Management of neurotropic low-grade B-cell lymphoma: report of two cases.

Abstract

Low-grade lymphomas do not commonly involve the central or peripheral nervous system. Case report and review of the literature of two cases of B-cell lymphoma of the extranodal marginal zone type involving the head and neck region with evidence of extensive neurotropism are detailed in this report. One patient was initially seen with a mass in the temporalis muscle and the other with a masticator space mass. The clinical course was indolent in both cases, although associated imaging studies suggested a more aggressive tumor. Both patients were treated with moderate-dose radiotherapy only. At the time of writing, one patient has no evidence of disease 6.5 years after treatment and the other at 6 months. This suggests that some marginal zone lymphomas exhibit a low-grade clinical course despite an aggressive radiographic pattern of perineural and neurotropic spread. This type of lymphoma might be effectively treated with moderate-dose radiotherapy.