Beyond the Masquerade: Primary Follicular Lymphoma Mimicking a Parotid Gland Tumor

Abstract

Primary follicular lymphoma (PFL) is an uncommon subset of non-Hodgkin lymphoma known for its indolent nature, predominantly afecting lymph nodes. This report presents a rare case of PFL manifesting in the parotid gland, posing challenges in diagnosis and management. A 74-year-old female with pre-auricular swelling underwent diagnostic procedures, including contrast-enhanced computed tomography and fne needle aspiration cytology (FNAC), leading to an initial suspicion of pleomorphic adenoma. Subsequent core needle biopsy confrmed the diagnosis of PFL, highlighting the need for comprehensive diagnostic approaches in unusual presentations. Notably, the patient’s favorable response to chemotherapy aligns with the typical indolent behavior of follicular lymphomas, emphasizing the importance of accurate diagnosis for tailored therapeutic interventions. This case underscores the signifcance of considering lymphoid malignancies in the diferential diagnosis of parotid gland masses and contributes valuable insights into the diagnostic and management complexities of PFL in extranodal sites. Clinicians should remain vigilant to such atypical presentations, recognizing the importance of a multimodal diagnostic approach and personalized treatment strategies.