Gastric and gingival localization of mucosa-associated lymphoid tissue (MALT) lymphoma. An immunohistochemical, virological and clinical case report

A Rare Case of Low-Grade B-cell Non-Hodgkin's Lymphoma of the Lower Lip Mimicking a Mucocele

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.

Unusual cause of tooth mobility

We describe a case of a 71-year-old otherwise healthy man who presented to the dental clinic with the chief complaint of mobility involving his upper left molar teeth. The patient was a febrile, and clinical oral examination revealed localised grade II mobility and absence of gingival swelling, erythema or sinus tract. Orthopantogram revealed a poorly defined radiolucency involving the upper left second and third molar teeth. Surgical exploration of the involved area was performed and revealed the presence of a 'jelly like' brown tissue that fragments easily. Pathological examination confirmed the diagnosis of diffuse large B cell lymphoma.

Lymphoma presenting as a toothache: a wolf in sheep's clothing

Although rare in the oral cavity, oral non-Hodgkin lymphoma frequently mimics odontogenic and other oral pathologies. The purpose of this report is to discuss the diagnostic difficulty in a case of a 75-year-old man with diffuse large B-cell lymphoma presenting initially as a toothache.

Primary extranodal malignant lymphoma affecting the periodontium

BACKGROUND

Non-Hodgkin's lymphoma may arise in extranodal tissues within the head and neck region. These lesions may occur in the oral cavity, but rarely appear on the gingiva. Due to their malignant nature, rapid identification, diagnosis, and treatment of non-Hodgkin's lymphomas are essential to patient survival.

METHODS

An unusual case of primary extranodal non-Hodgkin's lymphoma is described. The small lesion arose on the gingiva and alveolar mucosa. Upon excision, the tissue was submitted for microscopic examination, with the expectation that the lesion would be benign and excision would constitute the entirety of treatment. However, a diagnosis of primary extranodal large B-cell lymphoma was returned.

RESULTS

In addition to excision of the lesion, the patient underwent a complete work-up to rule out other systemic lesions. Chemotherapy and radiation therapy were performed. The patient has remained healthy, without recurrence of lymphoma for 3 years.

CONCLUSIONS

This case reinforces the importance of submitting excised tissues for microscopic examination even when the lesion appears totally benign. In addition, it highlights the need for complete excision of suspected lesions, with generous borders of normal tissue. With current periodontal plastic surgical techniques, most defects remaining after soft tissue biopsy can be managed with good esthetic results.