Hodgkin's disease of the nasopharynx can arise:
(1) in the lymphoid tissue of Waldeyer's ring
(2) outside of Waldeyer's ring
Both are considered extranodal sites.
Clinical and pathologic findings:
(1) Most patients are male.
(2) The patient may present with:
(2a) adenoidal hypertrophy causing nasal obstruction.
(2b) a polypoid mass
(3) Cervical lymphadenopathy may be present.
(4) A biopsy shows histologic features of Hodgkin's disease.
(5) Flow cytometry is negative for monoclonal T and B cell populations.
Complications:
(1) intracranial extension through the skull base with increased intracranial pressure
Differential diagnosis:
(1) nasopharyngeal carcinoma
(2) non-Hodgkin's lymphoma
(3) Epstein-Barr virus related lymphoproliferative disorder
The prognosis is usually good.
