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Primary Diffuse Large B-Cell Lymphoma of the Mandible: Case Report and Review of the Literature

Identifieur interne : 006165 ( Ncbi/Merge ); précédent : 006164; suivant : 006166

Primary Diffuse Large B-Cell Lymphoma of the Mandible: Case Report and Review of the Literature

Auteurs : Amr Bugshan [États-Unis] ; James Kassolis [États-Unis] ; John Basile [États-Unis]

Source :

RBID : PMC:4649735

Abstract

In the oral cavity, extranodal non-Hodgkin's lymphoma can occur in the periapical region either in the maxilla or mandible. Also, it can mimic inflammatory lesions that arise around the teeth apices such as periapical granuloma, radicular cyst and osteomyelitis. Misdiagnosis of lymphomas in the jaws may reduce the chance of successful treatment and worsen the prognosis. Therefore, any growth of periapical tissue must be submitted for histopathological evaluation to avoid a delay in the diagnosis. We present a case of extranodal non-Hodgkin's lymphoma of a 53-year-old male in the right posterior mandible that was initially misdiagnosed as a reactive periapical lesion. This case illustrates the importance for both the pathologist and the clinician of considering malignant lesions such as lymphoma in the differential diagnosis of periapical radiolucency.


Url:
DOI: 10.1159/000441469
PubMed: 26600778
PubMed Central: 4649735

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<p>In the oral cavity, extranodal non-Hodgkin's lymphoma can occur in the periapical region either in the maxilla or mandible. Also, it can mimic inflammatory lesions that arise around the teeth apices such as periapical granuloma, radicular cyst and osteomyelitis. Misdiagnosis of lymphomas in the jaws may reduce the chance of successful treatment and worsen the prognosis. Therefore, any growth of periapical tissue must be submitted for histopathological evaluation to avoid a delay in the diagnosis. We present a case of extranodal non-Hodgkin's lymphoma of a 53-year-old male in the right posterior mandible that was initially misdiagnosed as a reactive periapical lesion. This case illustrates the importance for both the pathologist and the clinician of considering malignant lesions such as lymphoma in the differential diagnosis of periapical radiolucency.</p>
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<journal-id journal-id-type="nlm-ta">Case Rep Oncol</journal-id>
<journal-id journal-id-type="iso-abbrev">Case Rep Oncol</journal-id>
<journal-id journal-id-type="publisher-id">CRO</journal-id>
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<article-id pub-id-type="pmid">26600778</article-id>
<article-id pub-id-type="pmc">4649735</article-id>
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<article-id pub-id-type="publisher-id">cro-0008-0451</article-id>
<article-categories>
<subj-group subj-group-type="heading">
<subject>Published online: October 2015</subject>
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<title-group>
<article-title>Primary Diffuse Large B-Cell Lymphoma of the Mandible: Case Report and Review of the Literature</article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname>Bugshan</surname>
<given-names>Amr</given-names>
</name>
<xref ref-type="aff" rid="aff1">a</xref>
<xref ref-type="corresp" rid="cor1">*</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Kassolis</surname>
<given-names>James</given-names>
</name>
<xref ref-type="aff" rid="aff2">b</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Basile</surname>
<given-names>John</given-names>
</name>
<xref ref-type="aff" rid="aff1">a</xref>
</contrib>
</contrib-group>
<aff id="aff1">
<sup>a</sup>
Department of Oncology and Diagnostic Sciences, Dental School, University of Maryland, Baltimore, Md., USA</aff>
<aff id="aff2">
<sup>b</sup>
Towson Periodontal Associates, Towson, Md., USA</aff>
<author-notes>
<corresp id="cor1">*Dr. Amr Bugshan, Department of Oncology and Diagnostic Sciences, Dental School, University of Maryland, 650 West Baltimore Street, 7261, Baltimore, MD 21201-1586 (USA), E-Mail
<email>abugshan@umaryland.edu</email>
</corresp>
</author-notes>
<pub-date pub-type="collection">
<season>Sep-Dec</season>
<year>2015</year>
</pub-date>
<pub-date pub-type="epub">
<day>24</day>
<month>10</month>
<year>2015</year>
</pub-date>
<pub-date pub-type="pmc-release">
<day>24</day>
<month>10</month>
<year>2015</year>
</pub-date>
<pmc-comment> PMC Release delay is 0 months and 0 days and was based on the . </pmc-comment>
<volume>8</volume>
<issue>3</issue>
<fpage>451</fpage>
<lpage>455</lpage>
<permissions>
<copyright-statement>Copyright © 2015 by S. Karger AG, Basel</copyright-statement>
<copyright-year>2015</copyright-year>
<license license-type="open-access" xlink:href="http://creativecommons.org/licenses/by-nc/4.0/">
<license-p>This article is licensed under the Creative Commons Attribution-NonCommercial-4.0 International License (CC BY-NC) (http://www.karger.com/Services/OpenAccessLicense). Usage and distribution for commercial purposes requires written permission.</license-p>
</license>
</permissions>
<abstract>
<p>In the oral cavity, extranodal non-Hodgkin's lymphoma can occur in the periapical region either in the maxilla or mandible. Also, it can mimic inflammatory lesions that arise around the teeth apices such as periapical granuloma, radicular cyst and osteomyelitis. Misdiagnosis of lymphomas in the jaws may reduce the chance of successful treatment and worsen the prognosis. Therefore, any growth of periapical tissue must be submitted for histopathological evaluation to avoid a delay in the diagnosis. We present a case of extranodal non-Hodgkin's lymphoma of a 53-year-old male in the right posterior mandible that was initially misdiagnosed as a reactive periapical lesion. This case illustrates the importance for both the pathologist and the clinician of considering malignant lesions such as lymphoma in the differential diagnosis of periapical radiolucency.</p>
</abstract>
<kwd-group>
<title>Key Words</title>
<kwd>Mandible</kwd>
<kwd>Non-Hodgkin's lymphoma</kwd>
<kwd>Periapical lesion</kwd>
<kwd>Oral cancer</kwd>
<kwd>Oral cavity</kwd>
<kwd>Swelling</kwd>
</kwd-group>
<counts>
<fig-count count="2"></fig-count>
<ref-count count="13"></ref-count>
<page-count count="5"></page-count>
</counts>
</article-meta>
</front>
<floats-group>
<fig id="F1" orientation="portrait" position="float">
<label>Fig. 1</label>
<caption>
<p>Primary NHL of the mandible.
<bold>a</bold>
Periapical radiograph showing widening of the periodontal ligament and ill-defined radiolucency extending from tooth No. 30 to tooth No. 32.
<bold>b</bold>
Periapical radiograph showing bony destruction after extraction of teeth No. 30 and 32.</p>
</caption>
<graphic xlink:href="cro-0008-0451-g01"></graphic>
</fig>
<fig id="F2" orientation="portrait" position="float">
<label>Fig. 2</label>
<caption>
<p>Right posterior mandible biopsy.
<bold>a</bold>
Photomicrograph showing multiple fragments of a squamous mucosa, soft tissue and bone with a dense lymphoid infiltrate (×10 magnification).
<bold>b</bold>
Photomicrograph showing an aggregate of atypical lymphoid cells (H&E staining; ×40 magnification).
<bold>c</bold>
Photomicrograph of immunohistochemical stain showing sheets of large mononuclear lymphoid cells positive for CD20 (×40 magnification).
<bold>d</bold>
Immunostaining for a CD10 showing a weak positivity (×40 magnification).
<bold>e</bold>
,
<bold>f</bold>
Scattered positivity is showing for CD3 and Bcl-6 immunostains (×40 magnification).</p>
</caption>
<graphic xlink:href="cro-0008-0451-g02"></graphic>
</fig>
</floats-group>
</pmc>
<affiliations>
<list>
<country>
<li>États-Unis</li>
</country>
<region>
<li>Maryland</li>
</region>
<settlement>
<li>College Park (Maryland)</li>
</settlement>
<orgName>
<li>Université du Maryland</li>
</orgName>
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<name sortKey="Bugshan, Amr" sort="Bugshan, Amr" uniqKey="Bugshan A" first="Amr" last="Bugshan">Amr Bugshan</name>
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<name sortKey="Kassolis, James" sort="Kassolis, James" uniqKey="Kassolis J" first="James" last="Kassolis">James Kassolis</name>
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</record>

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