Extranodal Malignant Lymphoma Originating from the Parapharyngeal Space: Two Cases

Abstract

Parapharyngeal space tumors develop deep inside the body and present with a wide variety of histological types, making them difficult to diagnose and treat. Here, we report two cases of lymphomas originating from the parapharyngeal space. Case 1: A 47-year-old man complaining of right facial numbness and right ear pain was found to have a tumor extending from the right parapharyngeal space to the skull base on magnetic resonance imaging. He underwent a biopsy under general anesthesia and was diagnosed with diffuse large B cell lymphoma. Case 2: A 60-year-old man presenting with left neck pain underwent a nasopharyngeal biopsy under general anesthesia for a tumor in the left parapharyngeal space, although a diagnosis could not be reached. After biopsy, the tumor enlarged dramatically and extended into the neck and skull base along the parapharyngeal space. A needle biopsy from below the left ear led to a diagnosis of diffuse large B cell lymphoma. Both patients underwent R-CHOP therapy and survived; their tumors were found to have disappeared on imaging investigations. Parapharyngeal space tumors, which extend diffusely along the parapharyngeal space to the neck and skull base, it is highly likely to be malignant lymphomas if the patient complains of intense pain.