Extranodal B-cell lymphomas of the larynx are a rare entity with less than 1 % of laryngeal neoplasias. Among these, non-Hodgkin's lymphomas are the most common, one third are diffuse large cell B-cell lymphomas (DLBCL). Here we describe the case of a 79-year-old female patient who had already presented with 8 months of progressive hoarseness and unspecific dysphagia in different disciplines. The diagnosis remained unresolved until thyroidectomy was indicated for CT-morphological suspicion of thyroid carcinoma. In the preoperative laryngoscopic examination, a tissue mass of the left endolarynx was noticed. A panendoscopy with laser-assisted biopsy was initiated and the thyroidectomy was postponed. Histology revealed the presence of a DLBCL of the "non-GCB" type according to Hans. In the course of staging no further lymphoma manifestations were observed, indicating a stage IE disease according to Ann Arbor classification. The interdisciplinary tumor conference recommended chemotherapeutic regimen with 4 cycles of R-CHOP and subsequent "involved field" radiation. The present case of a primary lymphoma of the larynx impressively shows an important, although rare differential diagnosis of hoarseness. The small number of comparative cases additionally complicates the diagnosis and therapy of extranodal lymphomas. In patients with progressive dysphonia, the ENT physician should consider rare entities and perform a structured diagnosis. Especially the preoperative laryngoscopy before thyroidectomy provided the decisive indication and underlines the importance of interdisciplinary cooperation in case of unclear findings.
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A-1707.pdf
