follicular lymphoma in bilateral submandibular glands and thyroid gland

Ultrasound is a great tool to evaluate lumps in the neck region; whether focusing on the single image, or seeing the whole picture of different parts, all information and characters of the image allow us to conclude the possible cause. Ultrasound-guided procedures, such as fine needle aspiration biopsy or core needle biopsy, help to conform the diagnosis. We present a 42-year-old man with right submandibular mass. A right submandibular tumor was found by ultrasound examination; in addition, nonpalpable lesions in the left submandibular gland and thyroid gland were found at the same time. Similar cytology reports suggested similar origins of these tumors. The final diagnosis of the right submandibular gland after excisional biopsy was follicular lymphoma. Information from the image is sometimes not enough to make a diagnosis, therefore invasive procedures like fine needle aspiration are essential. If the cytology report is beyond expectation, further management is required.