Non-Hodgkin lymphoma of the larynx: CT and MR imaging findings

BACKGROUND AND PURPOSE: Non-Hodgkin lymphoma (NHL) of the larynx is a rare tumor. The aim of this study was to report the CT and MR features of laryngeal NHL in four patients to determine if there are any features that might be helpful to distinguish NHL from other laryngeal tumors. METHODS: The CT and MR images of four patients with laryngeal NHL were retrospectively reviewed for tumor volume and distribution, appearance, local invasion, and lymphadenopathy. RESULTS: Tumor volume ranged from 4 to 45 mL(3). Tumor was based in the submucosal (2/4 [50%]), mucosal (1/4 [25%]), or both regions (1/4 [25%]) and was centered in the supraglottis (4/4 [100%]) but also involved the glottis (4/4 [100%]) and subglottis (2/4 [50%]). Laryngeal tumor involved the aryepiglottic folds (4/4 [100%)]), ventricles and false cords (4/4 [100%]), epiglottis (3/4 [75%]), paraglottis (3/4 [75%]), true cords (4/4 [100%]), anterior commissure (4/4 [100%]), and laryngeal cartilage (1/4 [25%]). The tumor extended into the hypopharynx (4/4 [100%]), strap muscles (1/4 [25%]), prevertebral muscles (1/4 [25%]), tongue base (1/4 [25%]), and walls of the oropharynx (1/4 [25%]) and nasopharynx (1/4 [25%]). Bilateral cervical lymphadenopathy with extracapsular tumor spread was present in one patient. CONCLUSION: Laryngeal NHL is a tumor that usually has a large submucosal component centered in the surpaglottis. The tumor extends into the glottis, with less frequent spread to the subglottis, laryngeal cartilage, and strap muscles. Laryngeal NHL also involves the hypopharynx, with large tumors extending superiorly into the tongue base, oropharynx, and nasopharynx. A laryngeal tumor with a large supraglottic submucosal component should alert the ragiologist to the possibility of NHL.