Lymphomatous neoplasm within the carotid sheath

In the head and neck region lymphomas represent approximately 5% of all malignant neoplasms. They can arise in nodal or extranodal sites. Extra-nodal manifestations typically consist of non-Hodgkin's lymphoma of B-cell lineage. Very rarely does Hodgkin's lymphoma manifest at extra-nodal sites. We present a case of a 42 year old male with a lymphomatous mass in his left carotid sheath with extension into the mediastinum. Upon review of literature, lymphomatous neoplasms within the carotid sheath have not been well described. In this article we review the presentation of lymphomas in the head and neck, examine the utility of FNA in neck masses suspicious for lymphoma, and briefly describe common carotid sheath lesions.