MedPeer Publisher

Nasopharyngeal lymphoma revealed by isolated odynophagia: a rare and misleading presentation

Authors

El Mehdi Harbili, Badr Amrani, Ahmed Rouihi, Mouad Moujoud, Mohamed Zalagh, Saloua Ouraini, Bouchaib Hemmaoui, Fouad Benariba, Noureddine Errami

Journal Information

Journal: Medpeer Publisher

ISSN: 3066-2737

Volume: 3

Issue: 7

Date of Publication: 2026/07/01

DOI: 10.70780/medpeer.000QGTZ

Abstract

Non-Hodgkin lymphoma of the nasopharynx is a rare entity among malignancies of the cavum, in contrast to undifferentiated carcinoma of nasopharyngeal type, which is far more frequent. It represents approximately 20–25% of lymphomas involving Waldeyer’s ring. We report the case of a 39-year-old man presenting with odynophagia and hypersalivation evolving over three months, associated with bilateral nasal obstruction, snoring, and significant weight loss. Clinical examination revealed multiple cervical lymphadenopathies and a downward displacement of the soft palate. Nasal endoscopy showed complete obstruction of the nasopharynx and choanae by a non-bleeding tumoral mass. Imaging demonstrated extensive locoregional disease with multiple cervical, mediastinal, and axillary lymphadenopathies, associated with bone involvement. Histopathological and immunohistochemical analysis of a biopsy specimen confirmed a diffuse large B-cell non-Hodgkin lymphoma. The disease was classified as stage IV according to the Lugano classification. The patient was treated with immunochemotherapy combined with radiotherapy. This case highlights odynophagia as an atypical revealing symptom of nasopharyngeal non-Hodgkin lymphoma and emphasizes the importance of histological diagnosis and appropriate staging for optimal management.

Keywords

Lymphoma, Non-Hodgkin; Diffuse large B-cell lymphoma; Nasopharynx; Nasopharyngeal neoplasms; Odynophagia; Waldeyer's ring; Immunochemotherapy.

Download PDF