Lymphomas presenting as lumps in the parotid region.

The clinical and pathological features of 17 patients who had lymphomas of the parotid region are discussed. Although it is in general impossible on clinical grounds to make a pathological diagnosis on clinical examination of a lump in the parotid region, features which are not typically seen in the majority of patients with parotid lumps, but which were present in 11 (65 per cent) of those patients, are emphasized. Multiple ipsilateral and bilateral lumps were seen in 30 per cent of our patients with lymphomas of the parotid region. However, these are statistically more likely to indicate the benign adenolymphoma. Palpable lymph nodes were seen in association with the parotid mass in 53 per cent of our patients. Whereas a clinical diagnosis cannot be established simply by the presence of an enlarged lymph node in association with the parotid lump, we suggest that the probability of the lump being a lymphoma is sufficient to justify biopsy of the lymph node as a first line of treatment. Biopsy of associated palpable lymph nodes enabled the diagnosis to be made in seven out of eight patients subjected to biopsy, and avoided the necessity for parotidectomy in these patients.