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Case Report
Diffuse B-cell lymphoma in a submandibular gland: A very rare case presentation in a 23 years old
1 ACCS CT1 Anaesthetics, Leicester Royal Infirmary, Infirmary Square, Leicester, LE1 5WW, United Kingdom
2 Foundation Year 2 Doctor, Queen Elizabeth Hospital, King’s Lynn, Gayton Road, PE30 4ET, United Kingdom
3 Consultant Maxillo-Facial Surgeon, Leicester Royal Infirmary, Infirmary Square, Leicester, LE1 5WW, United Kingdom
4 Consultant Radiologist, Barts Health NHS Trust, The Royal Hospital, Whitechapel Road, London, E1 1BB, United Kingdom
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Farooq Hassan Afzaal
ACCS CT1 Anaesthetics, Leicester Royal Infirmary, Infimary Square, Leicester, LE1 5WW,
United Kingdom
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Article ID: 101227Z01FA2021
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Afzaal FH, Khan BZ, Kassam K, Adams A. Diffuse B-cell lymphoma in a submandibular gland: A very rare case presentation in a 23 years old. Int J Case Rep Images 2021;12:101227Z01FA2021.ABSTRACT
Introduction: Malignant lymphomas of a salivary gland originate from either a lymph node (nodal) or from the parenchymal tissue of a lymphoid organ (extranodal). Primary lymphomas of the salivary glands are rare in nature, accounting for 1.7–7.4% of all salivary gland tumors. Non-Hodgkin lymphomas (NHL) of salivary glands most commonly (75%) affect the parotid gland. The submandibular gland lacks presence of intraglandular lymph nodes and the incidence of extranodal lymphomas of the submandibular gland are therefore very rare.
Case Report: A 23-year-old white Caucasian male reported a 3-month history of an asymptomatic lump in the right submandibular region. An ultrasound scan and a magnetic resonance imaging (MRI) demonstrated a large and well-defined hypercellular mass in the right level Ib/submandibular region. A fine needle aspiration (FNA) and excision biopsy were performed. Fluorescence in situ hybridization (FISH) confirmed a diagnosis of a diffuse large B-cell lymphoma, non-germinal center type. The patient was treated with a 12-week chemotherapy regime (R-CHOP). A pre- and post-chemotherapy PET-CT (positron emission tomography-computed tomography) was performed, the latter of which showed only normal physiological uptake and no recurrence or signs of distant metastasis.
Conclusion: Submandibular lymphomas are a well-documented yet rare presentation, particularly in the young adult. This case report highlights the successful diagnosis, treatment, and follow-up of an extremely rare finding in a 23-year-old patient and highlights the importance of considering a diffuse B-cell lymphoma in a patient presenting with a lump in the submandibular gland.
Keywords: Diffuse B-cell lymphoma, Head and neck cancer, MRI, Submandibular gland
SUPPORTING INFORMATION
Author Contributions
Farooq Hassan Afzaal - Substantial contributions to conception and design, Acquisition of data, Analysis of data, Interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
Basil Zia Khan - Substantial contributions to conception and design, Analysis of data, Interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
Karim Kassam - Substantial contributions to conception and design, Acquisition of data, Analysis of data, Interpretation of data, Drafting the article, Final approval of the version to be published
Ashok Adams - Acquisition of data, Analysis of data, Interpretation of data, Revising it critically for important intellectual content, Final approval of the version to be published
Guarantor of SubmissionThe corresponding author is the guarantor of submission.
Source of SupportNone
Consent StatementWritten informed consent was obtained from the patient for publication of this article.
Data AvailabilityAll relevant data are within the paper and its Supporting Information files.
Conflict of InterestAuthors declare no conflict of interest.
Copyright© 2021 Farooq Hassan Afzaal et al. This article is distributed under the terms of Creative Commons Attribution License which permits unrestricted use, distribution and reproduction in any medium provided the original author(s) and original publisher are properly credited. Please see the copyright policy on the journal website for more information.
