A Rare Masquerade: Primary Parotid Lymphoma Mimicking a Parotid Neoplasm in a Young Female Patient

Primary parotid lymphoma can closely mimic epithelial salivary gland tumors, making preoperative diagnosis challenging. We report the case of a 21-year-old female patient who presented with a left parotid swelling. Imaging was suggestive of a parotid neoplasm, and ultrasound-guided fine needle aspiration cytology (FNAC) demonstrated atypia of undetermined significance (Milan category III). The patient underwent a left total conservative parotidectomy. Histopathological examination with immunohistochemistry (IHC) established the diagnosis of diffuse large B-cell lymphoma (DLBCL), non-germinal center subtype, with involvement of the medial resection margin. She subsequently underwent staging evaluation and received systemic chemotherapy, with a favorable clinical response, and is currently disease-free on follow-up. This case highlights the diagnostic challenges associated with primary parotid lymphoma and underscores the importance of continued reporting of such cases to support the development of improved preoperative diagnostic strategies and management protocols.