Small B cell lymphocytic lymphoma presenting as obstructive sleep apnea

• Main Authors: Chang Weng-Cheng, Lin Chia-Der, Cheng Yuan-Kai, Tsou Yung-An, Tsai Ming-Hsui
• Format: Article
• Language: English
• Published: BMC 2004-07-01
• Series: World Journal of Surgical Oncology
• Online Access: http://www.wjso.com/content/2/1/26

<p>Abstract</p> <p>Background</p> <p>Most lymphomas that involve the tonsil are large B cell lymphomas. Large B-cell lymphoma is a high grade malignancy which progresses rapidly. Tonsillar lymphoma usually presents as either a unilaterally enlarged palatine tonsil or as an ulcerative and fungating lesion over the tonsillar area. Small lymphocytic lymphomas (SLL) of the Waldeyer's ring are uncommon.</p> <p>Case presentation</p> <p>We report a 41-year-old male who presented with a ten-year history of snoring. Physical examination revealed smooth bilateral symmetrically enlarged tonsils without abnormal surface change or cervical lymphadenopathy. Palatal redundancy and a narrowed oropharyngeal airway were also noted. The respiratory disturbance index (RDI) was 66 per hour, and severe obstruction sleep apnea (OSA) was suspected. No B symptoms, sore throat, odynophagia or dysphagia was found. We performed uvulopalatopharyngoplasty (UPPP) and pathological examination revealed incidental small B-cell lymphocytic lymphoma (SLL).</p> <p>Conclusion</p> <p>It is uncommon for lymphoma to initially present as OSA. SLL is an indolent malignancy and is not easy to detect in the early stage. We conclude that SLL may be a contributing factor of OSA in the present case.</p>