Posters
Presenting Author Academic/Professional Position
Medical Student
Academic Level (Author 1)
Medical Student
Academic Level (Author 2)
Medical Student
Discipline Track
Clinical Science
Abstract Type
Case Report
Abstract
Background: Lymphoma is a malignancy of lymphocytes, which are progenitors to B-cell lymphocytes and T-cell lymphocytes (Padala and Kallam 2025). Diffuse large B-cell lymphoma (DLBCL) is the most common subtype of non-Hodgkin lymphoma (31% of adult cases), typically presenting in males in their 60s (Thandra, Barsouk et al. 2021). Typical B symptoms include fever, night sweats, and weight loss; however, atypical presentations can delay diagnosis and treatment. Prompt treatment of DLBCL is crucial to maximize the chances of remission and potential cure. Treatment depends on staging and disease type but with appropriate chemotherapy, survival can be long and possibly curative. Within patients that achieve complete remission, up to 50% of them will be cured (Padala and Kallam 2025). This emphasizes the significance of prompt diagnosis and administration of treatment. This study aimed to depict a rare presentation of DLBCL initially manifesting as isolated, painless parotitis and to emphasize the importance of thorough evaluation and follow-up in the setting of persistent lymphadenopathy.
Methods: A 65-year-old white male presented with three weeks of painless right-sided parotitis. Initial outpatient treatment with amoxicillin-potassium clavulanate and ibuprofen failed to resolve symptoms. Upon follow-up, a new left inguinal mass was noted one week later. Imaging via CT and PET scan revealed extensive lymphadenopathy, pulmonary nodules, and hypermetabolic lesions in the sinuses, cervical lymph nodes, ribs, vertebrae, and adrenal glands. Biopsy of a cervical lymph node confirmed DLBCL, non-germinal center B-cell type, with high Ki-67 proliferation index and expression of CD20, PAX5, BCL6, BCL2, and mum-1. The patient had elevated levels of LDH and a family history of multiple malignancies, including pancreatic and breast cancers
Results/ Anticipated Outcome: The diagnosis of stage IV DLBCL was made based on PET imaging and histopathology. The patient was asymptomatic at oncology evaluation but had significant cervical and inguinal lymphadenopathy on physical exam. Prophylactic allopurinol was started, and R-CHOP chemotherapy with high-dose methotrexate was recommended due to possible CNS involvement. Genetic testing for the ATM mutation was recommended, given the family history.
Conclusion/Impact: This case underscores the importance of considering lymphoma in the differential diagnosis of painless parotitis, particularly in older adults with persistent lymphadenopathy and complex family cancer history. Early recognition and comprehensive workup are critical in preventing rapid disease progression and initiating timely treatment.
Presentation Type
Poster
Recommended Citation
Guillory, Mary Arden G. and Holubar, Ashlyn, "Diffuse large B-cell lymphoma presenting as painless parotitis in a 65-year-old male: A case report" (2025). Research Colloquium. 67.
https://scholarworks.utrgv.edu/colloquium/2025/posters/67
Included in
Diffuse large B-cell lymphoma presenting as painless parotitis in a 65-year-old male: A case report
Background: Lymphoma is a malignancy of lymphocytes, which are progenitors to B-cell lymphocytes and T-cell lymphocytes (Padala and Kallam 2025). Diffuse large B-cell lymphoma (DLBCL) is the most common subtype of non-Hodgkin lymphoma (31% of adult cases), typically presenting in males in their 60s (Thandra, Barsouk et al. 2021). Typical B symptoms include fever, night sweats, and weight loss; however, atypical presentations can delay diagnosis and treatment. Prompt treatment of DLBCL is crucial to maximize the chances of remission and potential cure. Treatment depends on staging and disease type but with appropriate chemotherapy, survival can be long and possibly curative. Within patients that achieve complete remission, up to 50% of them will be cured (Padala and Kallam 2025). This emphasizes the significance of prompt diagnosis and administration of treatment. This study aimed to depict a rare presentation of DLBCL initially manifesting as isolated, painless parotitis and to emphasize the importance of thorough evaluation and follow-up in the setting of persistent lymphadenopathy.
Methods: A 65-year-old white male presented with three weeks of painless right-sided parotitis. Initial outpatient treatment with amoxicillin-potassium clavulanate and ibuprofen failed to resolve symptoms. Upon follow-up, a new left inguinal mass was noted one week later. Imaging via CT and PET scan revealed extensive lymphadenopathy, pulmonary nodules, and hypermetabolic lesions in the sinuses, cervical lymph nodes, ribs, vertebrae, and adrenal glands. Biopsy of a cervical lymph node confirmed DLBCL, non-germinal center B-cell type, with high Ki-67 proliferation index and expression of CD20, PAX5, BCL6, BCL2, and mum-1. The patient had elevated levels of LDH and a family history of multiple malignancies, including pancreatic and breast cancers
Results/ Anticipated Outcome: The diagnosis of stage IV DLBCL was made based on PET imaging and histopathology. The patient was asymptomatic at oncology evaluation but had significant cervical and inguinal lymphadenopathy on physical exam. Prophylactic allopurinol was started, and R-CHOP chemotherapy with high-dose methotrexate was recommended due to possible CNS involvement. Genetic testing for the ATM mutation was recommended, given the family history.
Conclusion/Impact: This case underscores the importance of considering lymphoma in the differential diagnosis of painless parotitis, particularly in older adults with persistent lymphadenopathy and complex family cancer history. Early recognition and comprehensive workup are critical in preventing rapid disease progression and initiating timely treatment.
