Anaplastic Large Cell Lymphoma Masquerading as Submandibular Sialolithiasis

Anaplastic large cell lymphoma (ALCL) is an aggressive neoplasm of T- or null cell phenotype. It is rarely associated with a leukemic phase. Based on a structured literature review, salivary duct obstruction and sialolithiasis have not been reported as a presenting feature of lymphoma. Here, we report a case of a 74-year-old male who was initially referred to an otolaryngologist for sialolithiasis and was later found to have a rare and aggressive form of lymphoma on further evaluation. He was diagnosed with anaplastic lymphoma kinase (ALK) positive anaplastic large cell lymphoma with a leukemic phase complicated by multiorgan failure and tumor lysis syndrome, leading to death prior to the initiation of chemotherapy. The aim of this report is to make clinicians aware of this unusual presentation, as early recognition and timely referral to the appropriate specialist is important to prevent adverse outcomes. This also emphasizes the importance of exploring the underlying etiology of disease in addition to treating the disease itself, as presenting symptoms can mask the underlying etiology.