Clinical presentation and characteristics of lymphoma in the head and neck region

Background:

The study analyses characteristics of head and neck (H&N) lymphoma to raise the awareness of ENT specialists to the clinical symptoms.

Methods:

From 2003 to 2011, all patients with H&N lymphoma were included.

Results:

This study identified 221 patients with H&N lymphoma comprising 193 non-Hodgkin lymphomas (NHL) and 28 Hodgkin lymphomas (HL). There were 77 indolent (iNHL), 110 aggressive (aNHL), six highly aggressive and 28 HL. Patients with highly aggressive NHL and HL were significantly younger (p < 0.0001). Corresponding to the leading symptoms, we found nodal and extranodal involvement. NHL demonstrated manifestation in neck lymph nodes, tonsils, major salivary glands, sinonasal-system and hypopharynx/larynx. HL showed exclusive manifestation in lymph nodes and the tonsils (p < 0.0001). The mean time from first symptoms to diagnosis ranged from 1.5 ± 0.7 months in highly aggressive lymphoma to 7.5 ± 11.5 months in iNHL.

Conclusion:

The variable clinical presentation of lymphoma is a challenge for the ENT specialist. Fast diagnosis is crucial for rapid treatment, especially in Burkitt-lymphoma and HL. A standardized medical history, clinical examination and imaging evaluations paired with patient's signs, symptoms and demographic knowledge might indicate lymphoma. Biopsies in the H&N region are easily performed and should always be immediately considered in suspicious findings.

Publication History

Publication Date:
23 April 2019 (online)