflammation and treated with antibiotics. Afterwards, a biopsy indicated liposarcoma. A repeated biopsy and histopathological examination at an oncology centre revealed extranodal diffuse large B-cell lymphoma- not otherwise specified (DLBCL-NOS). The patient was successfully treated with chemotherapy with rituximab and radiotherapy. Complete remission was achieved and the patient remains DLBCL-NOS free for over six years. It is vital for extranodal lymphomas to be thoroughly differentiated from other malignancies by experienced oncology centres, since a false diagnosis may lead to a dramatic mistreatment.
Keywords: lymphomanon-Hodgkinextranodalmandiblediagnostic errors
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