Laryngeal Lymphoma: Before and After Chemotherapy.

1Lung Care and Sleep Centre, 2Internal Medicine, 3Medical Oncologist, Cancure Foundation, 4Oncosurgeon, Cancure Foundation, 5Chief Intensivist, 6Director : Lung Care and Sleep Centre, Fortis Hiranandani Hospital, Vashi, Navi Mumbai Received; 02.04.2012; Revised: 21.09.2012; Accepted: 05.04.2014 6 year old female with ischaemic heart disease admitted to critical care unit with worsening stridor and breathlessness because of large thyroid mass which was causing significant tracheal luminal compromise. Computed Tomography of Chest showed tracheal narrowing to about 4 mm. Tracheostomy tube placement was difficult due to large size of thyroid mass. She underwent emergency total thyroidectomy in view of worsening stridor. Histopathology (Figure 1) and immunohistochemistry showed high grade Non Hodgkin’s lymphoma [Large cell, B cell phenotype, CD 20 and CD 45 positive]. Flexible bronchoscopy which was done before decannulation of tracheostomy showed large cystic lesion in the left aryepiglottic fold with vocal cord oedema (Figure 2). Patient received prephase chemotherapy with Cyclophosphamide, Vincristine a n d p r e d n i s o l o n e [ C O P r e g i m e n ] in the post operat ive per iod. This was followed by 6 cycles of R-CEOP [ R i t u x i m a b , C y c l o p h o s p h a m i d e , Etoposide, Vincristine and Prednisolone]. Anthracycline was avoided as patient had ischaemic heart disease with LVEF of about 35%. Recheck bronchoscopy showed resolution of cystic lesion and normal vocal cords (Figure 3).