False Identity: Lymphoid Hyperplasia Imitating a Large Paraganglioma
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The danger of the parapharyngeal space mass comes from the small space and vital neighboring structures. Its differential diagnosis is broad, however benign lymphoid hyperplasia in this region has not been previously reported. The clinical presentation, imaging, surgical findings and pathology slides were reviewed in an adult patient with a parapharyngeal space mass. The literature on somatostatin-positive parapharyngeal space lesions was reviewed. A 51-year old male with otalgia for 3 months, hearing loss, and tinnitus underwent audiogram, revealing asymmetric hearing loss. Laryngoscopy demonstrated a paretic true vocal cord. Subsequent MRI demonstrated 4.5 cm post-styloid parapharyngeal space mass displacing the carotid artery anterolaterally. Octreoscan scan showed significant uptake of the somatostatin analog. Angiogram showed prominent vascular blush. The mass was excised transcervically and histopathology demonstrated lymphoid hyperplasia. This case demonstrates that post-styloid parapharyngeal masses may be lateral retropharyngeal nodes. An octreotide-positive lymphoid hyperplasia has never been previously reported.
KeywordsParaganglioma Parapharyngeal space Octreoscan
Compliance with Ethical Standards
Conflict of interest
Courtney Shires and Karuna Dewan declared that they have no conflict of interest.
Human and Animal Rights
All procedures performed were in accordance with the ethical standards of the institutional IRB and with the 1964 Helskinki declaration and its later amendments or comparable ethical standards.
Informed consent was obtained from the study patient. All treatments described here are within clinical standards of practice.
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