Intraosseous Non-Hodgkin Lymphoma Mimicking a Periapical Lesion

Pereira, D.; Fernandes, Diego Tetzner; Santos‐Silva, Alan Roger; Vargas, Pablo Agustı́n; Almeida, Oslei Paes de; Lopes, Márcio Ajudarte

doi:10.1016/j.joen.2015.06.001

Cited by 24 publications

(24 citation statements)

References 33 publications

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“…This is unfortunately not an uncommon scenario. In a review from 2015, where the authors looked at 29 cases of oral DLBCL, 22 patients had an endodontic treatment or tooth extraction prior to correct diagnosis. The diagnosis is often difficult and delayed since clinical and radiological presentations are not specific and very heterogenous.…”

Section: Discussionmentioning

confidence: 99%

Oral presentation of diffuse large B‐cell lymphoma: a rare entity

Hindocha

Nilsson

2019

Oral Surgery

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Diffuse large B-cell lymphoma (DLBCL) is the second most common non-epithelial malignant tumour in the oral and maxillofacial region. It can mimic other benign conditions such as dental abscesses and benign tumours. We report a case of DLBCL mimicking a dental abscess. This resulted in delays of several months to correct diagnosis and thereby a poorer prognosis for the patient. Unfortunately, this is not uncommon, and it is therefore imperative that a histological examination is performed in cases where symptoms do not subside after a specific treatment. The earliest possible diagnosis is a critical prognostic factor for DLBCL.

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Section: Discussionmentioning

confidence: 99%

Oral presentation of diffuse large B‐cell lymphoma: a rare entity

Hindocha

Nilsson

2019

Oral Surgery

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“…Triantafillidou et al [12] evaluated 58 patients with primary extranodal NHL of the oral and maxillofacial region, and only 5.2% of cases (n = 3) were in the mandible or maxilla. Pereira et al [13] published an analysis of 29 cases of NHL appearing in the periapical region, with the mandible being one of the more commonly affected sites (58.6% of cases), and the most common type of NHL was DLBCL (51.7%). Similar results were found by Djavanmard et al [14] who reported that 68.7 and 31.3% of extranodal NHL affected the maxilla and mandible, respectively.…”

Section: Discussionmentioning

confidence: 99%

“…Similar results were found by Djavanmard et al [14] who reported that 68.7 and 31.3% of extranodal NHL affected the maxilla and mandible, respectively. NHL appearing in the periapical region can be misdiagnosed as endodontic lesions because of their non-specific signs and symptoms, delaying diagnosis and appropriate management [13,15,16]. Pereira et al [13] also reported endodontic treatment and tooth extraction in 52.7 and 24.1% of cases, respectively, prior to the diagnosis of lymphoma, indicating that most cases are initially misdiagnosed.…”

Section: Discussionmentioning

confidence: 99%

T-Cell/Histiocyte-Rich Large B-Cell Lymphoma: Report of the First Case in the Mandible

Rnf

Batista

et al. 2018

Head and Neck Pathol

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T-cell/histiocyte-rich large B-cell lymphoma (THRBCL) is an uncommon subtype of non-Hodgkin's lymphoma. It is a predominant nodal neoplasm; however, extranodal sites, such as the spleen, liver and bone marrow, can be involved at diagnosis. However, only one case of primary THRLBCL in the jaws have been reported. We herein describe a 29-year-old female patient who presented with a swelling of the right mandible that had grown rapidly over the previous 2 months. Periapical and panoramic radiographs showed a multilocular osteolytic lesion located in the mandibular periapical region of the canine and premolar teeth and molar region. Preoperative examination and incisional biopsy were performed. Immunohistochemistry was applied to confirm the diagnosis of THRBCL in the jaw. The treatment consisted of CHOP therapy and radiotherapy. After complete tumor remission following initial treatment, additional sites of the disease appeared in the lung, abdomen and long bones. The patient died within 2 months. THRLBCL is an uncommon and aggressive malignant neoplasm that can involve the jaws, mimicking a periapical disease.

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“…However, these molecular diagnostic approaches may not be used in routine clinical practice because of high costs and the need for specific technology. Moreover, the clinical situation at the time of the initial diagnosis of oral DLBCL is confusing, since oral DLBCL shows atypical symptoms, which present as a nonspecific enlarging swelling, ulceration and discomfort in the region of involvement, which mimic inflammatory odontogenic or periodontal diseases [ 5 ]. Thus, immunohistochemistry-based algorithms with subsequent excisional biopsy was initially used as an easy and reliable method for determining the molecular subtype of DLBCL, including DLBCL arising in the oral cavity.…”

Section: Introductionmentioning

confidence: 99%

Use of Liquid-based Cytology and Cell Block Combined Technique for an Accurate Diagnosis of Oral Diffuse Large B Cell Lymphoma: A Case Report

et al. 2020

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Primary oral diffuse large B cell lymphoma (DLBCL) is rare and the differential diagnosis is difficult due to its low incidence and nonspecific symptoms, which resemble those of common oral diseases in the initial clinical setting. We aimed to discuss the value of making an accurate diagnosis using liquid-based cytology (LBC) and cell block (CB) for not only the morphological interpretation but also cytohistological assessment of oral DLBCL. LBC and CBs made from oral brushing materials were prepared on the first medical examination and a morphological analysis and immunohistochemical analysis of specific biomarkers were performed. The analysis of LBC preparations showed the presence of large-size lymphocytes with large irregular nuclei and prominent nucleoli, suggesting the existence of large B-cell lymphoma. A more detailed histological subclassification of the CB specimen was performed, which was classified as the activated B-cell (ABC) phenotype of DLBCL, by confirming the immunohistochemical expression of CD10−/ B-cell lymphoma 6 (BCL6)+/ multiple myeloma oncogene 1(MUM1)+, which is a significant risk factor in DLBCL. Our findings suggest that the combination of LBC and CB is a useful and informative tool for making an accurate molecular diagnosis of oral DLBCL in cases in which lymphomas are clinically suspected.

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Intraosseous Non-Hodgkin Lymphoma Mimicking a Periapical Lesion

Cited by 24 publications

References 33 publications

Oral presentation of diffuse large B‐cell lymphoma: a rare entity

Oral presentation of diffuse large B‐cell lymphoma: a rare entity

T-Cell/Histiocyte-Rich Large B-Cell Lymphoma: Report of the First Case in the Mandible

Use of Liquid-based Cytology and Cell Block Combined Technique for an Accurate Diagnosis of Oral Diffuse Large B Cell Lymphoma: A Case Report

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