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Jayabalan J, Albert D, Nathanael I, Abisheg JF, N BR. A Rare Case of Low-Grade B-cell Non-Hodgkin's Lymphoma of the Lower Lip Mimicking a Mucocele. Cureus 2024; 16:e57154. [PMID: 38681417 PMCID: PMC11055997 DOI: 10.7759/cureus.57154] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/28/2024] [Indexed: 05/01/2024] Open
Abstract
In a clinical context, oral lymphomas are very uncommon and frequently challenging to identify. Mucosa-associated lymphoid tissue (MALT) lymphomas are a diverse category of lymphomas that were formerly believed to be formed from B-cells located in the marginal zone, which surrounds B-cell follicles and the surrounding lymphoepithelium. Extranodal organs like the stomach, thyroid, and large salivary glands are where they most frequently appear. As a result, they are accurately identified as extranodal marginal zone B-cell lymphomas (ENMZL). This report presents a case of a 53-year-old female with lower lip swelling, which was diagnosed as a case of marginal low-grade B-cell non-Hodgkin's lymphoma after clinical, histopathological, and immunological examinations. Non-Hodgkin's lymphoma diagnosis can be aided by pathological examination and biopsy performed early in the lesion's development. The dentist has a key role to play in the early diagnosis process.
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Affiliation(s)
- Jones Jayabalan
- Oral and Maxillofacial Surgery, Dr. Jones Dental Clinic, Chennai, IND
- Oral and Maxillofacial Surgery, Tagore Dental College and Hospital, Chennai, IND
| | - Dyna Albert
- Oral and Maxillofacial Surgery, Dr. Jones Dental Clinic, Chennai, IND
| | - Israel Nathanael
- Oral and Maxillofacial Surgery, Dr. Jones Dental Clinic, Chennai, IND
- Oral and Maxillofacial Surgery, Tagore Dental College and Hospital, Chennai, IND
| | - Jedidiah Fredrick Abisheg
- Oral and Maxillofacial Surgery, Dr. Jones Dental Clinic, Chennai, IND
- Oral and Maxillofacial Surgery, Tagore Dental College and Hospital, Chennai, IND
| | - Balakrishna R N
- Oral and Maxillofacial Surgery, Tagore Dental College and Hospital, Chennai, IND
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de Araújo GR, Morais-Perdigão AL, de Cáceres CVBL, Lopes MA, Aguirre-Urizar JM, Carlos R, Tager EMJR, van Heerden WFP, Robinson L, Pontes HAR, de Andrade BAB, Soares CD, Gomez RS, Fonseca FP. Lymphomas Affecting the Sublingual Glands: A Clinicopathological Study. Head Neck Pathol 2023; 17:154-164. [PMID: 36166159 PMCID: PMC10063706 DOI: 10.1007/s12105-022-01489-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/07/2022] [Accepted: 08/12/2022] [Indexed: 12/09/2022]
Abstract
BACKGROUND Lymphomas affecting the sublingual glands are extremely rare and very few case reports are currently available. Therefore, the aim of the current study is to describe the clinicopathological features of a series of lymphomas involving the sublingual glands. METHODS Cases diagnosed in four pathology services were assessed and the formalin-fixed paraffin-embedded tissue blocks were retrieved for diagnosis confirmation. Clinical data were obtained from patients' medical files. RESULTS We obtained seven cases of lymphomas in the sublingual glands, representing two follicular lymphomas, two diffuse large B cell lymphomas not otherwise specified (DLBCL NOS), two extranodal marginal zone B cell lymphoma of mucosa-associated lymphoid tissue (MALT lymphomas) and one mantle cell lymphoma (MCL). In all cases the tumor cells infiltrated the glandular parenchyma, although in two of them the neoplastic cells were located more superficially and permeated the glandular acini and ducts. Clinically, the tumors presented as asymptomatic nodules and two patients (affected by DLBCL NOS and MCL) died, while the other five patients remained alive at last follow-up. CONCLUSION Lymphomas affecting the sublingual glands are usually of the mature B cell lineage, often represent low-grade subtypes and may clinically resemble other more common lesions in the floor of the mouth like salivary gland tumors.
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Affiliation(s)
- Gabriela Ribeiro de Araújo
- Department of Oral Surgery and Pathology, School of Dentistry, Universidade Federal de Minas Gerais, Av. Antônio Carlos, Belo Horizonte, 6627, Brazil
| | - Ana Luísa Morais-Perdigão
- Department of Oral Surgery and Pathology, School of Dentistry, Universidade Federal de Minas Gerais, Av. Antônio Carlos, Belo Horizonte, 6627, Brazil
| | | | - Márcio Ajudarte Lopes
- Department of Oral Diagnosis, Piracicaba Dental School, University of Campinas, Piracicaba, Brazil
| | | | - Roman Carlos
- Centro Clínico de Cabeza Y Cuello, Guatemala City, Guatemala
| | - Elena María José Román Tager
- Department of Oral Diagnosis, Piracicaba Dental School, University of Campinas, Piracicaba, Brazil
- Centro Clínico de Cabeza Y Cuello, Guatemala City, Guatemala
| | - Willie F P van Heerden
- Department of Oral Biology and Oral Pathology, University of Pretoria, Pretoria, South Africa
| | - Liam Robinson
- Department of Oral Biology and Oral Pathology, University of Pretoria, Pretoria, South Africa
| | - Hélder Antônio Rebelo Pontes
- Service of Oral Pathology, João de Barros, Barreto University Hospital, Federal University of Pará, Belém, Brazil
| | | | - Ciro Dantas Soares
- Private Pathology Service, Getúlio Sales Diagnósticos, Natal, RN, Brasil
| | - Ricardo Santiago Gomez
- Department of Oral Surgery and Pathology, School of Dentistry, Universidade Federal de Minas Gerais, Av. Antônio Carlos, Belo Horizonte, 6627, Brazil
| | - Felipe Paiva Fonseca
- Department of Oral Surgery and Pathology, School of Dentistry, Universidade Federal de Minas Gerais, Av. Antônio Carlos, Belo Horizonte, 6627, Brazil.
- Department of Oral Diagnosis, Piracicaba Dental School, University of Campinas, Piracicaba, Brazil.
- Department of Oral Biology and Oral Pathology, University of Pretoria, Pretoria, South Africa.
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de Arruda JAA, Schuch LF, Conte Neto N, de Souza LL, Rodrigues-Fernandes CI, Abreu LG, Soares CD, de Carvalho MGF, Agostini M, de Andrade BAB, Romañach MJ, Zanella VG, Barra MB, Martins MD, Souto GR, Etges A, Pontes HAR, Pontes FSC, Vargas PA, de Almeida OP, Santos-Silva AR, Lopes MA, Pires FR, Gomez RS, Fonseca FP, Mesquita RA. Oral and oropharyngeal lymphomas: A multi-institutional collaborative study. J Oral Pathol Med 2021; 50:603-612. [PMID: 34091952 DOI: 10.1111/jop.13211] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2021] [Accepted: 06/02/2021] [Indexed: 12/19/2022]
Abstract
BACKGROUND Lymphomas in the oral and oropharyngeal regions are relatively uncommon, and their diagnosis is challenging and complex due to the myriad histopathological subtypes. Herein, we report a large series of oral and oropharyngeal lymphomas and compare our data with the currently available literature. METHODS All cases diagnosed as lymphomas affecting the oral and oropharyngeal regions were retrospectively retrieved from seven Brazilian institutions. Clinicodemographic data and histopathological features were evaluated and described, while a comprehensive literature review was undertaken in order to compare our findings. RESULTS A total of 304 cases of oral and oropharyngeal lymphomas were obtained, mostly affecting individuals aged 60-69 years (n = 68) with a mean age at diagnosis of 54.2 ± 20.1 years. Males and females were equally affected. Mature B-cell neoplasms (87.2%) were the most common group, followed by mature T- and NK-cell neoplasms (11.2%) and precursor lymphoid neoplasms (1.6%). The most frequent subtypes in each group were diffuse large B-cell lymphomas, not otherwise specified (n = 99), extranodal NK/T-cell lymphomas, nasal type (n = 12), and B-lymphoblastic leukaemia/lymphomas, not otherwise specified (n = 4). The most commonly involved sites were the palate (26.3%), mandible (13%), and maxilla (10.5%). CONCLUSION Diffuse large B-cell lymphoma, not otherwise specified, remains the most common subtype of lymphomas in the oral and oropharyngeal region. Older patients are the most affected, with no gender predilection and the palate and jaw are usually affected.
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Affiliation(s)
- José Alcides Almeida de Arruda
- Department of Oral Surgery and Pathology, School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Lauren Frenzel Schuch
- Department of Oral Surgery and Pathology, School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil.,Department of Oral Diagnosis, Piracicaba Dental School, Universidade de Campinas, Piracicaba, Brazil
| | - Nicolau Conte Neto
- Department of Oral Surgery and Pathology, School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Lucas Lacerda de Souza
- Department of Oral Diagnosis, Piracicaba Dental School, Universidade de Campinas, Piracicaba, Brazil
| | | | - Lucas Guimarães Abreu
- Department of Child's and Adolescent's Oral Health, School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | | | | | - Michelle Agostini
- Department of Oral Diagnosis and Pathology, School of Dentistry, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| | | | - Mário José Romañach
- Department of Oral Diagnosis and Pathology, School of Dentistry, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Virgilio Gonzales Zanella
- Department of Head and Neck Surgery, Hospital Santa Rita, Santa Casa de Misericórdia de Porto Alegre, Porto Alegre, Brazil
| | - Marinez Bizarro Barra
- Service of Pathology, Hospital Santa Rita, Santa Casa de Misericórdia, Porto Alegre, Brazil
| | - Manoela Domingues Martins
- Department of Oral Pathology, School of Dentistry, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil.,Department of Oral Medicine, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Giovanna Ribeiro Souto
- Department of Dentistry, Pontifícia Universidade Católica de Minas Gerais, Belo Horizonte, Brazil
| | - Adriana Etges
- Diagnostic Centre for Oral Diseases, School of Dentistry, Universidade Federal de Pelotas, Pelotas, Brazil
| | - Hélder Antônio Rebelo Pontes
- Service of Oral Pathology, Hospital Universitário João de Barros Barreto, Universidade Federal do Pará, Belém, Brazil
| | | | - Pablo Agustin Vargas
- Department of Oral Diagnosis, Piracicaba Dental School, Universidade de Campinas, Piracicaba, Brazil
| | - Oslei Paes de Almeida
- Department of Oral Diagnosis, Piracicaba Dental School, Universidade de Campinas, Piracicaba, Brazil
| | - Alan Roger Santos-Silva
- Department of Oral Diagnosis, Piracicaba Dental School, Universidade de Campinas, Piracicaba, Brazil
| | - Marcio Ajudarte Lopes
- Department of Oral Diagnosis, Piracicaba Dental School, Universidade de Campinas, Piracicaba, Brazil
| | - Fábio Ramôa Pires
- Department of Oral Pathology, School of Dentistry, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Ricardo Santiago Gomez
- Department of Oral Surgery and Pathology, School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Felipe Paiva Fonseca
- Department of Oral Surgery and Pathology, School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Ricardo Alves Mesquita
- Department of Oral Surgery and Pathology, School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
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Bianco L, Solla SD, Parvis G, Gino E, Bollito E, Filippi AR, Massa F, Ruo Redda MG. Low-dose radiotherapy for extranodal marginal zone B lymphoma of the lip: Case report and literature review. Hematol Oncol Stem Cell Ther 2021; 14:76-81. [DOI: 10.1016/j.hemonc.2018.12.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2018] [Revised: 12/13/2018] [Accepted: 12/14/2018] [Indexed: 01/08/2023] Open
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5
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Epstein-Barr Virus-Positive Diffuse Large B-Cell Lymphoma, Not Otherwise Specified, in the Oral Cavity. J Craniofac Surg 2019; 30:e259-e262. [DOI: 10.1097/scs.0000000000005302] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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6
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Guidry JT, Birdwell CE, Scott RS. Epstein-Barr virus in the pathogenesis of oral cancers. Oral Dis 2018; 24:497-508. [PMID: 28190296 PMCID: PMC5554094 DOI: 10.1111/odi.12656] [Citation(s) in RCA: 57] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2017] [Revised: 01/30/2017] [Accepted: 01/31/2017] [Indexed: 12/28/2022]
Abstract
Epstein-Barr virus (EBV) is a ubiquitous gamma-herpesvirus that establishes a lifelong persistent infection in the oral cavity and is intermittently shed in the saliva. EBV exhibits a biphasic life cycle, supported by its dual tropism for B lymphocytes and epithelial cells, which allows the virus to be transmitted within oral lymphoid tissues. While infection is often benign, EBV is associated with a number of lymphomas and carcinomas that arise in the oral cavity and at other anatomical sites. Incomplete association of EBV in cancer has questioned if EBV is merely a passenger or a driver of the tumorigenic process. However, the ability of EBV to immortalize B cells and its prevalence in a subset of cancers has implicated EBV as a carcinogenic cofactor in cellular contexts where the viral life cycle is altered. In many cases, EBV likely acts as an agent of tumor progression rather than tumor initiation, conferring malignant phenotypes observed in EBV-positive cancers. Given that the oral cavity serves as the main site of EBV residence and transmission, here we review the prevalence of EBV in oral malignancies and the mechanisms by which EBV acts as an agent of tumor progression.
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Affiliation(s)
- Joseph T. Guidry
- Department of Microbiology and Immunology, Center for Tumor and Molecular Virology, and Feist-Weiller Cancer Center. Louisiana State University Health Sciences Center-Shreveport. Shreveport, LA 71103
| | - Christine E. Birdwell
- Department of Microbiology and Immunology, Center for Tumor and Molecular Virology, and Feist-Weiller Cancer Center. Louisiana State University Health Sciences Center-Shreveport. Shreveport, LA 71103
| | - Rona S. Scott
- Department of Microbiology and Immunology, Center for Tumor and Molecular Virology, and Feist-Weiller Cancer Center. Louisiana State University Health Sciences Center-Shreveport. Shreveport, LA 71103
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7
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Vo Quang S, Sicard L, Samama M, Benslama L, Goudot P. Mandibular lymphoma. JOURNAL OF STOMATOLOGY, ORAL AND MAXILLOFACIAL SURGERY 2018; 119:49-51. [DOI: 10.1016/j.jormas.2017.10.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/01/2016] [Revised: 09/04/2017] [Accepted: 10/02/2017] [Indexed: 11/28/2022]
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8
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Kudo Y, Tada H, Fujiwara N, Tada Y, Tsunematsu T, Miyake Y, Ishimaru N. Oral environment and cancer. Genes Environ 2016; 38:13. [PMID: 27482300 PMCID: PMC4968003 DOI: 10.1186/s41021-016-0042-z] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2016] [Accepted: 04/19/2016] [Indexed: 01/10/2023] Open
Abstract
Cancer is now the leading cause of death in Japan. A rapid increase in cancer mortality is expected as Japan is facing a super-aged society. Many causes of cancer are known to be closely linked to life style factors, such as smoking, drinking, and diet. The oral environment is known to be involved in the pathogenesis and development of various diseases such as bronchitis, pneumonia, diabetes, heart disease, and dementia. Because the oral cavity acts as the bodily entrance for air and food, it is constantly exposed to foreign substances, including bacteria and viruses. A large number of bacteria are endemic to the oral cavity, and indigenous oral flora act to prevent the settlement of foreign bacteria. The oral environment is influenced by local factors, including dental plaque, tartar, teeth alignment, occlusion, an incompatible prosthesis, and bad lifestyle habits, and systemic factors, including smoking, consumption of alcohol, irregular lifestyle and eating habits, obesity, stress, hormones, and heredity. It has recently been revealed that the oral environment is associated with cancer. In particular, commensal bacteria in the oral cavity are involved in the development of cancer. Moreover, Candida, human papilloma virus and Epstein-Barr virus as well as commensal bacteria have been reported to be associated with the pathogenesis of cancer. In this review, we introduce recent findings of the correlation between the oral environment and cancer.
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Affiliation(s)
- Yasusei Kudo
- Department of Oral Molecular Pathology, Institute of Biomedical Sciences, Tokushima University Graduate School, Tokushima, Japan
| | - Hidesuke Tada
- Department of Oral Molecular Pathology, Institute of Biomedical Sciences, Tokushima University Graduate School, Tokushima, Japan ; Tada Dental Clinic, Kakogawa, Japan
| | - Natsumi Fujiwara
- Department of Oral Healthcare Promotion, Institute of Biomedical Sciences, Tokushima University Graduate School, Tokushima, Japan
| | | | - Takaaki Tsunematsu
- Department of Oral Molecular Pathology, Institute of Biomedical Sciences, Tokushima University Graduate School, Tokushima, Japan
| | - Yoichiro Miyake
- Department of Oral Microbiology, Institute of Biomedical Sciences, Tokushima University Graduate School, Tokushima, Japan
| | - Naozumi Ishimaru
- Department of Oral Molecular Pathology, Institute of Biomedical Sciences, Tokushima University Graduate School, Tokushima, Japan
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9
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V S, B K YD, Mysorekar VV, Kamath NP. Primary Extranodal Lymphomas of Lip - A Rare Manifestation in Sjogren's Syndrome. J Clin Diagn Res 2014; 8:272-4. [PMID: 24783157 DOI: 10.7860/jcdr/2014/7616.4184] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2013] [Accepted: 01/15/2014] [Indexed: 11/24/2022]
Abstract
Sjogren's syndrome (SS) is a chronic autoimmune disorder which is characterized by lymphocyte-mediated destruction of exocrine glands, which produces the classical symptoms of dry eyes and dry mouth, which is referred to as primary SS or the Sicca complex. When it is associated with another autoimmune disease such as rheumatoid arthritis or lupus erythematosus, the condition is termed as secondary SS. One of the known major complications in patients with Sjogren's syndrome is the occurrence of Non-Hodgkin's lymphoma of B cell type. It is not uncommon for malignant lymphomas to occur in head and neck region at nodal and sometimes, extranodal sites. However, only rarely may they involve the oral cavity primarily. This case report describes a rare occurrence of isolated extranodal lymphomas in the upper and lower lips of a patient, which clinically resembled a mucocele, and eventually was diagnosed as lymphoma which was associated with Sjogren's syndrome, thereby stressing the importance which was played by an oral diagnostician.
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Affiliation(s)
- Shwetha V
- Senior Lecturer, Department of Oral Medicine and Radiology, M.S. Ramaiah Medical College, M.S. Ramaiah Education Campus , Bangalore, India
| | - Yashoda Devi B K
- Senior Lecturer, Department of Oral Medicine and Radiology, M.S. Ramaiah Medical College, M.S. Ramaiah Education Campus , Bangalore, India
| | - Vijaya V Mysorekar
- Professor, Department of Pathology, M.S. Ramaiah Medical College, M.S. Ramaiah Education Campus , Bangalore, India
| | - Namrata P Kamath
- Postgraduate Student, Department of Oral Medicine and Radiology, M.S. Ramaiah Medical College, M.S. Ramaiah Education Campus , Bangalore, India
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Ashraf MJ, Makarempour A, Monabati A, Azarpira N, Khademi B, Hakimzadeh A, Abedi E, Valibeigi B. Comparison between presence of epstein barr virus in nodal and extra nodal diffuse large B cell lymphoma of head and neck, an Iranian experience. IRANIAN RED CRESCENT MEDICAL JOURNAL 2012; 14:764-70. [PMID: 23482890 PMCID: PMC3587864 DOI: 10.5812/ircmj.1302] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/26/2011] [Revised: 08/26/2011] [Accepted: 08/27/2011] [Indexed: 12/13/2022]
Abstract
Background Epstein Barr Virus (EBV) is one of the most common viral infections in human population. EBV has a significant role in pathogenesis of Hodgkin's lymphoma, Burkitt's lymphoma and nasopharyngeal carcinoma. The role of EBV in non-Hodgkin’s lymphoma, diffuse large B cell (NHL - DLBL) in the head and neck is controversial. Objectives The purpose of this study is to find out the difference between the presence of Epstein Barr virus in nodal and extra nodal lymphoma of head and neck. Patients and Methods A total of 30 cases of DLBL in two separate groups were collected from pathology department. The first group was consisted of 15 patients with DLBL of neck lymph node and the other was consisted of 15 patients with extra nodal DLBL of head and neck mainly in palatine tonsil. Both immune-histo-chemical (IHC) study and polymerase chain reaction (PCR) for detection of late membrane antigen (LMP) were performed on formalin fixed paraffin embedded tissue. Results All 30 cases were negative for EBV in IHC method. But in PCR method, 10% of patients were positive for LMP gene. There were 2 positive cases in nodal lymphoma and 1 positive case in extra nodal lymphoma group. Conclusions Compare with PCR method, it seems that IHC is not a sensitive method for detection of EBV. Overall, the finding of EBV in NHL depends on site, type of lymphoma and the detection method.
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Affiliation(s)
- Mohammad Javad Ashraf
- Transplant Research Center, Department of Pathology, Shiraz Medical School, Shiraz University of Medical Sciences, Shiraz, IR Iran
| | - Alireza Makarempour
- Transplant Research Center, Department of Pathology, Shiraz Medical School, Shiraz University of Medical Sciences, Shiraz, IR Iran
| | - Ahmad Monabati
- Transplant Research Center, Department of Pathology, Shiraz Medical School, Shiraz University of Medical Sciences, Shiraz, IR Iran
| | - Negar Azarpira
- Transplant Research Center, Department of Pathology, Shiraz Medical School, Shiraz University of Medical Sciences, Shiraz, IR Iran
- Corresponding author: Negar Azarpira, Transplant Research Center, Department of Pathology, Shiraz Medical School, Shiraz University of Medical Sciences, Shiraz, IR Iran. Tel.: +98-7116474331, Fax: +98-7116474331, E-mail:
| | - Bijan Khademi
- Department of Otolaryngology, Shiraz Medical School, Shiraz University of Medical Sciences, Shiraz, IR Iran
| | - Afsoon Hakimzadeh
- Transplant Research Center, Department of Pathology, Shiraz Medical School, Shiraz University of Medical Sciences, Shiraz, IR Iran
| | - Elham Abedi
- Transplant Research Center, Department of Pathology, Shiraz Medical School, Shiraz University of Medical Sciences, Shiraz, IR Iran
| | - Bita Valibeigi
- Transplant Research Center, Department of Pathology, Shiraz Medical School, Shiraz University of Medical Sciences, Shiraz, IR Iran
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Azarpira N, Ashraf MJ, Monabati A, Makarempour A, Khademi B, Hakimzadeh A, Abedi E, Valibeigi B. Primary Lymphoma of Nasal Cavity and Paranasal Sinuses. Lab Med 2012. [DOI: 10.1309/lmkh083qcxfuuigs] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
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12
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Sai S, Watanabe C, Okada S. A rare case of childhood precursor B-cell lymphoblastic lymphoma in the mandible. Leuk Res 2011; 36:e37-8. [PMID: 21899887 DOI: 10.1016/j.leukres.2011.08.012] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2011] [Revised: 07/27/2011] [Accepted: 08/15/2011] [Indexed: 11/26/2022]
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13
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Mohammadianpanah M, Daneshbod Y, Ramzi M, Hamidizadeh N, Dehghani SJ, Bidouei F, Khademi B, Ahmadloo N, Ansari M, Omidvari S, Mosalaei A, Dehghani M. Primary tonsillar lymphomas according to the new World Health Organization classification: to report 87 cases and literature review and analysis. Ann Hematol 2010; 89:993-1001. [PMID: 20440503 DOI: 10.1007/s00277-010-0970-9] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2010] [Accepted: 04/19/2010] [Indexed: 12/16/2022]
Abstract
The present study aimed to define the natural history, World Health Organization (WHO) classification, prognostic factors, and treatment outcome of 87 patients with primary lymphoma of the palatine tonsil and literature review and analysis. Between 1990 and March 2008, 87 consecutive patients diagnosed with primary lymphoid malignancy of the palatine tonsil. All pathologic specimens were reviewed and reclassified according to the recent WHO classification. To investigate the association of tonsillar lymphomas with Epstein-Barr virus (EBV), in situ hybridization was performed for 24 tonsillar lymphomas (23 diffuse large B-cell lymphoma (DLBC) and one classic Hodgkin's disease) and ten normal tonsils as control group. In literature review, we found 26 major related series including 1,602 patients with primary tonsillar lymphoma. The median age of our patients was 52 years (range 11-86 years). There were 39 women and 48 men with a median follow-up of 67 months for living patients. The vast majority (95%) of patients had B-cell phenotype. DLBC was the most frequent histology. In situ hybridization revealed none of 23 DLBC to be positive for EBV. The 5-year disease-free and overall survival rates were 78.9% and 86%, respectively. In the literature review and by analyzing the data collection from 26 major reported series, the median age was 55 years and male/female ratio was 1.3:1. Intermediate grade tumors consisted of 72% of all tonsillar lymphomas and B-cell lymphomas constituted 82% of all cell immunophenotypes. The 5-year disease-free and overall survival rates were 61% and 67%, respectively. The vast majority of tonsillar lymphomas are of B-cell origin and with intermediate to high-grade histology. These neoplasms tend to present in early stage disease and to have favorable outcome. WHO classification predicts more accurately treatment outcome of patients with tonsillar lymphoma. The association of DLBC in the palatine tonsil with EBV infection is infrequent.
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Affiliation(s)
- Mohammad Mohammadianpanah
- Hematology Research Center, Department of Radiation Oncology, Shiraz University of Medical Sciences, Iran
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Pastor-Nieto M, Kilmurray L, López-Chumillas A, O’Valle F, García-del Moral R, Puig A, Bautista P. Úlceras orales como manifestación clínica de proceso linfoproliferativo asociado a metotrexato en una paciente con artritis reumatoide. ACTAS DERMO-SIFILIOGRAFICAS 2009. [DOI: 10.1016/s0001-7310(09)70233-9] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
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15
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Mawardi H, Cutler C, Treister N. Medical management update: Non-Hodgkin lymphoma. ACTA ACUST UNITED AC 2009; 107:e19-33. [PMID: 19101479 DOI: 10.1016/j.tripleo.2008.08.054] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2008] [Revised: 08/11/2008] [Accepted: 08/27/2008] [Indexed: 11/19/2022]
Abstract
Lymphoma is a heterogeneous malignancy of the lymphatic system characterized by proliferation of lymphoid cells or their precursors. Non-Hodgkin lymphoma (NHL) is associated with significant morbidity and is the seventh leading cause of death in the United States. Manifestations of NHL as well as complications of the disease and its management are frequently encountered in the head and neck region and often require specific treatment and modifications in the provision of oral health care. The purpose of this article is to review current concepts of the pathophysiology, as well as medical and oral health care management of NHL.
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Affiliation(s)
- Hani Mawardi
- Department of Oral Medicine, Infection and Immunity, Harvard School of Dental Medicine, Boston, MA, USA.
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16
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Methotrexate-Associated Lymphoproliferative Disorder Presenting As Oral Ulcers in a Patient With Rheumatoid Arthritis. ACTAS DERMO-SIFILIOGRAFICAS 2009. [DOI: 10.1016/s1578-2190(09)70031-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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17
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Adouani A, Bouguila J, Jeblaoui Y, Ben Aicha M, Abdelali MA, Hellali M, Zitouni K, Amani L, Issam Z. B-cell lymphoma of the mandible: a case report. Clin Med Oncol 2008; 2:445-50. [PMID: 21892315 PMCID: PMC3161690 DOI: 10.4137/cmo.s366] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
Introduction The mandible is an infrequent localisation of primary osseous non-Hodgkin’s lymphomas. Few cases of mandibular non-Hodgkin’s lymphomas (NHL) have been reported. Case report A rare condition of primary malignant non-Hodgkin’s lymphoma of the mandible in 53-year-old man, was reported at the Department of Maxillofacial and Plastic Surgery in Charles Nicolle Hospital (Tunis, Tunisia). Histologic and Immunohistochemical (IHC) examination Confirmed a B-Cell lymphoma. Discussion The purpose of this report is to describe this rare case of NHL of the mandible, explore the diagnosis and workup, and discuss treatment strategies. In this localisation, neither the clinical features nor the radiologic appearances are often pathognomonic. Conclusion Particular care must be taken to consider lymphoma in the differential diagnosis because this uncommon lesion can pose significant diagnostic problems and is frequently misdiagnosed.
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Affiliation(s)
- Ali Adouani
- Departement of Maxillofacial and Plastic Surgery. Charles Nicolle Hospital. Tunis-Tunisia (Head of the department: Ali Adouani)
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18
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Cox DP, Treseler P, Dong R, Jordan RCK. Rare oral cavity presentation of a B-cell lymphoblastic lymphoma. A case report and review of the literature. ACTA ACUST UNITED AC 2007; 103:814-9. [PMID: 17531941 DOI: 10.1016/j.tripleo.2005.11.037] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2005] [Revised: 11/18/2005] [Accepted: 11/23/2005] [Indexed: 11/21/2022]
Abstract
Lymphoblastic lymphoma is an uncommon malignancy, with most cases showing a T-cell phenotype and presenting as a mediastinal mass. By contrast, B-cell lymphoblastic lymphoma/leukemia is a rare high-grade malignancy that comprises approximately 10% of all lymphoblastic lymphomas. Lymphomas of the oral cavity are rare and typically present as intraosseous lesions that are most commonly diffuse large B-cell type. Here we present what we believe is the first B-cell lymphoblastic lymphoma initially presenting in the oral cavity. The case involves a 46-year-old white woman who presented with a mass in the right mandible. This report discusses this rare malignancy, including clinical presentation, histopathologic features, immunologic profile, treatment, and prognosis. This case emphasizes the importance of recognizing rare entities that may present in the oral cavity and the impact of the disease and its management.
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Affiliation(s)
- Darren P Cox
- Department of Orofacial Sciences, University of California, San Francisco, California, USA
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19
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Bruce AJ, Subtil A, Rogers RS, Castro LA. Monomorphic Epstein-Barr virus (EBV)-associated large B-cell posttransplant lymphoproliferative disorder presenting as a tongue ulcer in a pancreatic transplant patient. ACTA ACUST UNITED AC 2006; 102:e24-8. [PMID: 16997090 DOI: 10.1016/j.tripleo.2006.01.014] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2005] [Revised: 12/12/2005] [Accepted: 01/11/2006] [Indexed: 11/24/2022]
Abstract
Posttransplant lymphoproliferative disorders are a group of lymphoid proliferations and lymphomas that develop as a consequence of immunosuppression in recipients of solid organ or bone marrow allografts. We describe an unusual oral presentation of posttransplant Epstein-Barr virus-associated diffuse large B-cell lymphoma in a 45-year-old woman after pancreatic transplant.
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Affiliation(s)
- Alison J Bruce
- Dermatology consultant, Department of Dermatology, Mayo Clinic, Rochester, MN 55905, USA.
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20
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Abstract
Epstein-Barr virus (EBV), a B-lymphotropic gamma-herpesvirus, causes infectious mononucleosis and oral hairy leukoplakia, and is associated with various types of lymphoid and epithelial malignancies. Saliva is the main vehicle for EBV transmission from individual to individual. Recent studies have also implicated EBV in the pathogenesis of advanced types of periodontal disease. EBV DNA is detected in 60-80% of aggressive periodontitis lesions and in 15-20% of gingivitis lesions or normal periodontal sites. The periodontal presence of EBV is associated with an elevated occurrence of periodontopathic anaerobic bacteria. Moreover, EBV active infection occurs in approximately 70% of symptomatic and large-size periapical lesions. EBV and cytomegalovirus often co-exist in marginal and apical periodontitis. Periodontal therapy can markedly suppress the EBV load in periodontal pockets as well as in saliva, which has the potential to reduce the risk of viral transmission between close individuals. EBV proteins up-regulate cytokines and growth factors, which seem to play a central role in the proliferative response of tongue epithelial cells in oral hairy leukoplakia and in the cell-transformation process of EBV-associated malignancies. Further research is needed to identify the full range of EBV-related diseases in the human oral cavity.
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Affiliation(s)
- J Slots
- University of Southern California, School of Dentistry - MC 0641, Los Angeles, California 90089-0641, USA.
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21
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Yunos AM, Jaafar H, Idris FM, Kaur G, Mabruk MJEMF. Detection of Epstein-Barr virus in lower gastrointestinal tract lymphomas: a study in Malaysian patients. Mol Diagn Ther 2006; 10:251-6. [PMID: 16884329 DOI: 10.1007/bf03256464] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
BACKGROUND Many studies in the literature have shown that Epstein-Barr virus (EBV) is associated with several human lymphoid and epithelial malignancies. However, the prevalence of EBV in non-Hodgkin lymphoma (NHL) of the lower gastrointestinal (GI) tract has not been fully elucidated. AIM The aim of this study was to determine the presence and distribution of EBV in formalin-fixed paraffin-embedded tissue samples obtained from 18 Malaysian patients diagnosed with NHL of the lower GI tract. METHODS The GI tract lymphoma tissue samples analyzed for the presence of EBV were divided into the following groups: NHL of the small intestine (seven cases); NHL of the ileocecum (ten cases); and NHL of the rectum (one case). The presence of EBV-encoded RNA (EBER) in all of the above tissue samples was tested for using conventional in situ hybridization technology. RESULTS Two of 18 cases (11.1%) of NHL of the lower GI tract demonstrated positive signals for EBV/EBER. In the first positive case, EBV/EBER signals were located in lymphoma cells in the serosa layer of the small intestine. In the second EBV/EBER-positive case, EBV/EBER signals were detected in diffuse B-cell lymphoma of the ileocecum. CONCLUSION These findings demonstrate a rare association between EBV and lower GI tract lymphomas in this group of Malaysian patients.
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Affiliation(s)
- Asmah M Yunos
- Advanced Medical and Dental Institute, Universiti Sains Malaysia, Kelantan, Malaysia
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22
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Rhinow K, Schirmer I, Loddenkemper C, Anagnostopoulos I, Stein H, Reichart PA. Orale Epstein-Barr-Virus-assoziierte diffuse großzellige B-Zell-Lymphome bei HIV-negativen immunsupprimierten Patienten. ACTA ACUST UNITED AC 2006; 10:155-61. [PMID: 16685566 DOI: 10.1007/s10006-006-0689-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
BACKGROUND Diffuse large B-cell lymphomas (DLBCL) are non-Hodgkin's lymphomas (NHL) and with a prevalence of 30-40% they comprise the most frequent NHL in adults. Although their etiology is still unknown, a virus induction, especially by the Epstein-Barr-virus (EBV), is the subject of discussion. Patients with congenital or acquired immunodeficiency are primarily afflicted. PATIENT 1: A 39-year-old female patient developed an EBV-associated DLBCL of the plasmablastic subtype in the maxillary alveolar ridge in the region of teeth 11 and 21 after 24 years of immunosuppressive therapy with azathioprine due to myasthenia gravis. Clinically the lesion presented as a localized acute necrotizing periodontitis that was resistant to symptomatic therapy. After polychemotherapy the disease is in complete remission until today. PATIENT 2: A 56-year-old male patient developed an EBV-associated DLBCL of immunoblastic variant of the right maxillary edentulous alveolar ridge in the posterior region 7 weeks after heart transplantation and immunosuppressive therapy with azathioprine and cyclosporine A. Clinically, a soft, nonpainful, swelling measuring 1.5x0.5x0.5 cm with a central ulceration was evident. The tumor was excised followed by local radiation therapy. No recurrence was noted during a 15-year-follow-up. DISCUSSION The presented clinical cases demonstrate the increased risk of occurrence of oral malignant B-cell lymphomas as adverse effects of immunosuppressive therapy. The demonstration of EBV in the tumor cells in both cases underlines the involvement of this virus in the pathogenesis of oral DLBCL arising in the setting of an immunodeficiency as has been shown previously in patients with HIV. CONCLUSIONS Due to the varying and often nonspecific clinical appearance of oral DLBCL, an early biopsy and work-up by an institute specialized in hematopathology is essential for diagnosis, because these tumors may disseminate in early stages.
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Affiliation(s)
- K Rhinow
- Abteilung für Oralchirurgie und zahnärztliche Röntgenologie, Zentrum für Zahnmedizin, Charité - Universitätsmedizin Berlin, Campus Virchow-Klinikum, Augustenburger Platz 1, 13353, Berlin,
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23
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Bahnassy AA, Zekri ARN, Asaad N, El-Houssini S, Khalid HM, Sedky LM, Mokhtar NM. Epstein-Barr viral infection in extranodal lymphoma of the head and neck: correlation with prognosis and response to treatment. Histopathology 2006; 48:516-28. [PMID: 16623777 DOI: 10.1111/j.1365-2559.2006.02377.x] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
AIMS To determine the prevalence of Epstein-Barr virus (EBV) infection in primary extranodal lymphoma of the head and neck (PELHN) in immunocompetent patients. PELHN represents 16.18% of all lymphoma diagnosed at the National Cancer Institute, Cairo. Although EBV infection is highly associated with lymphoma in immunocompromised patients, the situation in immunocompetent patients is still unclear. MATERIAL AND METHODS The study included 50 PELHN (11 cases in the nose and paranasal sinuses, 11 in the nasopharynx, 13 in the tonsils, seven in the oropharynx and eight in the oral cavity), five reactive lymph nodes, 15 normal nasopharyngeal tissue and 25 throat washes of healthy subjects from Egypt. Cases and controls were assessed for the presence of EBV by polymerase chain reaction (PCR) and in situ hybridization techniques, the presence of 30 base pair deletion of the LMP-1 (del-LMP1) gene and for the expression of p53, Ki67, bcl-2 and Bax by immunohistochemistry. This was also correlated with the clinical outcome of patients. RESULTS EBV was detected in 90% and 70% of the cases using EBER in situ hybridization and PCR, respectively. All cases of nasal type lymphoma were positive for EBV. del-LMP1 gene was detected in 24/35 of EBV+ cases (68.6%), whereas 11 cases had wild-type variant either alone or mixed with del-LMP1. There was a significant difference in the frequency of del-LMP1 between lymphoma and normal tissues. Overexpression of Ki67, p53 and bcl-2 was detected in 78.1%, 62.5% and 20% of cases, whereas loss of Bax was detected in 18% of the cases. Multivariate analysis showed that only p53 overexpression, del-LMP1 variant and advanced disease stage are independent prognostic factors. CONCLUSION EBV infection is frequent in PELHN in Egypt. Possible pathogenic mechanisms involve deregulation of p53 and enhanced proliferation (as detected by high Ki67 index). The presence of del-LMP1 variants, p53 overexpression and advanced disease stage are poor prognostic factors associated with reduced survival and poor response to therapy.
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Affiliation(s)
- A A Bahnassy
- Pathology Department, Menofya University, Cairo, Egypt.
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24
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Kolokotronis A, Konstantinou N, Christakis I, Papadimitriou P, Matiakis A, Zaraboukas T, Antoniades D. Localized B-cell non-Hodgkin's lymphoma of oral cavity and maxillofacial region: a clinical study. ACTA ACUST UNITED AC 2005; 99:303-10. [PMID: 15716836 DOI: 10.1016/j.tripleo.2004.03.028] [Citation(s) in RCA: 81] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
OBJECTIVE Non-Hodgkin's lymphomas (NHL) are the third most common group of malignant lesions in the oral cavity and maxillofacial region. Most such lymphomas have been shown to be predominantly of B-lineage. The purpose of the present study is to analyze the clinical signs and symptoms and the clinical staging of B-cell NHL of this region. STUDY DESIGN Eighteen adults, with B-cell NHL manifestations of the oral cavity and maxillofacial region, were available for this study. The clinical stage according to the Ann Arbor system was assessed by history, physical, and laboratory examination. Hematoxylin and eosin--stained slides and paraffin blocks were available for all cases. Histologic diagnosis was based on the WHO classification of tumors. RESULTS The mean age of patients at the time of biopsy was 64 years. At the time of the disease presentation, according to the Ann Arbor system, 11 patients were in stage IE, 2 patients in stage IIE, 2 patients in stage IIIE, 1 patient in stage IVE, and 2 patients in stage IV. The typical clinical appearance was a painless local mass lateral or bilateral. Often there is a superficial ulceration of the tumor mass. Tonsillar NHL was the most frequent site occurring in 8 patients followed by NHL of the oral cavity, of the salivary glands, and of the mandible. Grading revealed that most cases were high grade (11 cases), followed by the cases of low grade (5 cases) and intermediate grade (2 cases). All the different histologic types may be observed, but the most frequently encountered is the diffuse large type. CONCLUSIONS The B-cell NHL may involve both osseous and soft tissues of the oral cavity and maxillofacial region. The favored sites are tonsils, palatal mucosa and parotid glands. The typical clinical appearance is a painless local mass lateral or bilateral. Often there is a superficial ulceration of the tumor mass. According to the Ann Arbor system, the majority of the cases at the time of diagnosis are in stage I or II. Most patients have high grade disease. All the different histologic types may be observed, but the most frequently encountered is the diffuse large type.
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MESH Headings
- Adult
- Aged
- Aged, 80 and over
- Female
- Humans
- Lymphoma, B-Cell/drug therapy
- Lymphoma, B-Cell/pathology
- Lymphoma, B-Cell/surgery
- Lymphoma, B-Cell, Marginal Zone/drug therapy
- Lymphoma, B-Cell, Marginal Zone/pathology
- Lymphoma, B-Cell, Marginal Zone/surgery
- Lymphoma, Large B-Cell, Diffuse/drug therapy
- Lymphoma, Large B-Cell, Diffuse/pathology
- Lymphoma, Large B-Cell, Diffuse/surgery
- Male
- Middle Aged
- Mouth Neoplasms/drug therapy
- Mouth Neoplasms/pathology
- Mouth Neoplasms/surgery
- Neoplasm Staging
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Affiliation(s)
- Alexandros Kolokotronis
- Department of Oral Medicine/Pathology, Dental School, Aristotle University of Thessaloniki, Greece.
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Chen YK, Huang E, Lin CC, Lin YJ, Hsue SS, Wang WC, Lin LM. Composite lymphoma: angiocentric T-cell lymphoma (CD8+ cytotoxic/supressor T-cell) and diffuse large B-cell lymphoma associated with EBV, and presenting clinically as a midfacial necrotizing lesion. Oral Oncol 2004; 40:353-9. [PMID: 14747069 DOI: 10.1016/j.oraloncology.2003.09.001] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
A composite lymphoma is defined as the simultaneous occurrence of two histologically different types of lymphomas situated in one anatomical location. Reports of composite B- and T-cell lymphomas, especially in the head and neck region, are rare. We describe a 76-year-old Taiwanese aboriginal female patient clinically presenting with a midfacial necrotizing lesion (MNL). Microscopic examination of the incisional biopsy specimen revealed extensive surface necrosis with infiltrates of inflammatory cells. Beneath the necrotic surface, there appeared to be two distinct populations of pleomorphic lymphoid cells exhibiting the characteristic features of the angiocentric distribution of the tumor cells and evidence of angiodestruction. Immunohistochemical staining revealed that these atypical lymphoid cells were positive for LCA, CD45, CD5, CD20, CD3 epsilon, CD8, bcl-2 and bcl-6 and negative for CD56, CD4, CD68, keratin, S-100, kappa and lambda. Furthermore, these atypical lymphoid cells also expressed EBV-encoded nuclear RNAs (EBERs) following in situ hybridization. Therefore, this was a case of composite lymphoma: angiocentric T-cell lymphoma (ATCL) (CD8+ cytotoxic/suppressor T-cell) and diffuse large B-cell lymphoma (DLBL) associated with the Epstein-Barr virus (EBV) and presenting clinically as MNL.
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MESH Headings
- Aged
- Epstein-Barr Virus Infections/complications
- Epstein-Barr Virus Infections/pathology
- Female
- Humans
- Lymphoma, B-Cell/diagnosis
- Lymphoma, B-Cell/pathology
- Lymphoma, B-Cell/virology
- Lymphoma, Large B-Cell, Diffuse/diagnosis
- Lymphoma, Large B-Cell, Diffuse/pathology
- Lymphoma, Large B-Cell, Diffuse/virology
- Lymphoma, T-Cell/diagnosis
- Lymphoma, T-Cell/pathology
- Lymphoma, T-Cell/virology
- Mouth Neoplasms/diagnosis
- Mouth Neoplasms/pathology
- Mouth Neoplasms/virology
- Neoplasms, Multiple Primary/diagnosis
- Neoplasms, Multiple Primary/pathology
- Neoplasms, Multiple Primary/virology
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Affiliation(s)
- Yuk-Kwan Chen
- Department of Oral Pathology, School of Dentistry, Kaohsiung Medical University, Kaohsiung, Taiwan
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26
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Abstract
At present, information concerning the role of viruses in the pathogenesis of human neoplasms is fragmented and incomplete. It is clear that their role is complex, and a complete understanding of the intricacies involved in viral interaction with the human genome may still take many years. New virologic study techniques can be expected to emerge and epidemiologic studies will continue. With each new report, a bit more will be understood, new hypotheses stimulated, and additional studies undertaken. The identification of viral agents as causative agents of neoplasia and the pathogenetic mechanisms by which they act will have a profound effect on our approaches to oral cancer.
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Affiliation(s)
- Joan Andersen Phelan
- Department of Oral Pathology, New York University College of Dentistry, 345 East 24th Street, New York, NY 10010, USA.
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Iamaroon A, Pongsiriwet S, Mahanupab P, Kitikamthon R, Pintong J. Oral non-Hodgkin lymphomas: studies of EBV and p53 expression. Oral Dis 2003; 9:14-8. [PMID: 12617252 DOI: 10.1034/j.1601-0825.2003.01808.x] [Citation(s) in RCA: 19] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
OBJECTIVES The aims of the study were to assess sociodemographic and clinicopathologic characteristics of patients with oral non-Hodgkin lymphomas (NHLs) and the expression of Epstein-Barr virus (EBV) and p53. MATERIALS AND METHODS The clinical and pathologic features of 11 patients with oral NHLs were studied. The expression of EBV mRNA and p53 protein were studied by means of in situ hybridization and immunohistochemical methods in 11 formalin-fixed, paraffin-embedded specimens from these patients. RESULTS The patients' age ranged from 13 to 70 years with the mean of 42 years. Human immuno-deficiency virus (HIV) status was documented in five of the 11 patients and three were known to be HIV-positive. The most common locations were gingiva and alveolar mucosa. Pain and tenderness were major symptoms of the patients. The most common histologic subtype was diffuse large-cell, intermediate-grade NHL. Eight of 11 cases (72.7%) showed positive expression of p53 protein. Four of 10 cases (40%) expressed EBV-encoded RNA (EBER) transcripts. All known HIV-positive cases were EBV-positive. CONCLUSIONS The findings suggest that appropriately expressed p53 protein may play a role in tumorigenesis of oral NHLs. In addition, EBV may be involved with the pathogenesis of oral NHLs particularly in patients with HIV infection.
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MESH Headings
- Adolescent
- Adult
- Aged
- Herpesvirus 4, Human/isolation & purification
- Humans
- Immunoenzyme Techniques
- In Situ Hybridization
- Lymphoma, AIDS-Related/genetics
- Lymphoma, AIDS-Related/metabolism
- Lymphoma, AIDS-Related/virology
- Lymphoma, Large B-Cell, Diffuse/genetics
- Lymphoma, Large B-Cell, Diffuse/metabolism
- Lymphoma, Large B-Cell, Diffuse/virology
- Lymphoma, Non-Hodgkin/genetics
- Lymphoma, Non-Hodgkin/metabolism
- Lymphoma, Non-Hodgkin/virology
- Middle Aged
- Mouth Neoplasms/genetics
- Mouth Neoplasms/metabolism
- Mouth Neoplasms/virology
- RNA, Viral/analysis
- Tumor Suppressor Protein p53/biosynthesis
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Affiliation(s)
- A Iamaroon
- Department of Odontology and Oral Pathology, Faculty of Dentistry, Chiang Mai University, Chiang Mai, Thailand.
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Yih WY, Stewart JCB, Kratochvil FJ, Zieper MB. Angiocentric T-cell lymphoma presenting as midface destructive lesion: case report and literature review. ORAL SURGERY, ORAL MEDICINE, ORAL PATHOLOGY, ORAL RADIOLOGY, AND ENDODONTICS 2002; 94:353-60. [PMID: 12324793 DOI: 10.1067/moe.2002.125198] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
A case of angiocentric T-cell lymphoma presenting as a midface destructive lesion is reported. Angiocentric T-cell lymphoma typically manifests as an aggressive, progressively destructive, and necrotizing disorder, often with a fatal outcome. This case was characterized microscopically by the presence of an atypical lymphoid population that expressed a CD45+, CD3+ cytoplasmic, CD5+, and CD56- T-cell phenotype within a background of a polymorphous inflammatory infiltrate. Because of the rarity of the disorder, the differential diagnosis is discussed. Recent advances in clinical immunodiagnostics, the variations in therapeutic modalities, and the prognosis of the disease as reported in the recent literature are reviewed.
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Affiliation(s)
- Wei Yung Yih
- Department of Pathology, Oregon Health & Science University, Portland, OR 97201, USA
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