Panel Discussion: Myeloma & Lymphoma

Non-Hodgkin’s lymphoma (NHL) is the third most frequent malignant tumour in the head and neck, basocellular carcinoma of the skin and mucosal squamous cell carcinoma being the most frequent. Although nodal enlargement is the most common presentation in the head and neck, NHL may occur in extranodal locations. Two distinct extranodal sites are recognised: extranodal lymphatic locations or involvement of the ring of Waldeyer, and extranodal extralymphatic locations. Neck extranodal NHL does not show pathognomonic imaging signs. However, if more than one extranodal mass is detected, if the mass appears huge without necrosis or ulceration, or when associated with large, non-necrotic adenopathies, the diagnosis of NHL can be suggested. The possibility of NHL should be kept open in any infiltrating soft tissue mass in the head and neck region. While fine needle aspiration is often helpful to reach a diagnosis of squamous cell carcinoma, formal biopsy is usually required to diagnose lymphoma. Head and neck Hodgkin’s lymphoma is less common than NHL. Furthermore, extranodal involvement only rarely occurs in Hodgkin’s lymphoma.