Two cases of rare subglottic MALT lymphoma of the larynx

• Published in: American journal of otolaryngology Vol. 41; no. 6; p. 102736
• Main Authors: Johnson, Alexander O., Stevens, Benjamin P., Lam, John T., Schweinfurth, John M.
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.11.2020; Elsevier Limited
• Subjects: Aged; Aged, 80 and over; Airway management; Biopsy; Cough; Cough - etiology; Dysphagia; Dyspnea; Dyspnea - etiology; Etiology; Female; Females; Fever; Health care facilities; Hoarseness - etiology; Humans; Laryngeal Neoplasms - complications; Laryngeal Neoplasms - diagnosis; Laryngeal Neoplasms - pathology; Laryngeal Neoplasms - surgery; Laryngoscopy; Laryngostenosis - etiology; Laryngostenosis - surgery; Larynx; Lymphocytes; Lymphoma; Lymphoma, B-Cell, Marginal Zone - complications; Lymphoma, B-Cell, Marginal Zone - diagnosis; Lymphoma, B-Cell, Marginal Zone - pathology; Lymphoma, B-Cell, Marginal Zone - surgery; Male; MALT; Medical diagnosis; Medical instruments; Metastases; Mucosa; Mucosal-associated lymphoid tissue; Oncology; Otolaryngology; Patients; Pharyngitis; Pharyngitis - etiology; Radiation; Radiation therapy; Rare Diseases; Signs and symptoms; Stenosis; Subglottis; Sweating; Tumors; Weight loss; Larynx; Lymphoma; Subglottis; MALT
• ISSN: 0196-0709; 1532-818X
• DOI: 10.1016/j.amjoto.2020.102736

Primary MALT lymphoma of the larynx is a rare condition first described in 1990. There have been only 43 reported cases as of 2015. The disease appears to be indolent in nature and responds well to radiation therapy. Symptoms are non-specific and may be limited to a combination of hoarseness, sore throat, shortness of breath, or cough. We describe two cases of subglottic laryngeal MALT lymphoma identified from one academic medical center within five years of each other. Though identical in pathology, the presentation of the two cases were distinct in both patient demographic and tumor appearance. One patient required dilation of a subglottic stenosis caused by tumor, and the other required surgical debulking of a ball-valve-like mass. Neither patient presented with B-symptoms (fever, night sweats, weight loss) that often characterize other lymphomas. In both cases, histopathological exam revealed extensive infiltration of mucosa with atypical monomorphous lymphocytes, consistent with MALT lymphoma. MALT lymphoma of the larynx may present with non-specific symptoms such as cough and/or hoarseness. Thorough evaluation including flexible laryngoscopy should be performed should these symptoms persist without a known cause. Surgical biopsy and histopathological exam are crucial to determine the etiology of unknown subglottic masses.