Introduction: Majority of tumors of larynx are squamous cell carcinomas. Other rare tumors are neuroendocrine, connective tissue, salivary gland, epithelial cell, malignant melanoma and immune cell derivatives. Non Hodgkin Lymphoma with primary laryngeal presentation is very rare. Usually presents with dysphonia and progressive airway obstruction. Repeated biopsies are needed most of the times. It has very good response to radiotherapy and chemotherapy.

Case presentation: 88 year old female presented with dysphagia for 3 months, change in voice for 1 month and breathing difficulty for 3 days. On examination,patient was in stridor. VLS showed edema over left arytenoid and aryepiglottic fold with fi xity of left hemilarynx. CECT neck was taken, suggestive of soft tissue density lesion in left pyriform fossa with extralaryngeal extension. Patient underwent emergency tracheostomy and DL scopy biopsy. 2 biopsies were inconclusive and 3rd time IHC showed CD 20 positivity. So final diagnosis was Bcell NHL of larynx.

Follow up: Patient was referred to radiation oncology and underwent chemotherapy. Complete resolution of the lesion during follow up. Tracheostomy decannulation was done and the patient is doing really well.

Aneesha Davis MS ENT, DNB, MRCS (England) Competent ENT specialist with a strong commitment to clinical excellence and academic advancement. She completed her post graduation from Government Medical College, Thrissur, Kerala, India in 2023 with university rank and Gold Medal. With a solid foundation in otolaryngology, she has developed expertise in diagnosing and managing a wide range of ENT conditions. She is a member of Royal College of surgeons, England. She has published a case report on laryngeal malignancy in the International Journal of Phonosurgery and Laryngology. Her career reflects a balance of clinical proficiency, academic engagement and a passion for improving patient outcomes in otolaryngology. Her areas of interests are microscopic ear surgeries and endoscopic sinus surgeries