title: Anaplastic large-cell lymphoma presenting as a nasopharyngeal mass and cervical lymphadenopathy.
abstract: Cervical lymphadenopathy in adults has a broad differential diagnosis, including bacterial and viral infections, Kikuchi-Fujimoto disease, systemic lupus erythematosus, and various neoplasms. Many of its etiologies share similar symptomatology and presentations, which complicates the diagnosis. A thorough history and a comprehensive physical examination, to include nasopharyngoscopy and imaging as indicated by the specific case, are key to determining the origin of the lymphadenopathy and to avoid a missed or delayed diagnosis. Based on our review of the literature, we present the second reported case of anaplastic lymphoma kinase-positive anaplastic large-cell lymphoma presenting in an adult with an obstructing adenoid/nasopharyngeal mass and lymphadenopathy. The mass, which occurred in a 19-year-old woman of Asian descent, caused nasal airway obstruction in the setting of cervical lymphadenopathy that was initially ascribed to mononucleosis.
authors.affiliation: Otolaryngology-Head and Neck Surgery Service, San Antonio Military Medical Center, ATTN: MCHE-SDT (Oto), 3551 Roger Brooke Dr., Ft. Sam Houston, TX 78234, USA. gregrdion@gmail.com.
authors.forename: Gregory R
authors.initials: GR
authors.lastname: Dion
authors.forename: Mark D
authors.initials: MD
authors.lastname: Packer
mesh_terms: D000402:Airway Obstruction / Q000209:etiology; D000077548:Anaplastic Lymphoma Kinase; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D003520:Cyclophosphamide / Q000627:therapeutic use; D003937:Diagnosis, Differential; D004317:Doxorubicin / Q000627:therapeutic use; D004724:Endoscopy; D005260:Female; D006801:Humans; D008206:Lymphatic Diseases / Q000209:etiology; D017728:Lymphoma, Large-Cell, Anaplastic / Q000175:diagnosis* / Q000188:drug therapy / Q000201:enzymology; D009303:Nasopharyngeal Neoplasms / Q000175:diagnosis* / Q000188:drug therapy / Q000201:enzymology; D009333:Neck; D010784:Photomicrography; D011241:Prednisone / Q000627:therapeutic use; D011379:Prognosis; D020794:Receptor Protein-Tyrosine Kinases / Q000032:analysis; D014057:Tomography, X-Ray Computed; D014750:Vincristine / Q000627:therapeutic use; D055815:Young Adult
chemical_list: D014750:Vincristine; D004317:Doxorubicin; D003520:Cyclophosphamide; C000626173:ALK protein, human; D000077548:Anaplastic Lymphoma Kinase; D020794:Receptor Protein-Tyrosine Kinases; D011241:Prednisone