Isolated B-cell non-Hodgkin's lymphoma of the parotid gland presenting as an ulcerating facial mass and sepsis during an acute medical take.
Lymphoma presenting as a parotid gland tumour without systemic involvement is rare, especially with respect to a non-Hodgkin's lymphoma. Furthermore, when such cases present there is often a low degree of clinical suspicion as there may be few clinical features to suggest the diagnosis. We describe an unexpected case that presented during an acute medical intake. The case was an 84-year-old man presenting acutely unwell with an ulcerating mass over the right side of the face, septicaemia and acute kidney injury. Following aggressive initial management the patient improved. Later cytological examination of a fine needle aspiration from the mass confirmed a B-cell non-Hodgkin's lymphoma. He had no evidence of other systemic involvement or of B-symptoms. We report on the case and briefly review the available literature relating to the prevalence of non-Hodgkin's lymphoma of the parotid gland.
Department of Diabetes & Endocrinology, Morriston Hospital,  ABM University Health Board, Swansea,  UK.
Victoria Angharad
VA
Anthony
David Owen
DO
Rees
Jeffrey W
JW
Stephens
D000369:Aged, 80 and over; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D005153:Facial Neoplasms / Q000188:drug therapy / Q000209:etiology*; D006801:Humans; D016393:Lymphoma, B-Cell / Q000150:complications* / Q000188:drug therapy; D008297:Male; D010307:Parotid Neoplasms / Q000150:complications* / Q000188:drug therapy; D018805:Sepsis / Q000209:etiology* / Q000628:therapy