Primary diffuse large B-cell lymphoma of the Larynx

Area of Science:

• Oncology
• Hematology
• Head and Neck Surgery

Background:

• Extranodal non-Hodgkin lymphoma (NHL) of the larynx is exceptionally rare, comprising less than 1% of primary laryngeal tumors.
• Diffuse large B-cell lymphoma (DLBCL) is an aggressive form of NHL, and its occurrence in the larynx presents unique diagnostic and therapeutic challenges.

Observation:

• A case report details an 85-year-old female with laryngeal DLBCL, initially difficult to diagnose despite multiple biopsies.
• Diagnosis was confirmed via lymph node biopsy adjacent to the larynx, obtained two months after initial laryngeal biopsies.
• The rarity and potential for insufficient sampling underscore the need for repeated biopsies in suspected laryngeal NHL.

Findings:

• The case highlights diagnostic delays in laryngeal DLBCL due to the rarity and potential for inadequate biopsy samples.
• Management consensus for laryngeal NHL is lacking; standard DLBCL protocols like R-CHOP are adapted.
• Treatment for this patient involved a modified R-COP regimen due to age and cardiac issues, omitting doxorubicin.

Implications:

• This case emphasizes the importance of considering NHL in laryngeal lesions, especially when initial biopsies are inconclusive.
• Adapted chemotherapy regimens, like R-COP, may be necessary for elderly patients with comorbidities.
• Further research into optimal diagnostic and treatment strategies for rare laryngeal lymphomas is warranted.