We report a case of primary extranodal non-Hodgkin’s lymphoma of the parapharyngeal space. A 47-year-old female patient presented with a rapidly increasing right infraauricular firm mass. Oropharyngeal examination revealed a medially displaced right
lateral oropharyngeal wall and tonsil. Parotid CT and MR scans showed a huge dumbbell-shaped mass in Rt. parotid gland and parapharyngeal space with carotid artery and internal jugular vein displacement. Fine needle aspiration cytology of Rt.
Infraauricular mass was taken and reported as reactive hyperplasia, predominantly polymorphous lymphoid cells. Under general anestheisa, transparotid and transcervical approach was done and huge mass in Rt. parapharyngeal space was removed completely. The mass was confirmed as an extranodal marginal zone B-cell lymphoma (Stage II(AE)). The patient received a combination chemotherapy (cytoxan, adriamycin, oncovin, prednisolone) and no evidence of recurrence was noted during a 7-month follow-up period. This condition especially required communication between the surgeon and the pathologist, as it was essential to prevent an incorrect or delayed diagnosis. Although extranodal non-Hogkin’s lymphoma of the parapharyngeal space is rare and difficult to
diagnose pre-operatively, an accurate early diagnosis and proper surgical intervention may result in good prognosis.
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