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Acta Otorrinolaringológica Española Head and neck manifestations of indolent T-cell lymphoproliferative disorder of ...
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Review article
Available online 7 July 2026

Head and neck manifestations of indolent T-cell lymphoproliferative disorder of the gastrointestinal tract: a systematic review

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Sarah Figueras-Pereza,
Corresponding author
sarah.figueras@scsalud.es

Corresponding author.
, Julia Cecilia Pipaón-Palominoa, Lucía Haro-Núñeza, Sonia Gonzalez-de-Villambrosia- Pellonb,c, Trinidad Dierssen-Sotosd,e, Carmelo Morales-Anguloa,f,g
a Department of Otolaryngology – Head and Neck Surgery, Hospital Universitario Marqués de Valdecilla, Santander, Spain
b Department of Hematology, Hospital Universitario Marqués de Valdecilla, (IDIVAL), Santander, Spain
c Cell Cycle, Stem Cell Fate and Cancer Laboratory (IDIVAL), Santander, Spain
d Professor of Preventive Medicine and Public Health, Department of Medical and Surgical Sciences. Faculty of Medicine, University of Cantabria, Spain
e CIBER Epidemiología y Salud Pública (CIBERESP), Spain
f Instituto de Investigación Sanitaria Valdecilla (IDIVAL), Cantabria, Spain
g Departamento de Ciencias Médicas y Quirúrgicas, Facultad de Medicina, Cantabria, Spain
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Abstract

Indolent T-cell lymphoproliferative disorder of the gastrointestinal tract (iTLPD-GI) is a rare lymphoproliferative disorder with a heterogeneous clinical presentation. Although primarily involving the gastrointestinal tract, head and neck manifestations have been sporadically reported and remain poorly characterized. We conducted a systematic review of case reports and case series, in accordance with PRISMA guidelines, to describe the otorhinolaryngological manifestations of iTLPD-GI and to facilitate early diagnosis and appropriate clinical management. MEDLINE/PubMed, LILACS, Cochrane Library and Web of Science Core Collection were searched to identify case reports and case series published from January 1995 to January 2026 that described head and neck involvement in patients with histologically confirmed iTLPD-GI. Ten studies comprising 13 patients with head and neck manifestations were identified. Patients ranged in age from 22 to 77 years and were predominantly male.

Oral and oropharyngeal ulcerations were observed in all patients with head and neck involvement, most frequently affecting the soft palate, while laryngeal involvement was reported in three cases. In eight patients, head and neck manifestations represented the initial presentation of the disease, including three cases with isolated oral or oropharyngeal lesions.

Lesions were predominantly ulcerative in appearance, whereas pseudotumoral presentations were less common. Most patients experienced recurrent spontaneous resolution of head and neck lesions, although some showed clinical improvement only after systemic treatment.

Head and neck involvement in iTLPD-GI, although rare, may precede gastrointestinal manifestations and should be considered in the differential diagnosis of persistent or treatment-resistant oral or oropharyngeal ulcers.

Keywords:
T-cell lymphoma
Head and neck
Oral ulcers
Larynx
Systematic review
Resumen

El trastorno linfoproliferativo indolente de células T del tracto gastrointestinal (iTLPD-GI) es una entidad rara con una presentación clínica heterogénea. Aunque afecta principalmente al tracto gastrointestinal, se han descrito de forma esporádica manifestaciones en cabeza y cuello, que en la actualidad permanecen pobremente caracterizadas. Se realizó una revisión sistemática de informes de casos y series de casos, de acuerdo con las directrices PRISMA, con el objetivo de describir las manifestaciones otorrinolaringológicas del iTLPD-GI y facilitar el diagnóstico precoz y el manejo clínico adecuado. Se llevaron a cabo búsquedas en MEDLINE/PubMed, LILACS, la Biblioteca Cochrane y Web of Science Core Collection para identificar informes y series de casos publicados entre enero de 1995 y enero de 2026 que describieran afectación de cabeza y cuello en pacientes con iTLPD-GI confirmado histológicamente. Se identificaron diez estudios que incluían un total de 13 pacientes con manifestaciones en cabeza y cuello. La edad de los pacientes osciló entre 22 y 77 años, con predominio del sexo masculino. Se observaron ulceraciones orales y orofaríngeas en todos los pacientes con afectación de cabeza y cuello, afectando con mayor frecuencia al paladar blando, mientras que la afectación laríngea se describió en tres casos. En ocho pacientes, las manifestaciones de cabeza y cuello constituyeron la forma inicial de presentación de la enfermedad, incluidos tres casos con lesiones orales u orofaríngeas aisladas. Las lesiones fueron predominantemente de carácter ulcerativo, mientras que las presentaciones pseudotumorales fueron menos frecuentes. La mayoría de los pacientes experimentaron una resolución espontánea recurrente de las lesiones de cabeza y cuello, aunque algunos mostraron mejoría clínica únicamente tras el tratamiento sistémico. La afectación de cabeza y cuello en el iTLPD-GI, aunque infrecuente, puede preceder a las manifestaciones gastrointestinales y debe considerarse en el diagnóstico diferencial de las úlceras orales u orofaríngeas persistentes o resistentes al tratamiento.

Palabras clave:
Linfoma de células T
Cabeza y cuello
úlceras orales
Laringe
Revisión sistemática

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