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The most commonly encountered lesions arising from the epiglottic valleculae are benign cysts. Malignancy, particularly lymphoma, is infrequently encountered. Small lymphocytic lymphoma has never been described as being diagnosed from a vallecular biopsy. A patient with the previous history of small lymphocytic lymphoma was referred to the otolaryngology department with a seemingly innocent vallecular cyst causing globus symptoms. The lesion was biopsied using a channeled flexible nasolaryngoscope yielding a diagnosis of small lymphocytic lymphoma. This case demonstrates the importance of maintaining a high level of suspicion for rarer differential diagnoses, even for benign-appearing lesions, in patients with pertinent previous medical history. The diagnostic workup described employs a biopsy under local anesthesia in an outpatient clinic setting, avoiding the risk of general anesthesia in a patient with significant comorbidities.
Cite this article as: Cooper F, Bashat G, Preston G, Asimakopoulos P, Shakeel M. Small lymphocytic lymphoma masquerading as a vallecular mucous retention cyst. B-ENT. 2022;18(4):298-301.