The Case Report of Malignant Lymphoma on the Submandibular Gland

턱밑샘에 발생한 악성 림프종의 치험례

  • Bea, Chung Sang (Department of Plastic and Reconstructive Surgery, Medical School, Chonbuk National University) ;
  • Lee, Nae Ho (Department of Plastic and Reconstructive Surgery, Medical School, Chonbuk National University) ;
  • Yang, Kyung Moo (Department of Plastic and Reconstructive Surgery, Medical School, Chonbuk National University)
  • 배충상 (전북대학교 의과대학 성형외과학교실) ;
  • 이내호 (전북대학교 의과대학 성형외과학교실) ;
  • 양경무 (전북대학교 의과대학 성형외과학교실)
  • Received : 2006.12.13
  • Published : 2007.03.10

Abstract

Purpose: Extranodal marginal zone B cell lymphoma of MALT type represents approximately 8% of non-Hodgkin's lymphomas and this lymphoma is present in extranodal sites. Although the presentation of this lymphomain in stomach is usually associated with H. pylori infection in 95% of cases, MALT lymphoma found in soft tissue has been reported very rarely in the field of plastic surgery. We report a case of MALT lymphoma in the submandibular gland without any involvement of other organs such as the stomach. Methods: A 49-year-old man complained of a huge neck mass sized about $10{\times}12cm$. It started about 2 years ago and grew rapidly for the late 6 months. It was of hard nature with erythematous skin overlying it. Under the diagnosis of possible malignant lymphoma or sarcoma, radical resection was performed and the defect was reconstructed using transverse rectus abdominis musculocutaneous free flap. Results: The mass was well demarcated from the normal tissue, $11{\times}10.5{\times}10cm$ in size and whitish-gray color. Immunohistochemical analysis demonstrated that the tumor cells were LCA(+), CD20(+), CD3(-) and CD5(-). The tumor was diagnosed as extranodal marginal zone B cell lymphoma. The patient was treated with prophylactic radiation therapy after surgery, there was no complication for 1 year. Conclusion: We reported that very rare form of MALT lymphoma in 49-year-old male patient was experienced with clinical characteristics, histologic features and references.

Keywords

References

  1. Greiner A, Marx A, Heesernann J, Leebrnann J, Schmausser B, Muller-Hemnelink HK: Idiotype identity in a MALT-type lymphoma and B cells in Helicobacter pylori associated chronic gastritis. Lab Invest 70: 572, 1994
  2. Isaacson PG, Norton AJ: Malignant lymphoma of the salivary gland. In Isaacson PG, Norton AJ (eds): Extranodal Lymphomas. New York, Churchill Linvingstone, 1994, p 67
  3. Harris NL, Jaffe ES, Stein H, Banks PM, Chan JK, Geary ML, Delsol G, Wolf-Peeters C, Falini B, Gatter KC, Grogan TM, Isaacson PG, Knowles DM, Mason DY, Muller-Hermelink HK, Pileri SA, Piris MA, Ralfkiaer E, Warnke RA: A revised European-American classification of lymphoid neoplasms: a proposal from the International Lymphoma Study Group. Blood 84: 1361, 1994
  4. Balm AJ, Delaere P, Hilgers FJ, Somers R, Van Heerde P: Primary lymphoma of mucosa associated lymphoid tissue (MALT) in the parotid gland. Clin Otolaryngol Allied Sci 18: 528, 1993
  5. Park ES, Park SJ, Lee YM, Yang SJ, Park CS: A case of malignant lymphoma of the parotid gland. J Korean Soc Plast Reconstr Surg 24: 205, 1997
  6. Isaacson P, Wright DH: Malignant lymphoma of mucosaassociated lymphoid tissue: a distinctive type of B-cell lymphoma. Cancer 52: 1410, 1983
  7. Ando M, Matsuzaki M, Murofushi T: Mucosa-associated lymphoid tissue lymphoma presented as diffuse swelling of the parotid gland. Am J Otolaryngol 26: 285, 2005 https://doi.org/10.1016/j.amjoto.2005.01.011
  8. Sclunid U, Helbron D, Lennert K: Development of malignant lymphoma in myoepithelial sialadenitis (Sjogren's syndrome). Virchows Arch Pathol Anat Histol 395: 11, 1982
  9. Iyengar P, Deodhare S: Primary extranodal marginal zone B-cell lymphoma of MALT type of the endometrium. Gynecol Oncol 93: 238, 2004
  10. Theodossy T, Prvulovich E, Hyde NC: FDG-PET and MALT lymphoma in the parotid gland. Oral Oncology EXTRA 41: 230, 2005 https://doi.org/10.1016/j.ooe.2005.06.007