Unusual head and neck manifestations of non-hodgkin’s lymphomas in children and adults

Certain patterns of “lymphoma masquerade” are examined, where the diagnosis is very difficult to establish. The presence of prolonged symptoms prior to the acute event or indolent slow healing wounds should alert clinicians to the possibility that lymphoma may be involved. Localizing tumors in order to make a tissue diagnosis is one potential problem encountered even with computerized tomography, but magnetic resonance imaging has been helpful in demonstrating the presence of tumor mass. Included in this report is an unusual series of non-Hodgkin’s lymphoma cases in which there was not an obvious tumor. Three patients presented with symptoms and findings of deep neck abscess, two of which were associated with an esophageal perforation or tracheoesophageal fistula. The other cases involved chronic sinusitis and an apparent viral polyneuropathy affecting multiple cranial nerves. Treatment of these non-Hodgkin’s lymphomas and techniques for establishing the pathological diagnosis are discussed.