Neck Lymphoma

  • Frank A. Pameijer
  • Rick L. M. Haas
Part of the Medical Radiology book series (MEDRAD)


About 5% of malignant lymphomas in the head and neck are lymphomas. Frequently, lymphoma is not limited to the head and neck region, but also involves other parts of the body. The work-up of a patient with lymphoma requires a multidisciplinary approach. This chapter approaches lymphoma as a systemic disease describing the imaging work-up of patients with newly diagnosed head and neck lymphoma. This includes discussion of commonly applied imaging techniques such as, chest X-ray, computed tomography (CT), ultrasound, magnetic resonance imaging, and metabolic imaging (PET-CT). Both nodal disease, as well as non-nodal lymphoma manifestations (e.g. in Waldeyer’s ring, larynx, orbit, lacrimal gland, parotid gland, sinonasal cavities, thyroid and bone) are discussed and illustrated with examples from daily practice. Frequently, imaging findings are non-specific. However, some imaging patterns can suggest the diagnosis of lymphoma.


Parotid Gland Malignant Lymphoma Lacrimal Gland Mucosa Associate Lymphoid Tissue Lymphoma Primary Lymphoma 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


  1. Abbondanzo SL (2001) Extranodal marginal-zone B-cell lymphoma of the salivary gland. Ann Diagn Pathol 5:246–254PubMedCrossRefGoogle Scholar
  2. Agulnik M, Tsang R, Baker MA et al (2001) Malignant lymphoma of mucosa-associated lymphoid tissue of the lacrimal gland: case report and review of literature. Am J Clin Oncol 24:67–70PubMedCrossRefGoogle Scholar
  3. Aloulou S, Farhat H, Bosq J et al (2002) Hodgkin’s disease primarily involving the oropharynx: case report and review of the literature. Hematol J 3:164–167PubMedCrossRefGoogle Scholar
  4. Ansell SM, Grant CS, Habermann TM (1999) Primary thyroid lymphoma. Semin Oncol 26:316–323PubMedGoogle Scholar
  5. Berti E, Alessi E, Caputo R et al (1988) Reticulohistiocytoma of the dorsum. J Am Acad Dermatol 19:259–272PubMedCrossRefGoogle Scholar
  6. Cartwright R, Brincker H, Carli PM et al (1999) The rise in incidence of lymphomas in Europe 1985–1992. Eur J Cancer 35:627–633PubMedCrossRefGoogle Scholar
  7. Cheson BD (2008) New response criteria for lymphomas in clinical trials. Ann Oncol 19:iv35–iv38PubMedCrossRefGoogle Scholar
  8. Cheson BD, Horning SJ, Coiffier B et al (1999) Report of an international workshop to standardize response criteria for non-Hodgkin’s lymphomas. J Clin Oncol 17:1244–1253PubMedGoogle Scholar
  9. Cheson BD, Pfistner B, Juweid ME et al (2007) Revised response criteria for malignant lymphoma. J Clin Oncol 25:579–586PubMedCrossRefGoogle Scholar
  10. Chisin R, Weber AL (1994) Imaging of lymphoma manifestations in the extracranial head and neck region. Leuk Lymphoma 12:177–189PubMedCrossRefGoogle Scholar
  11. Dimopoulos MA, Kiamouris C, Moulopoulos LA (1999) Solitary plasmacytoma of bone and extramedullary plasmacytoma. Hematol Oncol Clin North Am 13:1249–1257PubMedCrossRefGoogle Scholar
  12. Fehr-Merhof A, Flury R, Ruttimann S (1999) From Hashimoto thyroiditis to B-cell lymphoma of the thyroid gland. Schweiz Med Wochenschr 129:883–889PubMedGoogle Scholar
  13. Foss F (2004) Mycosis fungoides and the Sezary syndrome. Curr Opin Oncol 16:421–428PubMedCrossRefGoogle Scholar
  14. Gritzmann N, Rettenbacher T, Hollerweger A et al (2003) Sonography of the salivary glands. Eur Radiol 13:964–975PubMedGoogle Scholar
  15. Hanna E, Wanamaker J, Adelstein D et al (1997) Extranodal lymphomas of the head and neck. A 20-year experience. Arch Otolaryngol Head Neck Surg 123:1318–1323PubMedCrossRefGoogle Scholar
  16. Harnsberger RH (2004) Diagnostic imaging head and neck. 1st edn. Amirsys, Salt lake City, UtahGoogle Scholar
  17. Harris NL, Jaffe ES, Stein H et al (1994) A revised European-American classification of lymphoid neoplasms: a proposal from the International Lymphoma Study Group. Blood 84:1361–1392PubMedGoogle Scholar
  18. Harris NL, Jaffe ES, Diebold J et al (2000) World Health Organization classification of neoplastic diseases of the hematopoietic and lymphoid tissues: report of the Clinical Advisory Committee meeting-Airlie House, Virginia, November 1997. J Clin Oncol 17:3835–3849Google Scholar
  19. Hermans R (2004) Extranodal lymphoma—neck. Cancer Imaging 4:1–5CrossRefGoogle Scholar
  20. Hermans R, Horvath M, De Schrijver T et al (1994) Extranodal non-Hodgkin lymphoma of the head and neck. J Belge Radiol 77:72–77PubMedGoogle Scholar
  21. Jemal A, Siegel R, Ward E et al (2007) Cancer tatistics. CA Cancer J Clin 57:43–66PubMedCrossRefGoogle Scholar
  22. Jerusalem G, Beguin Y, Najjar F et al (2001) Positron emission tomography (PET) with 18F-fluorodeoxyglucose (18F-FDG) for the staging of low-grade non-Hodgkin’s lymphoma (NHL). Ann Oncol 12:825–830PubMedCrossRefGoogle Scholar
  23. Kesari S, Bundock EA (2004) Punched-out skull. Arch Neurol 61:958–959PubMedCrossRefGoogle Scholar
  24. King AD, Lei KI, Richards PS et al (2003) Non-Hodgkin’s lymphoma of the nasopharynx: CT and MR imaging. Clin Radiol 58:621–625PubMedCrossRefGoogle Scholar
  25. King AD, Yuen EH, Lei KI et al (2004) Non-Hodgkin lymphoma of the larynx: CT and MR imaging findings. Am J Neuroradiol 25:12–15PubMedGoogle Scholar
  26. Kirshenbaum KJ, Nadimpalli SR, Friedman M et al (1991) Benign lymphoepithelial parotid tumors in AIDS patients: CT and MR findings in nine cases. Am J Neuroradiol 12:271–274PubMedGoogle Scholar
  27. Koom WS, Chung EJ, Yang WI et al (2004) Angiocentric T-cell and NK/T-cell lymphomas: radiotherapeutic viewpoints. Int J Radiat Oncol Biol Phys 59:1127–1137PubMedCrossRefGoogle Scholar
  28. Kwee ThC, Takahara T, Ochiai R et al (2008) Diffusion-weighted whole-body imaging with background body signal suppression (DWIBS): features and potential applications in oncology. Eur Radiol 18:1937–1952PubMedCrossRefGoogle Scholar
  29. Kwee ThC, Quarles van Ufford HME, Beek FJ et al (2009) Whole-Body MRI, including Diffusion-Weighted Imaging, for the initial staging of malignant lymphoma. Invest Radiol 44:683–690PubMedCrossRefGoogle Scholar
  30. Lee JL, Kim MK, Lee KH et al (2005) Extranodal marginal zone B-cell lymphomas of mucosa-associated lymphoid tissue-type of the orbit and ocular adnexa. Ann Hematol 84:13–18PubMedCrossRefGoogle Scholar
  31. Lister TA, Crowther D, Sutcliffe SB et al (1989) Report of a committee convened to discuss the evaluation and staging of patients with Hodgkin’s disease: Cotswolds meeting. J Clin Oncol 7:1630–1636PubMedGoogle Scholar
  32. Mancuso AA (1998) Lymphoma: master of chicanery (editorial). Am J Neuroradiol 19:1808PubMedGoogle Scholar
  33. Mendenhall WM, Mendenhall CM, Mendenhall NP (2003) Solitary plasmacytoma of bone and soft tissues. Am J Otolaryngol 24:395–399PubMedCrossRefGoogle Scholar
  34. Michels JJ, Delcambre C, Marnay J et al (2002) Primary thyroid lymphomas: clinicopathologic study of 30 cases and review of the literature. Ann Pathol 22:10–17PubMedGoogle Scholar
  35. Moog F, Bangerter M, Diederichs CG et al (1997) Lymphoma: role of whole-body 2-deoxy-2-[F-18]fluoro-d-glucose (FDG) PET in nodal staging. Radiology 203:795–800PubMedGoogle Scholar
  36. Muwakkit SA, Razzouk BI, Shabb NS et al (2004) Clinical presentation and treatment outcome of children with Burkitt lymphoma in Lebanon: a single institution’s experience. J Pediatr Hematol Oncol 26:749–753PubMedCrossRefGoogle Scholar
  37. Palacios E, Larusso G, Rojas R et al (2004) Lymphoma of the parotid gland in Sjőgren’s syndrome. Ear Nose Throat J 83:156PubMedGoogle Scholar
  38. Pfeffer MR, Rabin T, Tsvang L et al (2004) Orbital lymphoma: is it necessary to treat the entire orbit? Int J Radiat Oncol Biol Phys 60:527–530PubMedCrossRefGoogle Scholar
  39. Rao CR, Gutierrez MI, Bhatia K et al (2000) Association of Burkitt’s lymphoma with the Epstein-Barr virus in two developing countries. Leuk Lymphoma 39:329–337PubMedCrossRefGoogle Scholar
  40. Shields JA, Shields CL, Scartozzi R (2004) Survey of 1264 patients with orbital tumors and simulating lesions. Ophthalmology 111:997–1008PubMedCrossRefGoogle Scholar
  41. Smithers DW (1971) Summary of papers delivered at the Conference on Staging in Hodgkin’s Disease (Ann Arbor). Cancer Res 31:869–870Google Scholar
  42. Som P, Curtin H, Mancuso A (2000) Imaging-based classification for evaluation of neck metastatic adenopathy Am J Roentgenol 174:837–844Google Scholar
  43. Takahara T, Imai Y, Yamashita T et al (2004) Diffusion weighted whole body imaging with background body signal suppression (DWIBS): technical improvement using free breathing, STIR and high resolution 3D display. Radiat Med 22:275–282PubMedGoogle Scholar
  44. Takashima S, Nomura N, Noguchi Y et al (1995) Primary thyroid lymphoma: evaluation with US, CT and MRI. J Comput Assist Tomogr 19:282–288PubMedCrossRefGoogle Scholar
  45. Tart RP, Mukherji SK, Avino AJ et al (1993) Facial lymph nodes: normal and abnormal CT appearance. Radiology 188:695–700PubMedGoogle Scholar
  46. Therasse P, Arbuck SG, Eisenhauer EA et al (2000) New guidelines to evaluate the response to treatment in solid tumors. European Organization for Research and Treatment of Cancer, National Cancer Institute of the United States, National Cancer Institute of Canada. J Natl Cancer Inst 92:205–216PubMedCrossRefGoogle Scholar
  47. Tonami H, Matoba M, Yokota H et al (2002) Mucosa-associated lymphoid tissue lymphoma in Sjőgren’s syndrome: initial and follow-up imaging features. Am J Roentgenol 179:485–489Google Scholar
  48. Tonami H, Matoba M, Kuginuki Y et al (2003) Clinical and imaging findings of lymphoma in patients with Sjőgren’s syndrome. J Comput Assist Tomogr 27:517–524PubMedCrossRefGoogle Scholar
  49. UICC (2009) TNM classification of malignant tumours, 7th edn. Springer, Berlin Heidelberg Google Scholar
  50. Vose JM, Chiu BC, Cheson BD et al (2002) Update on epidemiology and therapeutics for non-Hodgkin’s lymphoma. Hematology 1:241–262CrossRefGoogle Scholar
  51. Weber AL, Randolph G, Aksoy FG (2000) The thyroid and parathyroid glands. CT and MR imaging and correlation with pathology and clinical findings. Radiol Clin North Am 38:1105–1129PubMedCrossRefGoogle Scholar
  52. Weber AL, Rahemtullah A, Ferry JA (2003) Hodgkin and non-Hodgkin lymphoma of the head and neck: clinical, pathologic, and imaging evaluation. Neuroimaging Clin N Am 13:371–392PubMedCrossRefGoogle Scholar
  53. Widder S, Pasieka JL (2004) Primary thyroid lymphomas. Curr Treat Options Oncol 5:307–313PubMedCrossRefGoogle Scholar
  54. World Health Organization Classification of Tumors (2001) Tumors of haematopoietic and lymphoid tissues. Jaffe ES, Harris HL, Stein H et al (eds). Oxford University Press, Oxford, pp 162–167Google Scholar
  55. Yan J, Wu Z, Li Y (2004) The differentiation of idiopathic inflammatory pseudotumor from lymphoid tumors of orbit: analysis of 319 cases. Orbit 23:245–254PubMedCrossRefGoogle Scholar
  56. Yuen A, Jacobs C (1999) Lymphomas of the head and neck. Semin Oncol 26:338–345PubMedGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 2011

Authors and Affiliations

  1. 1.Department of RadiologyUniversity Medical Center UtrechtUtrechtThe Netherlands
  2. 2.Department of RadiotherapyThe Netherlands Cancer Institute–Antoni van Leeuwenhoek HospitalAmsterdamThe Netherlands

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