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Wu Y, Zhang Y, Li C, Xie Y, Jiang S, Jiang Y, Qiu Y, Luo X, Chen Q. Follicular lymphoma manifests as multiple erosive and proliferative lesions of the oral mucosa: case report and brief literature review. BMC Oral Health 2022; 22:514. [PMCID: PMC9675221 DOI: 10.1186/s12903-022-02567-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2022] [Accepted: 11/05/2022] [Indexed: 11/21/2022] Open
Abstract
Background Erosion is one of the most common and basic lesions of oral mucosal diseases. Long-term refractory oral erosions, induced by autoimmune blistering diseases, infectious diseases, malignant diseases, and some rare conditions, may substantially reduce the quality of life of patients or even constitute a life-threatening condition, resulting in a clinical dilemma regarding the accurate diagnosis and precise management of these diseases. As a special type of malignant lymphoma, most lesions of follicular lymphoma (FL) in the oral mucosa present as masses or swelling of the oral mucosa, while emerging novel presentations lead to intractable diagnoses. Hence, diagnostic algorithms for such diseases are clinically required. Case presentation A 55-year-old female patient presented to the clinic with long-lasting oral mucosal erosions and proliferative lesions. Blood tests, pathological examinations of oral lesions including haematoxylin–eosin (HE) staining, and direct immunofluorescence precluded all of the potential diagnoses described previously. Unexpectedly, positron emission tomography/computed tomography (PET/CT) and abdominal CT of the patient revealed a dense mass in the retroperitoneal area, and the final diagnosis of the retroperitoneal mass was FL. After three courses of chemotherapy conducted by the haematologist, the erosion and proliferative lesions in the patient's oral mucosa had significantly improved. HE and immunohistochemical staining results of intraoral lesions also confirmed it as oral FL. The successful diagnosis of FL in this case is of great clinical significance, as the oral and abdominal FL were treated in a timely manner to avoid unfavourable outcomes. Conclusions To the best of our knowledge, this is the first case of FL that exhibited widespread erosions interspersed with proliferative lesions. Clinicians should be aware of oral FL or seek systemic factors in the presence of similar refractory oral erosions when treatment is non-responsive and the diagnosis is intractable.
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Affiliation(s)
- Yuqi Wu
- grid.13291.380000 0001 0807 1581State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Research Unit of Oral Carcinogenesis and Management, Chinese Academy of Medical Sciences, West China Hospital of Stomatology, Sichuan University, 610041 Chengdu, China
| | - You Zhang
- grid.13291.380000 0001 0807 1581State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Research Unit of Oral Carcinogenesis and Management, Chinese Academy of Medical Sciences, West China Hospital of Stomatology, Sichuan University, 610041 Chengdu, China
| | - Chunyu Li
- grid.13291.380000 0001 0807 1581State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Research Unit of Oral Carcinogenesis and Management, Chinese Academy of Medical Sciences, West China Hospital of Stomatology, Sichuan University, 610041 Chengdu, China
| | - Yulang Xie
- grid.13291.380000 0001 0807 1581State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Research Unit of Oral Carcinogenesis and Management, Chinese Academy of Medical Sciences, West China Hospital of Stomatology, Sichuan University, 610041 Chengdu, China
| | - Sixin Jiang
- grid.13291.380000 0001 0807 1581State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Research Unit of Oral Carcinogenesis and Management, Chinese Academy of Medical Sciences, West China Hospital of Stomatology, Sichuan University, 610041 Chengdu, China
| | - Yuchen Jiang
- grid.13291.380000 0001 0807 1581State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Research Unit of Oral Carcinogenesis and Management, Chinese Academy of Medical Sciences, West China Hospital of Stomatology, Sichuan University, 610041 Chengdu, China
| | - Yan Qiu
- grid.412901.f0000 0004 1770 1022Department of Pathology, West China Hospital, Sichuan University, Chengdu, 610041 China
| | - Xiaobo Luo
- grid.13291.380000 0001 0807 1581State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Research Unit of Oral Carcinogenesis and Management, Chinese Academy of Medical Sciences, West China Hospital of Stomatology, Sichuan University, 610041 Chengdu, China
| | - Qianming Chen
- grid.13291.380000 0001 0807 1581State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Research Unit of Oral Carcinogenesis and Management, Chinese Academy of Medical Sciences, West China Hospital of Stomatology, Sichuan University, 610041 Chengdu, China
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Corail DR, Mondoloni M, Calvo AS, Quilhot P, Lescaille G, Baaroun V, Rochefort J. Oral manifestation of lymphomatoid papulosis: systematic review. JOURNAL OF ORAL MEDICINE AND ORAL SURGERY 2022. [DOI: 10.1051/mbcb/2021043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Introduction: Lymphomatoid Papulosis (LyP) is a lymphoproliferative disorder with typical histopathological criteria and a spontaneous regression. Only few cases of oral involvement have been reported. We wondered about their clinical characteristics and their association with lymphoma. Method: This systematic review is conducted according to the PRISMA statement. The Oxford Centre for Evidence Based Medicine table (OCEBM) and the scoring from the National Agency for Accreditation and Assessment in Health (ANAES) was assigned to each study. Results: We have included 16 references. LyP can occur at any age with a female predilection. Oral lesions were unique ulcer and tongue was mostly affected. Histological types A, and C were dominant and LyP resolved spontaneously. 1 case was associated with a lymphoma. Discussion: Cutaneous LyP more affects men and are mostly classified as type A while those orals are type A or C. Oral LyP is probably a progressive lesion whose evolution is not illustrated by the histological aspect which often reflects only the initial acute period. Conclusion: Our literature review has shown that the epidemiological aspects between oral and cutaneous LyP are not the same. LyP may be associated with an increased risk of developing systemic lymphoproliferative disorders.
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Machan S, Juárez Martín Á, Cullen Aravena D, Haro R, Pielasinski Ú, Fuertes L, Córdoba R, Santonja C, Rodríguez-Pinilla SM, Requena L. Acral lymphomatoid papulosis: Report of five cases, differential diagnosis, and review. J Cutan Pathol 2021; 48:650-658. [PMID: 33269496 DOI: 10.1111/cup.13929] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2020] [Revised: 11/17/2020] [Accepted: 11/21/2020] [Indexed: 11/26/2022]
Abstract
Acral lymphomatoid papulosis (a-LyP) is a rare clinical variant of LyP whose diagnosis may be challenging. A case series of a-LyP was studied clinically, histopathologically, immunohistochemically, and from molecular point of view. Including ours, 25 cases of a-LyP have so far been reported. Clinically, a-LyP may present as acral involvement exclusively, in combination with mucosal lesions, (in itself a rare presentation), or in association with conventional LyP. The age of presentation was slightly higher than that of conventional LyP (55 vs 45 years) and a male predominance has been observed, as usually reported. Histopathologically, no morphological differences exclusively from conventional LyP were observed. LyP types A and E were the main variants. We describe for the first time one case of type D a-LyP. Acral LyP is a rare entity and correct diagnosis can only be reached with clinical and histopathological correlation, to avoid aggressive treatment of this indolent lymphoproliferative disorder.
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Affiliation(s)
- Salma Machan
- Department of Dermatology, Fundación Jiménez Díaz, Universidad Autónoma, Madrid, Spain
| | - África Juárez Martín
- Department of Dermatology, Complejo Asistencial Universitario de Palencia, Palencia, Spain
| | | | - Rosario Haro
- Department of Dermatology, Fundación Jiménez Díaz, Universidad Autónoma, Madrid, Spain
| | - Úrsula Pielasinski
- Department of Dermatology, Fundación Jiménez Díaz, Universidad Autónoma, Madrid, Spain
| | - Laura Fuertes
- Department of Dermatology, Fundación Jiménez Díaz, Universidad Autónoma, Madrid, Spain
| | - Raúl Córdoba
- Department of Hematology, Fundación Jiménez Díaz, Universidad Autónoma, Madrid, Spain
| | - Carlos Santonja
- Department of Pathology, Fundación Jiménez Díaz, Universidad Autónoma, Madrid, Spain
| | | | - Luis Requena
- Department of Dermatology, Fundación Jiménez Díaz, Universidad Autónoma, Madrid, Spain
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Tratzmiller S, Schneider U, Dunsche A, Klemke CD. [Whitish-reddish circumscribed ulcerated nodule on the tongue of a younger woman]. Hautarzt 2019; 70:459-461. [PMID: 30874840 DOI: 10.1007/s00105-019-4382-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Affiliation(s)
- Sabine Tratzmiller
- Hautklinik, Städtisches Klinikum Karlsruhe, Akademisches Lehrkrankenhaus der Universität Freiburg, Moltkestr. 120 (Gebäude V), 76133, Karlsruhe, Deutschland.
| | - Ulrich Schneider
- Pathologisches Institut, Städtisches Klinikum Karlsruhe, Akademisches Lehrkrankenhaus der Universität Freiburg, Karlsruhe, Deutschland
| | - Anton Dunsche
- Klinik für Mund‑, Kiefer- und Gesichtschirurgie, Städtisches Klinikum Karlsruhe, Akademisches Lehrkrankenhaus der Universität Freiburg, Karlsruhe, Deutschland
| | - Claus-Detlev Klemke
- Hautklinik, Städtisches Klinikum Karlsruhe, Akademisches Lehrkrankenhaus der Universität Freiburg, Moltkestr. 120 (Gebäude V), 76133, Karlsruhe, Deutschland
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Bretsztajn S, Leturc T, Euvrard E, Bodard AG. Lymphomatoid papulosis localized to the oral mucosa: case report and literature review. JOURNAL OF ORAL MEDICINE AND ORAL SURGERY 2019. [DOI: 10.1051/mbcb/2019021] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Introduction: Lymphomatoid papulosis is a primary CD 30+ cutaneous lymphoproliferation. Observation: We report the case of a 39-year-old patient who presented with ulcers on the back of the tongue, gums, buccal mucosa, and soft palate, which evolved as spontaneously regressive flare-ups. The diagnosis of inflammatory bowel disease was initially proposed. Several years later, the patient presented an ulcer on the left middle finger. Histological examination confirmed the diagnosis of lymphomatoid papulosis. Discussion: This chronic dermatosis manifests a single rash or multiple papulonodular rashes, evolving as spontaneously regressive flare-ups. Mucosal involvement is rare, and no prognostic factor for this location has been highlighted to this date. Pathological examination is essential. Conclusion: The mucosal involvement of lymphomatoid papulosis is one of the diagnoses to be considered for recurrent mouth ulcers.
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Schwartz Z, Bowe RB, Coleman M, Magro CM. Pediatric oral Epstein-Barr virus associated self-remitting CD30+ lymphoproliferative disorder: A distinct entity. Ann Diagn Pathol 2018; 37:57-61. [PMID: 30292067 DOI: 10.1016/j.anndiagpath.2018.08.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2018] [Accepted: 08/22/2018] [Indexed: 01/28/2023]
Abstract
Epstein-Barr virus (EBV) has a well-known association with lymphoproliferative disorders of B and T cell origin. EBV-related B cell lymphoproliferative disorders include Hodgkin and Burkitt lymphomas, lymphomatoid granulomatosis, EBV positive diffuse large cell B cell lymphoma of the elderly, as well as B cell lymphomas associated with solid organ transplantation and methotrexate use. EBV-related T cell disorders are primarily represented by NK/T- cell lymphoma. In a subset of patients, EBV has been implicated in CD30 positive B cell lymphoproliferative disorders of the oral mucosa falling under the rubric of the mucocutaneous ulcer of the oral cavity. We previously reported on an index series of endogenous CD30 positive T cell lymphoproliferative disorder of the oral cavity resembling borderline type C lymphomatoid papulosis. The clinical manifestation of type C oral lymphomatoid papulosis is that of a recurrent self-remitting ulcer of the oral mucosa, which histologically resembles anaplastic large cell lymphoma. Such cases can be misdiagnosed as aggressive lymphoma leading to unnecessary treatment with aggressive chemotherapeutic regimens. Whereas none of the patients in our index series exhibited EBV positivity, here we discuss a very unique example of a 14-year-old girl diagnosed with EBV positive CD30 positive lymphoproliferative disorder strongly resembling the cases of intra-oral type C lymphomatoid papulosis. The patient was initially diagnosed by a senior hematopathology consultant as having EBV positive aggressive NK/T-cell lymphoma. The significance of raising physician awareness regarding pediatric oral EBV associated CD30 positive lymphoproliferative disease of the oral cavity lies in preventing inadvertent exposure to toxic chemotherapeutic agents intended for treatment of aggressive look-alikes, namely anaplastic large cell lymphoma. Additionally, we include a literature review of similar reports of pediatric intra-oral EBV positive CD30 positive T cell lymphoproliferative disease.
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Affiliation(s)
- Ziv Schwartz
- Weill Cornell Medicine, 1300 York Ave, New York, NY 10065, USA; SUNY Downstate College of Medicine, 450 Clarkson Ave, Brooklyn, NY 11203, USA
| | - Robert B Bowe
- NYU Langone Hospital - Brooklyn, 110 55th Street, Brooklyn, NY 11220, USA.
| | - Morton Coleman
- Weill Cornell Medicine, 1300 York Ave, New York, NY 10065, USA
| | - Cynthia M Magro
- Weill Cornell Medicine, 1300 York Ave, New York, NY 10065, USA.
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Oluwole OO, Zic JA, Douds JJ, Ann Thompson M, Greer JP. Cutaneous manifestations and management of hematologic neoplasms. Semin Oncol 2016; 43:370-83. [DOI: 10.1053/j.seminoncol.2016.02.021] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Miquel J, Fraitag S, Hamel‐Teillac D, Molina T, Brousse N, Prost Y, Bodemer C. Lymphomatoid papulosis in children: a series of 25 cases. Br J Dermatol 2014; 171:1138-46. [DOI: 10.1111/bjd.13061] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/12/2014] [Indexed: 12/21/2022]
Affiliation(s)
- J. Miquel
- Department of Dermatology Necker‐Enfants Malades Hospital, AP–HP René Descartes‐Paris V University Paris France
| | - S. Fraitag
- Department of Pathology Necker‐Enfants Malades Hospital, AP–HP René Descartes‐Paris V University Paris France
| | - D. Hamel‐Teillac
- Department of Dermatology Necker‐Enfants Malades Hospital, AP–HP René Descartes‐Paris V University Paris France
| | - T. Molina
- Department of Pathology Hôtel Dieu Hospital, AP–HP René Descartes‐Paris V University Paris France
| | - N. Brousse
- Department of Pathology Necker‐Enfants Malades Hospital, AP–HP René Descartes‐Paris V University Paris France
| | - Y. Prost
- Department of Dermatology Necker‐Enfants Malades Hospital, AP–HP René Descartes‐Paris V University Paris France
| | - C. Bodemer
- Department of Dermatology Necker‐Enfants Malades Hospital, AP–HP René Descartes‐Paris V University Paris France
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