Small Lymphocytic Lymphoma Masquerading as a Vallecular Mucous Retention Cyst

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.