Abstract
A patient with swelling of the left parotid gland of four-months' duration, sicca syndrome (xerophthalmia and xerostomia) and a history of progressive systemic sclerosis with an incomplete form of the CREST syndrome was referred to our department. On ultrasound a parotid mass of reduced echogenicity without any enlarged cervical lymph nodes was found. Ultrasonographically guided fine-needle biopsy could not provide any definitive diagnosis. After partial parotidectomy with complete tumor removal the histologic exam showed an extramedullary plasmacytoma with concurrent non-necrotizing granulomatous sialadenitis of the parotid gland. Complete systemic work-up excluded multiple myeloma, leukemia, lymphoma and sarcoidosis. Post-operative radiotherapy of the left parotid region and left neck including the supraclavicular lymph node area was performed. Six months after surgery an aggressive B-cell non-Hodgkin's lymphoma was diagnosed.
MeSH terms
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Aged
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Antibodies, Monoclonal / administration & dosage
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Antibodies, Monoclonal, Murine-Derived
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Antineoplastic Combined Chemotherapy Protocols / administration & dosage
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Antineoplastic Combined Chemotherapy Protocols / therapeutic use
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Biopsy, Needle
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Bone Marrow / pathology
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CREST Syndrome / diagnosis
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Cyclophosphamide / administration & dosage
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Doxorubicin / administration & dosage
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Follow-Up Studies
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Granuloma / diagnosis*
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Granuloma / pathology
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Granuloma / radiotherapy
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Granuloma / surgery
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Humans
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Lymphoma, B-Cell / diagnosis*
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Lymphoma, B-Cell / pathology
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Male
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Neoplasms, Radiation-Induced / diagnosis*
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Neoplasms, Radiation-Induced / drug therapy
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Neoplasms, Radiation-Induced / pathology
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Neoplasms, Second Primary / diagnosis*
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Neoplasms, Second Primary / drug therapy
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Neoplasms, Second Primary / pathology
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Parotid Gland / pathology
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Parotid Gland / radiation effects
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Parotid Gland / surgery
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Parotid Neoplasms / diagnosis*
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Parotid Neoplasms / pathology
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Parotid Neoplasms / radiotherapy
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Parotid Neoplasms / surgery
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Parotitis / diagnosis*
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Parotitis / pathology
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Parotitis / radiotherapy
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Parotitis / surgery
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Plasmacytoma / diagnosis*
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Plasmacytoma / pathology
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Plasmacytoma / radiotherapy
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Plasmacytoma / surgery
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Postoperative Complications / diagnosis
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Postoperative Complications / pathology
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Prednisone / administration & dosage
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Rituximab
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Vincristine / administration & dosage
Substances
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Antibodies, Monoclonal
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Antibodies, Monoclonal, Murine-Derived
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Rituximab
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Vincristine
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Doxorubicin
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Cyclophosphamide
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Prednisone