A 73-year-old male presented with bleeding from his tongue. He had a history of hypertension and diabetes for which he was taking medicines regularly. Moreover, he reported having shortness of breath for 48 hours due to an enlarged tongue.
Within the patient’s clinical documents, clinicians found a neck CT that indicated an enlarged tongue covered by a lesion. In addition, the scan showed enlarged submandibular and some cervical lymph nodes too. Furthermore, the patient reported having undergone surgery in the region.
Surgery To Remove the Tongue Lesion
Doctors performed a losangic biopsy under a combination of general and local anaesthesia. Intra-operatively, they found massively proliferative lymphoid tissue, suggesting a lymphoma. To make a definitive diagnosis, they sent the specimen for histopathological assay. The results confirmed a non- Hodgkin’s lymphoma (NHL).
Doctors also conducted CT scans of the thorax, abdomen and pelvis. Moreover, they did haematological studies and a bone marrow biopsy too. All of the findings were significant for non-Hodgkin’s lymphoma.
Suspicion of Relapse
Just a month after his initial visit, the patient showed up again. This time with complaints of severe dyspnea. On suspicion of a relapse, the doctors examined his oral cavity. His tongue had increased in size again. Moreover, there were ulcerative lesions on the tongue’s left margin and the adjoining ventral surface.
Doctors also did a laryngeal examination and found a constricted tracheal lumen. They performed an inferior tracheostomy to maintain the patient’s airway and gave him the necessary medical advice.
How Common is it For NHL to Affect Tongue?
Non-Hodgkin’s lymphoma rarely manifests on the tongue. However, we shouldn’t limit our list of differentials especially when there are enlarged regional lymph nodes accompanying lesions of the tongue. Early detection and timely management can significantly affect disease prognosis in such cases.