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Conflict of interestWe, hereby declare that we have no conflict of interest to disclose in
relation to the manuscript titled ”Primary Lymphoma of the Larynx: A
case report” submitted for publication. We affirm that there are no
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Introduction:
Marginal zone lymphoma corresponds to a sub-type of non-Hodgkin lymphoma
stated to arise from post-germinal center memory B cells of marginal
zone type that derive from and multiply anatomically in extranodal,
splenic, and nodal tissues respectively in MALT, splenic, and nodal type
lymphomas (1). Furthermore, Extranodal marginal zone lymphoma or MALToma
is most commonly localized in the stomach; other common sites include
the eyes and ocular adnexa, skin, lungs, salivary glands, breasts, and
thyroid. It is rarely seen in the larynx which has only been reported in
approximately 30 cases so far after the first case reported in 1990. (2)
Herein, we present a case of supraglottic low grade marginal zone
lymphoma of the larynx.
CLINICAL REPORT:
A 78-year-old male was evaluated in the ENT OPD of our hospital with the
only complaint of progressive hoarseness for 6 weeks. He had no history
of weight loss, fever, and night sweats. The past, family, and medical
history of the patient were not of significant note. On physical
examination, the superficial cervical lymph nodes were not enlarged.
Plain and contrast-enhanced MDCT of the neck showed a welldefined lesion
of size 22 x 17 mm predominantly involving the right side of the supra
glottis of the larynx. In the post-contrast study, the lesion showed
significant enhancement involving the right aryepiglottic fold and
causing the ipsilateral pyriform sinus narrowing.
On nasopharyngolaryngoscopy, a right false vocal cord mass was seen. The
specimen after direct laryngoscopy biopsy revealed multiple bits of
gray-white to gray-brown soft tissue measuring 1x1x0.5 cm.
Histologically, the section showed multiple fragments of tissue lined by
stratified squamous epithelium. The subepithelium showed sheets of small
monomorphic lymphoid cells having round hyperchromatic nuclei,
inconspicuous nucleoli, and scant cytoplasm.(Figure 1 A) Extensive
crushing artifactual changes were noted. These cells are also seen
infiltrating in between mucus glands. (Figure 1 B) Few skeletal muscle
fragments are also observed. Furthermore, immunohistochemistry revealed
small B cells positive for CD20, BCL2, and CD21. Immunohistochemistry
for CD3, CD10, CD5, CD43, CD23, CD138, and Cyclin D1 were negative. The
above findings confirmed the diagnosis of low-grade extranodal marginal
zone lymphoma.