Non-Hodgkin Lymphomas in the ENT Region: A Practical Framework for Diagnosis, Staging, and Management

Background: Non-Hodgkin lymphoma (NHL) involving the ear, nose, and throat (ENT) region comprises a heterogeneous group of nodal and extranodal lymphoid malignancies with distinct clinicopathological features. This review aimed to provide an integrated overview of clinical presentation, pathology, diagnostic workup, staging, and treatment. Methods: A structured narrative search of PubMed, ScienceDirect, MDPI, and Google Scholar covered publications from January 2015 to July 2026; earlier landmark studies were included when clinically pivotal. Evidence was synthesized by histological subtype, anatomical site, and three pragmatic patterns of ENT involvement: primary extranodal ENT lymphoma, cervical nodal or Waldeyer’s ring presentation, and secondary ENT involvement in systemic disease. An exploratory keyword co-occurrence analysis of 2732 Scopus-indexed publications (2015–2026) was performed using VOSviewer. Results: The review focuses on diffuse large B-cell lymphoma, extranodal marginal zone lymphoma of mucosa-associated lymphoid tissue, follicular lymphoma, extranodal NK/T-cell lymphoma, and mantle cell lymphoma. ENT manifestations are often non-specific and may mimic inflammatory, infectious, or epithelial disorders. Diagnosis requires adequate tissue sampling and integrated assessment of morphology, immunophenotype, imaging, and, when indicated, molecular or virus-associated studies. Treatment is guided by histological subtype, systemic stage, biological risk, previous therapy, and patient fitness, while anatomical site influences biopsy planning, local complications, radiotherapy, and functional preservation. Bibliometric mapping showed interconnected clinicopathological and therapeutic themes with increasing emphasis on molecular, biomarker, and immunotherapy-related research. Conclusions: NHL involving the ENT region should not be approached as a homogeneous entity. The three-pattern framework may facilitate diagnostic evaluation, staging, treatment planning, and multidisciplinary management.