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About 10% of pharyngeal malignancies are non‐Hodgkin’s lymphomas arising in the abundant lymphoid tissue of Waldeyer’s ring: the adenoids, palatine tonsils, and lingual tonsil [63]. Hodgkin’s disease involving the pharynx is uncommon, even though it is often first detected in cervical lymph nodes [64]. Patients with pharyngeal lymphoma frequently present with a neck mass, and cervical lymph nodes are initially involved in 60% of cases [63]. Other patients may present with nasal obstruction, sore throat, or dysphagia.

The palatine tonsil is the primary site of involvement by pharyngeal lymphoma in 40–60% of patients (Figure 6.32), the nasopharynx in 18–28%, and the lingual tonsil in 10% [40, 63]. Multiple sites are involved in about 25% of patients, but the hypopharynx is rarely involved by this tumor. Pharyngeal lymphomas typically appear on barium studies as large, bulky, lobulated masses (Figure 6.32). The mucosal surface may be smooth; however, because of the submucosal location of these tumors [31] (Figure 6.33).

Figure 6.21 Scarring from corrosive ingestion. Lateral view of the pharynx shows a thick radiolucent band of soft tissue (thick black arrow) crossing the hypopharynx. Obstruction is implied by a large standing column of barium (thin black arrow) in the oropharynx. The hypopharynx is small and contracted (thin white arrow). Barium pours into the open laryngeal vestibule (thick white arrow).

Source: Reproduced from Rubesin SE. The pharynx: structural disorders. Radiol Clin North Am1994; 32:1083–1101, with permission.

Other rare tumors involving the pharynx include Kaposi’s sarcoma, carcinoma of the minor salivary glands, synovial sarcoma, and cartilaginous tumors of the larynx or cricoid cartilage.