Primary Laryngeal Lymphoma: A Case Report of a Rare Entity

Primary laryngeal lymphoma is a rare form of non-Hodgkin lymphoma (NHL), with fewer than 100 cases reported worldwide. Although head and neck cancers are the second most common extranodal sites for NHL, the larynx, particularly the supraglottic region, is rarely involved. We present a case that underscores the importance of distinguishing primary laryngeal lymphoma from secondary involvement to ensure the appropriate management of the condition. A 53-year-old male presented with significant weight loss, hoarseness, and progressive dysphagia. He also reported an intermittent history of fever and night sweats. Physical examination revealed bilateral level IIa and III cervical lymphadenopathy and flexible laryngoscopy showed edema and ulceration in the supraglottic region. A contrast-enhanced CT scan from the skull base to the thorax revealed a fairly well-defined, mildly heterogeneous enhancing lesion involving the suprahyoid and glottic regions, measuring 2.3 x 2.1 x 5 cm (AP x TR x CC). Biopsy confirmed diffuse large B-cell lymphoma (DLBCL), with immunohistochemistry positive for CD45, CD20, and BCL6. The patient received eight cycles of the CHOP (doxorubicin, cyclophosphamide, prednisone, and vincristine) chemotherapy regimen, achieving complete clinical remission with no recurrence noted at the two-year follow-up. DLBCL of the larynx is rare but should be considered in cases of supraglottic masses due to its symptom overlap with other laryngeal conditions. Diagnosis is confirmed through histopathology and immunohistochemistry, and treatment typically involves chemotherapy, with CHOP being the most effective regimen. Early recognition is crucial for optimal treatment of this uncommon disease. Further research is needed to refine treatment protocols.