Primary Parotid Non-Hodgkin’s B-Cell Lymphoma in an Elderly Woman on Pembrolizumab for Metastatic Invasive Papillary Urothelial Cell Carcinoma of the Bladder

Author:

Osumo Bismarck1,Radzevich Joseph1,Nashed Nadia2,Ustwani Omar3,Slotman Gus1

Affiliation:

1. Departments of Surgery, Inspira Health Network, Vineland, NJ, USA

2. Departments of Pathology, Inspira Health Network, Vineland, NJ, USA

3. Departments of Medicine, Inspira Health Network, Vineland, NJ, USA

Abstract

Primary lymphomas of the parotid are rare (4-5%) and seldom appear in patients with pre-existing metastatic cancer from other primary sources. We present a primary marginal zone B-cell lymphoma of the mucosaassociated lymphoid tissue (MALT) in an 84-year-old female with preexisting metastatic bladder cancer. A PET scan that identified positive pelvic/cervical lymphadenopathy and bilateral parotid masses. She underwent transurethral resection of a bladder tumor and started on pembrolizumab chemotherapy. After two years, the left parotid mass decreased in size but the right increased to 3.9cm. Right superficial parotidectomy diagnosed B-Cell Marginal zone lymphoma, staining positive for CD20, PAX5, and Bcl2. pembrolizumab was held and the patient was started on 4 weekly rituximab infusions. A PET scan done 3 months after completion of rituximab showed a good response to chemotherapy. This is the first reported case of a primary parotid gland lymphoma in a patient with active metastatic bladder cancer.

Publisher

SAGE Publications

Subject

General Medicine

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