Unusual Presentation of Oropharyngeal B-Cell Lymphoma

We present the intriguing case of a 64-year-old woman in good health complaining of dysphonia and odynophagia for about 2 months. Flexible fiberoptic laryngoscopy revealed an excavated lesion on the right side of the base of the tongue, which was in communication with the laryngeal vestibule through the epiglottis. The patient underwent biopsy of the lesion by microlaryngoscopy under general anesthesia. Histological evaluation of the surgical specimen revealed a high-grade diffuse large B-cell lymphoma of non-germinal center type. Excavated lesion at the base of the tongue may be of various types, and it is important to consider rarer differential diagnoses, especially in patients with clinical histories not suggestive of squamous cell carcinomas or lesions of infectious origin. Non-Hodgkin's lymphomas arising from the base of the tongue are very rare. Moreover, this lesion is usually described in the literature as a swelling with an intact and smooth surface, totally different from that of our patient. The aim of this report is to examine clinically, endoscopically, and radiologically the main differential diagnoses of an excavated lesion of the base of the tongue, focusing on one of the rarest ones, large B-cell lymphoma of the oropharynx.