<abstract xmlns="http://www.w3.org/1999/xhtml"> BACKGROUND. Primary malignant lymphomas of the salivary gland are rare, accounting for 2% of salivary gland tumors and 5% of all extranodal lymphomas. The clinical presentation is not particularly characteristic, a feature that usually leads to diagnostic and treatment delays.CASE REPORT. We report a case of a parotid gland triple-hit diffuse large B-cell (DLBCL) lymphoma associated with follicular lymphoma in a 76-year-old female patient with a unique personal history, which included a diagnosis of Sjogren Syndrome and exposure to a toxic working environment with pesticides. Diffuse large B-cell lymphomas are uncommon given the fact that most lymphoid malignancies are low-grade lymphomas, with MALT (mucosa associated lymphoid tissue) lymphomas being the most common. Triple-hit DLBCL are extremely rare and the diagnosis can be challenging. Parotidectomy, as the first step, must be followed by histopathology and immunohistochemistry for final diagnosis and treatment.CONCLUSION. This case highlights the fact that B-cell lymphoma in the salivary gland can be unrecognized due to unspecific symptoms and requires immunohistochemistry studies for confirmation. It is important to recognize triple-hit lymphoma due to its worse prognosis and differentiated treatment. Patients with Sjogren syndrome have additional risk factors for progression to lymphoma.</abstract>

BACKGROUND. Primary malignant lymphomas of the salivary gland are rare, accounting for 2% of salivary gland tumors and 5% of all extranodal lymphomas. The clinical presentation is not particularly characteristic, a feature that usually leads to diagnostic and treatment delays.CASE REPORT. We report a case of a parotid gland triple-hit diffuse large B-cell (DLBCL) lymphoma associated with follicular lymphoma in a 76-year-old female patient with a unique personal history, which included a diagnosis of Sjogren Syndrome and exposure to a toxic working environment with pesticides. Diffuse large B-cell lymphomas are uncommon given the fact that most lymphoid malignancies are low-grade lymphomas, with MALT (mucosa associated lymphoid tissue) lymphomas being the most common. Triple-hit DLBCL are extremely rare and the diagnosis can be challenging. Parotidectomy, as the first step, must be followed by histopathology and immunohistochemistry for final diagnosis and treatment.CONCLUSION. This case highlights the fact that B-cell lymphoma in the salivary gland can be unrecognized due to unspecific symptoms and requires immunohistochemistry studies for confirmation. It is important to recognize triple-hit lymphoma due to its worse prognosis and differentiated treatment. Patients with Sjogren syndrome have additional risk factors for progression to lymphoma.

Case report. A rare case of triple-hit diffuse large B-cell lymphoma of the parotid gland in a patient with Sjogren’s syndrome

Department of Pathology, “Sfanta Maria” Hospital, Bucharest, Romania

Pathology Department, Faculty of Medicine, “Carol Davila” University of Medicine and Pharmacy, Bucharest,

CESITO Center, “Sfanta Maria” Hospital, Bucharest,

Pathology Department, Faculty of Medicine, “Carol Davila” University of Medicine and Pharmacy, Bucharest, Romania

Department of Pathology, Emergency University Hospital, Bucharest,

CESITO Center, “Sfanta Maria” Hospital, Bucharest, Romania

ENT&HNS Department, “Sfanta Maria” Hospital, Bucharest, Romania

ENT&HNS Department, Faculty of Dental Medicine, “Carol Davila” University of Medicine and Pharmacy, Bucharest,

Romanian Journal of Rhinology

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 License.

BACKGROUND. Primary malignant lymphomas of the salivary gland are rare, accounting for 2% of salivary gland tumors and 5% of all extranodal lymphomas. The...

Case report. A rare case of triple-hit diffuse large B-cell lymphoma of the parotid gland in a patient with Sjogren’s syndrome

Published Online: May 03, 2017

Page range: 103 - 107

DOI: https://doi.org/10.1515/rjr-2017-0011

Keywords
primary parotid gland lymphoma, triple-hit, diffuse large B-cell lymphoma, Sjogren’s syndrome

© 2017

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 License.

Case report. A rare case of triple-hit diffuse large B-cell lymphoma of the parotid gland in a patient with Sjogren’s syndrome

Published Online: May 03, 2017

Page range: 103 - 107

DOI: https://doi.org/10.1515/rjr-2017-0011

Keywordsprimary parotid gland lymphoma, triple-hit, diffuse large B-cell lymphoma, Sjogren’s syndrome

© 2017

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 License.

Keywords
primary parotid gland lymphoma, triple-hit, diffuse large B-cell lymphoma, Sjogren’s syndrome