Primary extranodal non‐Hodgkin's malignant lymphoma of the oral region: analysis of 11 autopsy cases

Abstract

The authors describe autopsy cases of primary extranodal non–Hodgkin's lymphoma of the oral regions in 11 (8%) of 134 patients: 10 were clinical stage IE, and one was IIE. Histologic subtypes of each lymphoma included the diffuse large cell type (8 cases), diffuse mixed type (2 cases) and Burkitt's type (1 case) according to the Japanese Lymphoma Study Group (JLSG) classification. All patients received anti‐lymphomatous chemotherapy and/or radiotheraphy. Nine cases had active disease, 3/9 manifesting leukemia. Nodes were involved. There was involvement of cervical lymph nodes in 7 (64%). Viscera most commonly involved were, in order of decreasing frequency: lung, kidney, pancreas, liver, spleen, heart, gastrointestinal tract, bone marrow, and adrenal gland. It is apparent that primary extranodal non‐Hodgkin's lymphomas of the oral region arise in a single focus, and extensions of the disease are not random. The primary lesions spread to regional lymph nodes by way of lymphatic channels, and to extranodal organs of the intrathoracic and intraabdominal regions by contiguous direct invasion of adjacent organs and by blood‐borne metastases. Wide spread dissemination at the time of death was found in 6 cases and 3 modes of spreading were observed.

Primary extra nodal non-Hodgkin′s lymphoma of the oral cavity in a young girl

“…Our patient had multiple gingival swellings, with most prominent swelling being in the right anterior maxilla. Secondary organ involvement along with the primary in the oral cavity is generally observed,[6] but it was not seen in our patient.…”

Oral Extranodal Non Hodgkin's Lymphoma: Series of Forty Two Cases in Malaysia

“…The most common site involved in oral cavity is palate and gingiva (Takahashi et al, 1987;Shah et al, 2011) in this series the palate and gingiva represent about 17.7 and 4.8% of the lesions respectively. It was reported that 15-45% of intra-oral NHL occurs in the jaws, with the mandible being the less frequent site.…”

Rare Manifestation of Granulomatosis With Polyangiitis

“…The patient had long‐term peri‐implant disease, but because she was on bisphosphonates for >3 years, it cannot be discounted that the rapid bone destruction and subsequent loss of the implants was not ultimately attributable to bone necrosis secondary to long‐term bisphosphonate therapy. Leukemia may present with gingival manifestations but with much smoother gingival surfaces 13 . Pyostomatitis vegetans commonly results in bumpiness on gingival surfaces but extends beyond gingiva to oral mucosa 14 .…”

“…Leukemia may present with gingival manifestations but with much smoother gingival surfaces. 13 Pyostomatitis vegetans commonly results in bumpiness on gingival surfaces but extends beyond gingiva to oral mucosa. 14 Pemphigus exhibits superficial non-granulomatous ulcerations with erythematous non-swollen gingival, starts from oropharynx or soft palate, and moves forward in the mouth (Nikolsky's sign is present, in which horizontal pressure to mucosa results in peeling away of blisters).…”