Tumour cells expressed CD3, CD4, and CD5. b. 1991;6(3):170-8. doi: 10.1007/BF02493520. Unable to load your collection due to an error, Unable to load your delegates due to an error. 1998;18:38792. After washing and amplification, target RNA was stained with DAB. Primary extra-nodal non-Hodgkin's lymphoma of the cheek. 2001;23:54758. PET-CT/CT/MRI scans of the cancerous areas were reviewed to assess the extension of the lesions, including to the bone and thorax. His IPI score was 2(low to intermediate risk group). https://doi.org/10.1016/S0344-0338(11)80514-5. This distribution is similar to that in previous reports [18,19,20,21,22] .The most common location was the base of the tongue. Not applicable. Other rare case reports describe upper airway obstruction[4] and systemic autoimmune disease.[5]. What is the treatment for reactive lymphoid hyperplasia? But when areas of focal nodular lymphoid hyperplasiawhich are well-known to occur in other areas of the bodyoccur in the mouth, they create a perplexing dilemma for dental professionals. Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations. In the literature, findings of RLH are well-documented. Among our cases, there were 1 GC and 3 NGC cases. Lymphoma cases were selected from 2010 to 2017 in PUMCH, and all cases were reviewed to identify lymphomas arising from the base of the tongue instead of other primary sites. Is it always necessary to carry out a biopsy on lymphoid hyperplasia or is endoscopic examination and MRI enough to decide that it is benign? Results came back "lymphoid hyperplasia". For this study, the international prognostic index (IPI) was adopted to predict prognosis. 2017;18:27815. Healy JA, Dave SS. A 64-year-old African Canadian female with a history of urinary incontinence was admitted for an elective bladder suspension procedure by the gynaecology service in our institution. Careers. May SA, Jones D, Medeiros LJ, Duvic M, Prieto VG, Lazar AJ. Springerplus. Video chat with a U.S. board-certified doctor 24/7 in less than one minute for common issues such as: colds and coughs, stomach symptoms, bladder infections, rashes, and more. The DLBCL, NOS cases were further divided into GC and NGC B cell like subtypes based on immunohistochemical expression of CD10, Bcl-6 and Mum1 [11]. Rinsho Ketsueki. PubMed PTCL, NOS occurring at the base of the tongue are rare. Three cases of DLBCL, NOS were were NGC subtypes and 1 case was a GC subtype. Chemotherapy containing rituximab was considered to significantly improve survival in DLBCL and MCL patients [39, 43]. 2008;88:2068. Disclaimer. b. H&E showed moderate to large cells with distorted nuclear contours (200 x). Nancy W. Burkhart, EdD, BSDH, AFAAOM, is an adjunct associate professor in the Department of Periodontics-Stomatology, College of Dentistry, Texas A&M University, Dallas, Texas. As seen in Figure 1, the soft palate, uvula, and posterior pharynx demonstrate multiple areas of enlargement that are consistent with lymphoid tissue. Reported cases involve the conjunctiva, liver, gastrointestinal tract, stomach, lungs, paranasal sinuses, and many cutaneous areas. At the time of manuscript preparation, there were only four articles indexed in Medline that described PTCL and tongue involvement (Table 4, [12,13,14,15]). The blastic variant of mantle cell lymphoma arising in Waldeyer's tonsillar ring. showed that 74% of DLBCL cases have P16 methylation and a relatively old age [32]. Briefly, the criteria and parameters for diagnosing and evaluating our cases were as follows: lymphoma classifications were based on the World Health Organization Classification of Tumors of Hematopoietic and Lymphoid Tissues (Revised Fourth Edition), and staging was based on the Ann Arbor Staging System. Most DLBCL cases of the tongue base had no Bcl-2, Bcl-6, or c-Myc rearrangement and they were sensitive to rituximab. We thank Violette Ghali, Gina Elhammady, Mark Persky and Songyang Yuan for confirming the pathological diagnosis. Patient ages ranged from the thirties to the nineties, with an average age of 61.8years. Takahashi H, Fujita S, Okabe H, Tsuda N, Tezuka F. Immunophenotypic analysis of extranodal non-Hodgkin's lymphomas in the oral cavity. Int J Cancer. Image courtesy of James J. Sciubba, DMD, PhD. Spontaneous regression has also been reported. Please enable it to take advantage of the complete set of features! To our knowledge, none of these have highlighted the presence of airway obstruction related to pharyngeal lymphoid hyperplasia. c. Immunohistochemistry staining showed diffuse and strong staining of P16 protein (40 x) d. Immunohistochemistry staining showed diffuse and strong staining of P16 protein (100 x). Acta Oncol. The most common subtype of NHLs of the tongue base is DLBCL, and the occurrence at this site may have a good prognosis. Abstract Background Benign lymphoid hyperplasia (BLH) is a benign proliferation of lymphoid tissue in response to external irritation. Head and neck extranodal lymphoma in a single institute: a 17-year retrospective analysis. Regezi JA, Sciubba JJ, Jordan RCK. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated. [2] Lymph node anatomy [ edit] Bratisl Lek Listy. official website and that any information you provide is encrypted Call your doctor or 911 if you think you may have a medical emergency. Had biopsy on axillary lymph node. Here, in our cases, none of our patients had EBV infection, but one DLBCL patient was HPV DNA positive and P16 protein positive, but HPV RNA negative, which may indicated HPV infection. Pseudotumours of the oropharynx due to muscular contraction. c. Tumour cells diffusely expressed CD20 (200 x). https://doi.org/10.1007/s12185-008-0142-z. 2010;77:96105. Bone marrow biopsy is necessary to rule out CNS involvement. Google Scholar. Content on HealthTap (including answers) should not be used for medical advice, diagnosis, or treatment, and interactions on HealthTap do not create a doctor-patient relationship. Abstract. A positive and a negative control were included in each batch of staining. The presence of an excessively large tongue, which may be congenital or may develop as a result of a tumor or edema due to obstruction of lymphatic vessels, or it may occur in association with hyperpituitarism or acromegaly. The airway was subsequently secured, and the procedure was undertaken. showed that loss of P16 expression has no effect on life expectancy [33], but high P16 levels may inhibit tumour growth in DLBCL [34]. In summary, NHLs in the base of the tongue are rare with nonspecific symptoms of oropharyngeal discomfort, and they could present with normal-like mucosal surfaces. a. CT showed a well-bordered cystic mass. Follicular lymphoid hyperplasia (FLH) is a benign lymphoproliferative process of unknown etiology, uncommon in the head and neck region. All these factors might explain why the patient survived only 3months after diagnosis although he was in an early stage and had a low IPI score. Mod Pathol. Tumours in this site are predominantly DLBCL subtypes in histology. As always, continue to ask good questions and listen to what your patients are telling you! 2013;91 Thesis 5:127. 1997;36:41320. HealthTap uses cookies to enhance your site experience and for analytics and advertising purposes. 37, no. Differential diagnoses include benign lymphoid hyperplasia and carcinoma. 1984 Apr;151(1):123-6. doi: 10.1148/radiology.151.1.6322222. Ann Diagn Pathol. In terms of pathological characteristics, 6 patients were diagnosed with B-cell NHL, and 1 patient was diagnosed with PTCL, NOS (Table2). To learn more, please visit our, Internal Medicine - Hematology & Oncology, It means that there is an increase of the number of a type of white, called lymphocytes. Lee YY, Van Tassel P, Nauert C, North LB, Jing BS. Sun J, Zhang J, Ling Q, Luo Y, Wu S, Liang Z, Zhong D, Zeng X. Fakhry C, Westra WH, Li S, Cmelak A, Ridge JA, Pinto H, Forastiere A, Gillison ML. It has been historically referred to as reactive lymphoid hyperplasia or pseudolymphoma [1]. Oral and Maxillofacial Pathology. c. Tumour cell infiltrated squamous epithelium (400x). Asano N, Suzuki R, Kagami Y, Ishida F, Kitamura K, Fukutani H, Morishima Y, Takeuchi K, Nakamura S. Clinicopathologic and prognostic significance of cytotoxic molecule expression in nodal peripheral T-cell lymphoma, unspecified. Lymphomas of the head and neck: CT findings at initial presentation. Manage cookies/Do not sell my data we use in the preference centre. Curr Top Microbiol Immunol. Lee JT, Paquette R, Sercarz JA, Wang MB. Methods We reported a severe case of tongue base BLH compromising the breathing and swallowing of the affected patient. 7th ed. None of the seven patients presented systemic symptoms (body weight loss, fever and night sweating). Federal government websites often end in .gov or .mil. Benign lymphoid hyperplasia is a benign proliferation of lymphoid tissue in response to external irritation and occurrence within oral cavity is rare. Postoperatively the patient was deemed unsafe for extubation and transferred to the intensive care unit while placed on high-dose intravenous dexamethasone. In addition, HPV-positive tumours are a unique clinical entity distinct from HPV-negative tumours [30], and involve, for instance, less exposure to tobacco. This conditions means you have a increase in their number which is a benign condition as the name implies.. What is the treatment of reactive lymphoid hyperplasia? Article https://doi.org/10.1111/aos.12189. Of the 6 B-cell NHL cases, 5 were DLBCLs and 1 was MCL. One case was P53 positive (Fig. 1970 Dec;8(3):413-24. e. Tumour cells were positive for P53 (200 x). e. Tumour cells were positive for CD4 (200x). 2002;15:4205. World J Gastroenterol. In the orofacial region, RLH most often occurs in the oropharynx, Waldeyers tonsillar ring, the soft palate, the lateral tongue, and the floor of the mouth.2 Waldeyers ring includes the lingual and palatine tonsils, the adenoids, lymphoid follicles located on the posterolateral tongue in the area of the foliate papillae, and level 1 lymph nodes in the floor of the mouth. The phenomenon was observed in our PTCL case and is also mentioned in Steve As research [13]. 1998;112:9914. The PubMed wordmark and PubMed logo are registered trademarks of the U.S. Department of Health and Human Services (HHS). f. Ki-67 staining of the tumour cells (200x). Never disregard or delay professional medical advice in person because of anything on HealthTap. Thus, Thus, in the early stages, such tumours are misdiagnosed as infectious or proliferative lesions. Carcinomas of the base of the tongue: diagnosis using double-contrast radiography of the pharynx. https://doi.org/10.1016/j.kjms.2012.02.014. The prognosis for MCL seems to be poorer than that for DLBCL at the base of the tongue. Diagnostic Pathology f. Tumour cells were negative for CD8 (200x). Curr Allergy Asthma Rep. 2008 May;8(3):240-4. doi: 10.1007/s11882-008-0040-8. Improved survival of patients with human papillomavirus-positive head and neck squamous cell carcinoma in a prospective clinical trial. 1999;21:24754. The CT and 67Ga scintigraphy scans revealed lymphadenopathy of the bilateral cervical, mediastinal, and deep surface boundaries to the right of her sternocleidomastoid. ( BLH ) is a benign lymphoproliferative process of unknown etiology, in... Case reports describe upper airway obstruction [ 4 ] and systemic autoimmune disease. [ 5 ], findings RLH... Stages, such tumours are lymphoid hyperplasia base of tongue as infectious or proliferative lesions to large cells with distorted contours! Image courtesy of James J. Sciubba, DMD, PhD the complete set of features VG. 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