All authors have made significant contributions by making diagnosis and intellectual input in the case and writing the manuscript

All authors have made significant contributions by making diagnosis and intellectual input in the case and writing the manuscript. == Acknowledgements == We sincerely thanks Pr Mohammed Ismaili for his assistance == Contributor Information == Ismail Essadi, Email: ismail_onco@yahoo.fr. Nabil Ismaili, Email: ismailinabil@yahoo.fr. Elmehdi Soyasaponin BB Tazi, Email: elmehditazi@yahoo.fr. Sanaa Elmajjaoui, Email: drsanaamajjaoui@hotmail.com. Ammar Saidi, Email: saidianapath@yahoo.fr. Mohammed Ichou, Email: medichou@yahoo.fr. Hassan Errihani, Email: h_errihani@yahoo.fr. == Recommendations ==. (CHOP) regimen. Soyasaponin BB == Conclusion == These two cases highlight the important role of CHOP based chemotherapy for achieving successful treatment remedy for patients having an early stage head and neck lymphoma. == Introduction Soyasaponin BB == Lymphomas are malignant neoplasms of the lymphocyte cell lines. They mainly involve lymph nodes, spleen and other non-haemopoietic tissues. They are mainly classified as either Hodgkin’s or non-Hodgkin’s lymphoma (NHL), and of either B-lymphocyte or T-lymphocyte origin. The head and neck is the second most common region for the extra-nodal lymphomas after that of gastrointestinal tract. Approximately 2.5% of malignant lymphoma arise in the oral and paraoral region, mainly in the form of Waldeyer’s ring (ie, the tonsils and base, nasopharynx and base of the tongue) [1]. The diffuse large B-cell lymphoma (DLBCL) appeares to be the most common type of primary oral and paraoral NHL [1,2]. In this paper, we will present two cases of early stage head and neck lymphoma, HES7 the first with DLBCL of the oro-pharynx at early bulky stage and the second with nasal NK/T cell lymphoma of the left nasal pit at early stage. The two patients were managed successfully with CHOP based chemotherapy treatment. == Case 1 == A 48 years old man, was admitted to the National Institute of Oncology hospital with enlarged cervical lymph nodes, dysphagia, dysphonia and having continuous weight loss for 5 months. The patient had an ECOG performance status equal to 2.0 [3]. A physical examination revealed a fixed cervical masse measuring Soyasaponin BB 13 cm long and 10 cm large (physique1). Otolaryngology examination showed an ulcerative-vegetative tumour on the right posterolateral wall of the oropharynx. The tumour spread to the soft palate ant hard palate filling partially the nasopharynx. Head and neck computed tomography scan showed a large tissular oropharyngeal tumour (Physique2). The oropharyngeal mass invaded the nasopharynx (Physique3). This process was associated by the infiltration of the tonsillar fossa and the parotid space by a bulky cervical mass (13 cm 10 cm) growing on the right cervical region vast, starting from the submaxillary region up to the supra-clavicular region (Physique2). The oropharyngeal biopsy was performed. Histological and immunohistochemistry studies showed diffuse large B-cell Lymphoma of the oropharynx according to the Revised European-American Classification of Lymphoid Neoplasms/World Health Organisation classification of lymphoid neoplasms (REAL/WHO). Most of the neoplasic cells were positive for CD-20 and for leucocyte common antigen (LCA) antibody. Computed tomography of the chest, stomach and pelvis was normal. A bone marrow biopsy showed no abnormalities. The patient was staged IIEXB according to the Ann Arbor Staging system. The patient received 7 cycles of standard Rituximab 375 mg/m2, Cyclophosphamide 750 mg/m2d1, Doxorubicine 50 mg/m2d1, Vincristine 1.4 mg/m2d1, and prednisone 50 mg/m2d1-5 (RCHOP) regimen with complete response. He remained disease free, until now, 22 months after the end of chemotherapy (Physique4). == Physique 1. == Right cervical masse fixed, bulky, measured 13 10 cm in diameter. == Physique 2. == Computed tomography of the head and neck shows the oropharyngeal process and a bulky cervical mass. == Physique 3. == Computed tomography of the head and neck shows the involvement of the nasopharynx by the oropharyngeal process. == Physique 4. == The right cervical region was free from the disease 22 month after the end of chemotherapy. == Case 2 == A 50 years old female was admitted to the Oncology hospital. She had 5 months history of running nose (clear liquid at the beginning then becoming yellowish at the end). Evolution was marked by a foreign body sensation in the nasal passages without general indicators. Naso-fibroscopy examination showed a process of the left nasal pit, inserted into the nasal septum. Histological and immunohistochemistry studies showed the indicators of malignant non-Hodgkin lymphoma NK/T nasal type, with strong expression of CD3 and CD56 (physique5) (Physique6) (Figue7). Head and neck computed tomography scan showed a tumour of the left nasal pit with a mass volume measuring 4 cm 2 cm 3 cm. Computed tomography of the chest, stomach and pelvis was normal. A bone marrow biopsy showed no abnormalities. The patient was staged IE according to the Ann Arbor Staging system. The patient received 6 cycles of standard Cyclophosphamide 750 mg/m2d1, Doxorubicine 50 mg/m2d1, Vincristine 1.4 mg/m2d1, and prednisone 50 mg/m2d1-5 (CHOP) regimen. The response to the treatment was successful. The patient, 6 months after the end of chemotherapy, remains disease.