Lymphoma of the head and neck. A diagnostic dilemma

The surgeon should remember that lymphoma may involve any tissue in the head and neck region. By maintaining a high level of suspicion when evaluating a tumor that appears to be more aggressive than expected (that is, multiple primary sites), the head and neck surgeon will expedite treatment of the patient with lymphoma. Aids in early diagnoses center around providing sufficient tissue to the pathologist by avoiding needle biopsy and piecemeal removal of the regional lymph nodes or obtaining undistorted representative tissue from extranodal sites. We stress the need for a continuing dialogue between the head and neck surgeon and the pathologist regarding early identification of the potential lymphoma patient, thereby preventing a diagnostic dilemma.