What Is Tonsillar Lymphoma?

Tonsillar lymphoma is a rare but highly treatable throat cancer that affects the tonsils. The most common treatment for this type of lymphoma is chemotherapy. Radiation and surgery to remove the tonsils are also options.

Your tonsils are lymphatic tissue at the back of your throat. Tonsillar lymphoma causes tumor growth on a tonsil and leads to symptoms such as chronic pain in the mouth, ears, and throat.

Tonsillar lymphoma typically responds very well to treatment and typically has a good outlook at diagnosis.

In this article, we take a closer look at the full range of symptoms, along with causes, diagnosis, and treatment.

Lymphoma is a cancer that affects your body’s lymphatic system, a part of your immune system.

Tonsillar lymphoma is a type of lymphoma that develops on the tonsils. Your tonsils are located in the back of your throat and are made of lymphoid tissue.

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There are two main subtypes of tonsillar lymphoma:

  • non-Hodgkin’s lymphoma
  • Hodgkin’s lymphoma

Tonsillar lymphoma is most often non-Hodgkin’s lymphoma and falls under a smaller subtype of non-Hodgkin’s called diffuse large B-cell lymphoma.

There are multiple symptoms of tonsillar lymphoma. Symptoms are very similar to another type of throat cancer, squamous cell carcinoma of the tonsils. This type of tonsil cancer is more common than tonsillar lymphoma. Only medical testing can diagnose which type of cancer is causing your symptoms.

Symptoms of tonsillar lymphoma include:

  • a mass (lump) in your neck
  • chronic sore throat
  • chronic and severe ear pain
  • chronic mouth pain
  • chronic bad breath
  • difficulty breathing
  • difficulty eating
  • one tonsil that appears larger than the other
  • blood in your saliva
  • intolerance to citrus foods and beverages

People with tonsillar lymphoma can sometimes experience general lymphoma symptoms. However, this is relatively rare. General symptoms of lymphoma include:

There isn’t a known cause of tonsillar lymphoma. It’s been linked with previous infections with viruses such as Epstein-Barr and human papillomavirus (HPV). However, there’s a clearer association between HPV and squamous cell carcinoma of the tonsils.

Beyond these viruses, known risks for tonsillar lymphoma include smoking and heavy alcohol use.

The first step to a lymphoma diagnosis is a medical appointment where you’ll discuss your symptoms, medical history, and family medical history with a doctor.

Your doctor will likely do a physical and visual exam of your throat. If they suspect you have tonsillar lymphoma, you’ll have a series of tests. These tests test will include:

  • Blood tests:Blood tests can measure the levels of blood cells and specific proteins in your blood. These levels can be a sign of lymphoma and lymphoma progression.
  • Imaging tests: Imaging tests, such as X-rays, CT scans, and positron emission tomography (PET) scans, allow doctors to get an up-close look at tonsil tumors and to see if they’ve begun to spread to areas such as your lungs.
  • Tonsil biopsy: If the primary tumor is located in a tonsil, a biopsy of that tonsil can provide a definitive diagnosis and also help to identify if the disease is contained within the tonsil or has spread to other sites.
  • Bone marrow biopsy: A bone marrow biopsy tests for cancer cells inside your bone marrow. It’s done by inserting a long and hollow needle into your hip bone.
  • Lumbar puncture: A lumbar puncture, also called a spinal tap, removes a sample of spinal fluid using a long and hollow needle. You might have this test done if your doctor suspects your tonsillar lymphoma has spread to your central nervous system.
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Your exact treatment plan for tonsillar lymphoma will likely depend on your stage at diagnosis and on your overall health. Common treatment options include:

  • Chemotherapy:Chemotherapy is the primary treatment for tonsillar lymphoma. It’s used to kill cancer cells and to stop the spread of cancer. Often, chemotherapy is used along with a medication called rituximab that helps chemotherapy fight lymphoma.
  • Radiation therapy:Radiation therapy also helps kill cancer cells. It can be used on its own or in combination with chemotherapy.
  • Surgery: Some people might have surgery to remove the tonsil affected by cancer.

Tonsillar lymphoma is typically highly treatable. It’s often diagnosed in the early stages and has an overall good prognosis. Factors such as overall health, treatment received, and your body’s response to treatment can all make a significant difference in the outcome.

Tonsillar lymphoma is rare, and there isn’t as much data on it as some, more common, types of cancer. It’s more difficult to estimate general outlooks for rarer cancer types with fewer people diagnosed and treated each year. However, the data that has been collected and analyzed on tonsillar lymphoma shows constantly high survival rates.

Multiple studies show overall 5-year survival rates of over 80%, with some studies indicating that people diagnosed in early stages have 5-year survival rates of over 95% .

What is a 5-year relative survival rate?

A 5-year relative survival rate is a measure of how many people with the disease are alive 5 years after diagnosis compared to people without the disease.

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