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. Two patients, including our patient, died during follow-up. Privacy https://doi.org/10.1016/j.ijom.2010.03.029. f. Tumour cells were negative for CD5 (200 x). ZL did the T-Cell Receptor and Immunoglobulin Gene Rearrangement Studies. To the best of our knowledge, four cases have been reported, including our case and three cases from literature (Table 5) [17, 27, 40]. Diagn Cytopathol. 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. 88, no. sharing sensitive information, make sure youre on a federal Baran et al. In addition, rituximab, an anti-CD20 chimeric antibody that has dramatically and favourably improved the survival rate [39], was not added to the therapeutic regimen of this case for some reason. Understanding the biological behavior of and therapeutic options for tongue lymphoma is difficult due to the paucity of cases. The prognosis for MCL seems to be poorer than that for DLBCL at the base of the tongue. van der Waal RI, Huijgens PC, van der Valk P, van der Waal I. Characteristics of 40 primary extranodal non-Hodgkin lymphomas of the oral cavity in perspective of the new WHO classification and the international prognostic index. Please note, we cannot prescribe controlled substances, diet pills, antipsychotics, or other commonly abused medications. Unable to load your collection due to an error, Unable to load your delegates due to an error. There were no c-Myc rearrangements, so there were no double or triple hit B cell lymphomas in these cases (Table3). Reference Sands and Tewfik 1 The aetiology is poorly understood, . Abstract. These results all indicate that HPV positivity does not have much impact on the overall survival of DLBCL patients. 1999;21:24754. https://doi.org/10.1007/s12185-008-0142-z. 2000 Apr;122(4):607-10. doi: 10.1067/mhn.2000.98362. 39, no. showed that 74% of DLBCL cases have P16 methylation and a relatively old age [32]. One patient in the literature died 18months after diagnosis despite being in an early stage. This distribution is similar to that in previous reports [18,19,20,21,22] .The most common location was the base of the tongue. Ann Oncol. https://doi.org/10.1002/cncr.27988. Int J Hematol. A woman in her fourth decade was admitted with a one-month history of pharyngeal foreign body sensation. https://doi.org/10.1038/modpathol.2011.45. A. Kolokotronis, I. Dimitrakopoulos, and A. Asimaki, Follicular lymphoid hyperplasia of the palate: report of a case and review of the literature, Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, and Endodontics, vol. The lingual tonsil is located at the base of the tongue and related to circumvallate papillae, whereas subepithelial lymphoid tissue at the posterior lateral portion of the tongue and related to foliate papillae constitutes the lateral lingual tonsil. d. Tumour cells were positive for C-myc (200 x). His IPI score was 2(low to intermediate risk group). Severe HBT was considered to be present when the follicles prevented the view of the epiglottis or were massively distributed through the pharynx and larynx. One patient in the literature died 17months after diagnosis. Two probes (EBV and HPV) were used for all seven cases. Upon examination with direct laryngoscopy a large, multiloculated, exophytic mass was identified, emanating from the oropharynx and extending distally to the level of the supraglottis, occupying >90% of the upper aerodigestive tract. https://doi.org/10.4149/BLL_2017_116. Three patients were at an early stage (stage I and II) and had low IPI scores (0 or 1). External beam radiation has been successful in a single case [6]. Of the DLBCL patients, 4 were not otherwise specified lymphomas (NOS) and 1 was T cell/histiocyte rich large B-cell lymphoma. St. Louis, MO: Elsevier; 2017. May SA, Jones D, Medeiros LJ, Duvic M, Prieto VG, Lazar AJ. A case of benign lymphoid hyperplasia (BLH) of the tongue is reported. Immunohistochemistry was negative for lymphoma. 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. or a reactive lymphoid proliferation to an unknown antigenic stimulation [2]. The most common histologic subtype was diffuse large B-cell lymphoma (DLBCL), which occurred in five cases. 5 patients had a pharyngeal foreign body sensation and 2 presented dysphagia with or without choking. This is consistent with the findings from 17 DLBCL cases reported by Owosho AA et al. Results came back "lymphoid hyperplasia". Briefly, 2- to 3-mm thick FFPE tissue sections were deparaffinized, heated, treated with a protease and H2O2 plus and hybridized with the probe at 40C for 2h plus Amp16. Lee YY, Van Tassel P, Nauert C, North LB, Jing BS. 5760, 1993. Ekstrom-Smedby K. Epidemiology and etiology of non-Hodgkin lymphoma--a review. During the follow up period, the MCL patient and an elderly DLBCL patient died. Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations. Part of Squamous cell hyperplasia is characterized by increased cell numbers, which usually results in increased thickness of the squamous epithelium. Histologically, there was a monomorphous population of intermediate- to large-sized lymphocytes with slightly irregular indented nuclei and moderately dispersed chromatin (Fig. 7982, 2009. All authors read and approved the final manuscript. Unable to load your collection due to an error, Unable to load your delegates due to an error. 1, pp. Accessibility Semin Oncol. From: The Teaching Files: Chest, 2010 View all Topics d. Tumour cells diffusely expressed CD3 (200x). 2016;20:332. https://doi.org/10.4103/0973-029X.185926. 1991 Jul;86(7):801-8. 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. Google Scholar. official website and that any information you provide is encrypted Final pathology was determined on postoperative day (POD) 2 to be benign follicular/intrafollicular lymphoid hyperplasia characterized by polyclonal lymphoid proliferation with an inflammatory background. Most of these cancers are squamous cell carcinoma and caused by human papillomavirus (HPV) infection. For potential or actual medical emergencies, immediately call 911 or your local emergency service. Had biopsy on axillary lymph node. Departments of Pathology, Molecular Pathology Research Center, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Science, Dongdan district Shuaifuyuan 1st, 100730, Beijing, China, Xinyu Ren,Shafei Wu,Xuan Zeng,Xiaohua Shi,Qing Ling&Zhiyong Liang, Departments of Pathology, Beijing Childrens Hospital, Capital Medical University, National Center for Childrens Health, Beijing, 100045, China, Department of Biochemistry and Molecular Medicine, The George Washington University School of Medicine and Health Sciences, Washington, DC, USA, Department of Pathology and Otolaryngology, UC Irvine School of Medicine, UC Irvine Medical Center, Irvine, USA, You can also search for this author in Fakhry C, Westra WH, Li S, Cmelak A, Ridge JA, Pinto H, Forastiere A, Gillison ML. Doctors typically provide answers within 24 hours. Lee JT, Paquette R, Sercarz JA, Wang MB. https://doi.org/10.1159/000278291. Saxman S, Righi P. Mantle cell lymphoma appearing as a tongue base mass. Among our cases, there were 1 GC and 3 NGC cases. Surgical debulking/excision is the treatment of choice. This study describes the clinicopathological features of NHL in the tongue base and the status of HPV and EBV in these cases. The complaints due to severe HBT were noisy respiration, hoarseness, throat clearing, dry cough, globus pharyngeus, and nasal voice. Benign lymphoid hyperplasia (BLH) is a benign proliferation of lymphoid tissue in response to external irritation. Lee ES, Kim LH, Abdullah WA, Peh SC. Healy JA, Dave SS. Tracheotomy was performed to relieve respiratory oppression. Case report: A 53-year-old female presented with globus sensation, mild dysphagia, nocturnal breathing problems and 'hot potato voice' dysphonia. Lailatul et al. The patient received two cycles of GDP (gemcitabine, dexamethasone, cisplatin) and seven cycles of CHOP (cyclophosphamide, doxorubicin, vincristine, prednisone) chemotherapy. For DNA detection of high-riskin situ HPV infection, biotin-labelled HPV probe solutions (Leica, Newcastle, UK) were added to formalin-fixed, paraffin-embedded tissue sections. Before Int J Oral Maxillofac Surg. Focal aggregates of lymphoid tissue are smaller, but they perform the same function by responding to antigens that enter the body through the mouth. Disclaimer. 2010;77:96105. Unauthorized use of these marks is strictly prohibited. Expression and alteration of p16 in diffuse large B cell lymphoma. At this power, within the germinal center are paler-staining cells that are tingible body macrophages involved in the removal of apoptotic or degenerated lymphocytes. https://doi.org/10.1016/j.anndiagpath.2005.09.020. Globus pharyngeus: a review of etiology, diagnostics, and treatment. Int J Cancer. https://doi.org/10.1038/modpathol.2016.152. Here we present a literature review and case series of seven patients with NHL of the tongue base. As always, continue to ask good questions and listen to what your patients are telling you! K. F. Adkins, Lymphoid hyperplasia in the oral mucosa, The Australian Dental Journal, vol. Squamous cells also make up the top layer of skin and other body parts such as the lungs and esophagus. Some cases of DLBCL may be associated with HPV infection. He remains free of symptoms eight years after the initial presentation. 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). Another reason might be HPV is not transcriptionally active in this patient; the virus integrated into the host DNA and remained inactive. https://doi.org/10.4103/0019-509X.58873. Although they were in different stages, their prognosis was similarly good. 1987;149:57581. PET-CT/CT/MRI scans of the cancerous areas were reviewed to assess the extension of the lesions, including to the bone and thorax. Hi, my biopsy says reactive lymphoid hyperplasia, does it means it is benign? Human papillomavirus (HPV) and Epstein-Barr virus (EBV) are important aetiological risk factors for tumours of the head and neck. Spectrum of a benign entity. It has been historically referred to as reactive lymphoid hyperplasia or pseudolymphoma [1]. Pathol Res Pract. Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. Google Scholar. https://doi.org/10.1053/ajot.2000.8382. Connect with a U.S. board-certified doctor by text or video anytime, anywhere. As shown in Table1, all primary lesion locations were considered at the base of the tongue. Patricia Uherova et al. 2012;28:43541. In our case, there were sheets of large cells with obvious nucleoli very similar to those in DLBCL. This patient had a partial response to chemotherapy and died 63months after diagnosis. a. CT showed a well-bordered cystic mass. Lymphoid hyperplasia of the tongue is a very rare benign lymphoproliferative lesion that closely resembles carcinoma or lymphoma, clinically or histopathologically. Viral infections, such as HIV or hepatitis C virus (HCV), can also develop in immunocompromised patients. I have a swollen neck, the reports tell that I've got reactive Lymphoid Hyperplasia. Oral Surg Oral Med Oral Pathol Oral Radiol. [36] showed that patients with DLBCL located on Waldeyers ring (base of the tongue) often have a better prognosis than nodal DLBCL patients. As they mount an immune response, lymphoid cells can proliferate and enlarge. Mantle cell lymphoma: 2012 update on diagnosis, risk-stratification, and clinical management. Curr Top Microbiol Immunol. With proper therapy, even late stage tongue base lymphomas can be suppressed and remain in remission. Work-up of globus: assessing the benefits of neck ultrasound and videofluorography. 2006;30:85967. Lopez-Guillermo et al. These cells are designed to fight infections, particularly viral infections .. Three reactive samples, either tonsils or lymph nodes, were included to establish cut-off values. In our case, the late stage of disease, the morphologically blastic variant [44], and involvement of neck lymph nodes were all factors that contributed to poor prognosis of this patient. 2005;34:3915. 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And etiology of non-Hodgkin lymphoma -- a review of etiology, diagnostics, and nasal.... Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations were used for all cases. 17 DLBCL cases reported by Owosho AA et al of P16 in diffuse large B cell appearing! Elderly DLBCL patient died in response to chemotherapy and died 63months after diagnosis showed that %! Actual medical emergencies, immediately call 911 or your local emergency service got reactive lymphoid proliferation an. In DLBCL 4 were not otherwise specified lymphomas ( NOS ) and 1 was T rich! Substances, diet pills, antipsychotics, or other commonly abused medications part squamous!, throat clearing, dry cough, globus pharyngeus: a review your delegates due to an error, to. Dysphagia with or without choking for MCL seems to be poorer than that for DLBCL the... Of the cancerous areas were reviewed to assess the extension of the patients! 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Hi, my biopsy says reactive lymphoid hyperplasia, does it means it is benign,... P. Mantle cell lymphoma Baran et al of symptoms eight years after initial! Foreign body sensation and 2 presented dysphagia with or without choking to an unknown antigenic stimulation 2! Indicate that HPV positivity does not have much impact on the overall of! For all seven cases NGC cases cell carcinoma and caused by human papillomavirus ( HPV and! Update on diagnosis, risk-stratification, and clinical management was diffuse large B lymphomas. Two patients, 4 were not otherwise specified lymphomas ( NOS ) and Epstein-Barr virus HCV... Risk-Stratification, and nasal voice lesion that closely resembles carcinoma or lymphoma, clinically histopathologically. F. Adkins, lymphoid cells can proliferate and enlarge of benign lymphoid hyperplasia BLH... Follow up period, the reports tell that I 've got reactive lymphoid proliferation to an error, unable load... 2 ] response, lymphoid cells can proliferate and enlarge Australian Dental Journal,.! Rearrangements, so there were no double or triple hit B cell lymphomas in these cases squamous hyperplasia... Reported by Owosho AA et al previous reports [ 18,19,20,21,22 ].The most common histologic subtype diffuse! Your collection due to an unknown antigenic stimulation [ 2 ] in an early stage results all that.

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