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Wongpattaraworakul W, Krongbaramee T, Lanzel EA, Hellstein JW, Teixeira FB. Hematolymphoid neoplasm mimicking endodontic lesions: case series and review of the literature. Oral Surg Oral Med Oral Pathol Oral Radiol 2024:S2212-4403(24)00406-1. [PMID: 39179451 DOI: 10.1016/j.oooo.2024.07.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2024] [Revised: 07/16/2024] [Accepted: 07/20/2024] [Indexed: 08/26/2024]
Abstract
Hematolymphoid neoplasms originating in the periapical region of a tooth are rare occurrences. Their signs, symptoms, and radiographic findings can also mimic lesions of endodontic origin. History-taking and clinical examination provide clues to determine the possibility of a non-endodontic lesion, although the definitive diagnosis can only be rendered based on histologic examination. In our case series, we present four cases of hematolymphoid neoplasms that radiographically mimicked endodontic lesions. All the cases initially underwent endodontic treatment, but the lesions failed to resolve. In one case, the clinician suspected a diagnosis of lymphoma based on the patient's history. In the other cases, the clinicians' impression was that the lesions originated from endodontic issues. We present two cases of diffuse large B-cell lymphoma, a case of a plasma cell neoplasm, and a case of Langerhans cell histiocytosis, along with a literature review of three entities when found in the oral cavity as well as review of hematolymphoid neoplasm mimicking endodontic lesion previously reported in literature.
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Affiliation(s)
- Wattawan Wongpattaraworakul
- Department of Oral Pathology, Radiology and Medicine, College of Dentistry and Dental Clinics, University of Iowa, Iowa City, IA, USA; Division of Oral Diagnostic Sciences, Faculty of Dentistry, Thammasat University, Pathumthani, Thailand
| | - Tadkamol Krongbaramee
- Division of Endodontics, Department of Restorative Dentistry & Periodontology, Chiang Mai University, Chiang Mai, Thailand
| | - Emily A Lanzel
- Department of Oral Pathology, Radiology and Medicine, College of Dentistry and Dental Clinics, University of Iowa, Iowa City, IA, USA
| | - John W Hellstein
- Department of Oral Pathology, Radiology and Medicine, College of Dentistry and Dental Clinics, University of Iowa, Iowa City, IA, USA
| | - Fabricio B Teixeira
- Department of Endodontics, College of Dentistry and Dental Clinics, University of Iowa, Iowa City, IA, USA.
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2
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Simonato LE, de Arruda JAA, Louredo BVR, Vargas PA, Tomo S. Drug-induced sarcoidosis-like reaction to adalimumab in the oral mucosa of a patient with Crohn's Disease. JOURNAL OF STOMATOLOGY, ORAL AND MAXILLOFACIAL SURGERY 2023:101543. [PMID: 37402424 DOI: 10.1016/j.jormas.2023.101543] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Revised: 06/15/2023] [Accepted: 06/27/2023] [Indexed: 07/06/2023]
Abstract
BACKGROUND The drug-induced sarcoidosis-like reaction (DISR) is a condition clinically and pathologically similar to sarcoidosis but is induced by certain drugs. A few cases of DISR associated with the use of TNF-α antagonists have been reported in the literature. CASE REPORT A 49-year-old female patient with a diagnosis of Crohn's Disease under treatment with adalimumab presented with a 2-month-long ulcerated swelling in the left lower fornix. Histological analysis of the biopsy specimen revealed multiple non-caseating granulomas multinucleated cells and epithelioid macrophages surrounded by lymphocytes. The lesion is under symptomatic control with a topical corticosteroid, and the patient is being monitored for manifestation in other organs and systems. CONCLUSION Lesions of DISR may occur isolated in the oral mucosa. Therefore, this complication must be considered in the differential diagnosis of oral granulomatous lesions in patients under treatment with anti-TNF-α drugs.
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Affiliation(s)
| | - José Alcides Almeida de Arruda
- Department of Oral Surgery, Pathology and Clinical Dentistry, School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | | | - Pablo Agustin Vargas
- Department of Oral Diagnosis, Piracicaba Dental School, Campinas State University, Piracicaba, São Paulo, Brazil
| | - Saygo Tomo
- Pathology Department, School of Dentistry, University of São Paulo, Av. Professor Lineu Prestes, 2227, São Paulo CEP 05508-000, Brazil.
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3
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Bernardo PS, Hancio T, Vasconcelos FDC, Nestal de Moraes G, de Sá Bigni R, Wernersbach Pinto L, Thuler LCS, Maia RC. Primary diffuse large B-cell lymphoma of the head and neck in a Brazilian single-center study. Oral Dis 2023; 29:968-977. [PMID: 34905288 DOI: 10.1111/odi.14104] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2021] [Revised: 11/18/2021] [Accepted: 11/19/2021] [Indexed: 11/30/2022]
Abstract
OBJECTIVES Lymphomas represent around 10% of head and neck neoplasms, among which the diffuse large B-cell lymphoma (DLBCL) is the most common histologic subtype. In the present study, we characterized demographic parameters, anatomical sites, and survival rates of patients in a Brazilian cancer center. MATERIALS AND METHODS Single-center retrospective epidemiological study of 243 head and neck DLBCL patients. Demographic characteristics, tumor localization, HIV status, lactate dehydrogenase (LDH) activity, and treatment modality were obtained from electronic medical records. RESULTS The most common primary head and neck tumor location in patients with DLBCL was Waldeyer's ring. Interestingly, age above 80 years, male gender, high LDH levels, and HIV positivity were significantly associated with shorter overall survival (OS) rates and increased risk of death. We further demonstrated that treatment had a protective effect, improving OS, and reducing risk of death. Notably, we found no benefit of combination of chemotherapy and radiotherapy versus isolated treatment modalities. CONCLUSION The study showed that primary head and neck DLBCL is more incident in middle age and elderly patients with a small male patients' majority in a Brazilian population. Moreover, we observed a 3-year OS rate of almost 60% and multivariate analysis showed that treatment was the only protective factor.
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Affiliation(s)
- Paula Sabbo Bernardo
- Laboratório de Hemato-Oncologia Celular e Molecular, Programa de Hemato-Oncologia Molecular, Instituto Nacional de Câncer (INCA), Rio de Janeiro, Brazil
| | - Thaís Hancio
- Laboratório de Hemato-Oncologia Celular e Molecular, Programa de Hemato-Oncologia Molecular, Instituto Nacional de Câncer (INCA), Rio de Janeiro, Brazil
| | - Flavia da Cunha Vasconcelos
- Laboratório de Hemato-Oncologia Celular e Molecular, Programa de Hemato-Oncologia Molecular, Instituto Nacional de Câncer (INCA), Rio de Janeiro, Brazil
| | - Gabriela Nestal de Moraes
- Laboratório de Hemato-Oncologia Celular e Molecular, Programa de Hemato-Oncologia Molecular, Instituto Nacional de Câncer (INCA), Rio de Janeiro, Brazil
- Instituto de Bioquímica Médica Leopoldo de Meis, Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro, Brazil
| | | | | | | | - Raquel Ciuvalschi Maia
- Laboratório de Hemato-Oncologia Celular e Molecular, Programa de Hemato-Oncologia Molecular, Instituto Nacional de Câncer (INCA), Rio de Janeiro, Brazil
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4
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Ashoub M, Wali M, Noureldin N, Keraa K, El Desouky E, Mokbel ElShafei M. Oral and para-oral lymphomas: a 10-year multi-center retrospective study in Egypt with time series analysis and forecasting to 2030. BMC Oral Health 2022; 22:556. [PMID: 36457022 PMCID: PMC9714137 DOI: 10.1186/s12903-022-02582-8] [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] [Received: 09/24/2022] [Accepted: 11/10/2022] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND Little is known about the epidemiology of lymphomas occurring in oral and para-oral sites, especially in developing countries such as Egypt. Hence, the aim of this study was to describe the frequency and time trends of oral and para-oral lymphomas in Cairo governorate from 2010 to 2019, with forecasting to 2030, and to examine relations between age, gender, site and type of lymphoma. METHODS Histopathological reports of patients diagnosed with oral and para-oral lymphomas from 2010 to 2019 were retrospectively retrieved from archives of six different centers in Cairo governorate. Data regarding age, gender and site was collected and associations between types of lymphoma and these variables were detected using appropriate statistical methods. The significance level was set at p ≤ 0.05. Time series analysis was used to determine the trend of lymphoma frequency within 10 years of the study and to predict frequency until 2030. RESULTS Lymphomas constituted 2.86% of oral and para-oral lesions. Non-Hodgkin lymphoma was more common than Hodgkin lymphoma. Patients with non-Hodgkin lymphoma showed a higher median age than patients with Hodgkin lymphoma (p = 0.001). Non-Hodgkin lymphoma was more prone to occur intra-orally (p = 0.014). No statistical significance was observed in gender distribution between Hodgkin and non-Hodgkin lymphoma. Even though no specific time trend was observed from 2010 to 2019, forecasting for frequency of lymphomas through 10 years (2020 to 2030) showed a predicted increase. CONCLUSIONS The findings of this study were consistent with majority of other studies held in various geographic regions. The study revealed that frequency of oral and para-oral lymphomas in Cairo governorate is expected to rise; hence, oral pathologists should be more clinically suspicious and expect to encounter these lesions more in their practice within the upcoming years.
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Affiliation(s)
- Madiha Ashoub
- grid.411810.d0000 0004 0621 7673Oral Pathology Department, Faculty of Oral and Dental Medicine, Misr International University, Cairo, Egypt
| | - Mona Wali
- grid.7776.10000 0004 0639 9286Oral and Maxillofacial Pathology Department, Faculty of Dentistry, Cairo University, Cairo, Egypt
| | - Nada Noureldin
- grid.7776.10000 0004 0639 9286Oral and Maxillofacial Pathology Department, Faculty of Dentistry, Cairo University, Cairo, Egypt
| | - Khaled Keraa
- grid.411810.d0000 0004 0621 7673Biostatistician, Faculty of Oral and Dental Medicine, Misr International University, Cairo, Egypt
| | - Eman El Desouky
- grid.7776.10000 0004 0639 9286Epidemiology and Biostatistics Department, National Cancer Institute, Cairo University, Cairo, Egypt
| | - Marwa Mokbel ElShafei
- grid.411810.d0000 0004 0621 7673Oral Pathology Department, Faculty of Oral and Dental Medicine, Misr International University, Cairo, Egypt
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5
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Abstract
Non-plaque induced diffuse gingival overgrowth represents a broad class of conditions caused by several etiological factors. The aim of this review is to highlight the most recent updates and classifications of all the existent gingival overgrowths. In addition, we highlighted the diagnostic pathway that should be employed in patients affected by gingival overgrowth. Gingival overgrowth can be related to syndromic diseases including a wide spectrum of genetic and chromosomal alterations. However, thanks to scientific sharing and the availability of genetic panels it is possible to obtain an accurate phenotypic identification of well-known syndromes and also to identify new ones. This narrative review shows that through rigid, strict diagnostic protocols, the work of the clinician is greatly facilitated, despite the wide variety of pathologies considered. In conclusion, the exchange of specialists’ competencies and the multidisciplinary management of these patients, are crucial to reach diagnosis and the correct clinical-therapeutic management.
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6
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Primary Extra Nodal Diffuse Large B-Cell Lymphoma of the Maxillary Sinus with Symptoms of Acute Pulpitis. Case Rep Dent 2022; 2022:8875832. [PMID: 35433056 PMCID: PMC9010219 DOI: 10.1155/2022/8875832] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2020] [Revised: 01/15/2022] [Accepted: 03/18/2022] [Indexed: 11/17/2022] Open
Abstract
Diffuse large B-cell lymphoma not otherwise specified (DLBCL-NOS) is a subtype of large B-cell non-Hodgkin lymphoma with various clinical and pathological manifestations. DLBCL-NOS which primarily arises from maxillary sinus is rare and hard to diagnose due to unique anatomy. Here, we present a case of DLBCL-NOS that developed in the left maxillary sinus of a 72-year-old male, who presented with severe toothache that resembled acute pulpitis. The lesion was diagnosed and treated based on radiographs, histological, immunohistological examinations, and PET-CT analysis. Despite its rare incidence, DLBCL-NOS should still be included in differential diagnoses to rule out malignancy in cases of endodontic disease.
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7
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Mori H, Fukatsu M, Ohkawara H, Oka Y, Kataoka Y, Taito S, Ikezoe T. Heterogeneity in the diagnosis of plasmablastic lymphoma, plasmablastic myeloma, and plasmablastic neoplasm: a scoping review. Int J Hematol 2021; 114:639-652. [PMID: 34462886 DOI: 10.1007/s12185-021-03211-w] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2021] [Revised: 08/20/2021] [Accepted: 08/24/2021] [Indexed: 12/19/2022]
Abstract
The diagnosis of plasmablastic lymphoma (PBL), plasmablastic myeloma (PBM), and plasmablastic neoplasm (PBN) may be arbitrary in some cases because these entities can be indistinct. We conducted this scoping review to investigate heterogeneity in diagnostic criteria used in previous studies and validate the diagnostic results of previous diagnostic algorithms and the algorithm we developed, which also includes diagnosis of PBN. Using the PRISMA Extension for Scoping Reviews, we analyzed literature published between September 2017 and April 2020. We identified a total of 163 cases (128 PBL, 32 PBM, and 3 PBN) from 77 case reports and 8 case series. We found that diagnostic criteria in the literature varied for PBL but were consistent for PBM. Our algorithm was the first attempt to include PBN in a complete structure. The results of the three diagnostic algorithms varied significantly. Hematologists and pathologists should pay more attention to the differential diagnosis of PBL, PBM, and PBN.
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Affiliation(s)
- Hirotaka Mori
- Department of Hematology, Fukushima Medical University, 1 Hikarigaoka, Fukushima, 9601295, Japan.
| | - Masahiko Fukatsu
- Department of Hematology, Fukushima Medical University, 1 Hikarigaoka, Fukushima, 9601295, Japan
| | - Hiroshi Ohkawara
- Department of Hematology, Fukushima Medical University, 1 Hikarigaoka, Fukushima, 9601295, Japan
| | - Yuka Oka
- Department of Diagnostic Pathology, Fukushima Medical University, Fukushima, Japan
| | - Yuki Kataoka
- Hospital Care Research Unit, Hyogo Prefectural Amagasaki General Medical Center, Amagasaki, Japan.,Department of Healthcare Epidemiology, School of Public Health in the Graduate School of Medicine, Kyoto University, Kyoto, Japan.,Systematic Review Workshop Peer Support Group (SRWS-PSG), Osaka, Japan.,Department of Respiratory Medicine, Hyogo Prefectural Amagasaki General Medical Center, Amagasaki, Japan
| | - Shunsuke Taito
- Systematic Review Workshop Peer Support Group (SRWS-PSG), Osaka, Japan.,Division of Rehabilitation, Department of Clinical Practice and Support, Hiroshima University Hospital, Hiroshima, Japan
| | - Takayuki Ikezoe
- Department of Hematology, Fukushima Medical University, 1 Hikarigaoka, Fukushima, 9601295, Japan
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8
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Azimi N, Razmara F, Derakhshan S, Kardouni Khoozestani N. Mandibular sporadic Burkitt lymphoma in an adult patient: A case report and review of the literature. Clin Case Rep 2021; 9:e04535. [PMID: 34306703 PMCID: PMC8294152 DOI: 10.1002/ccr3.4535] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2021] [Revised: 06/04/2021] [Accepted: 06/09/2021] [Indexed: 11/13/2022] Open
Abstract
Only a minor percent of lymphomas arise in the oral cavity. Although rare, dentists and clinicians should not neglect them as a possible consideration in the differential diagnosis of oral lesions.
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Affiliation(s)
- Nahal Azimi
- School of DentistryInternational CampusTehran University of Medical SciencesTehranIran
| | - Farnoosh Razmara
- Department of Oral and Maxillofacial SurgerySchool of DentistryTehran University of Medical SciencesTehranIran
- Craniomaxillofacial Research CenterTehran University of Medical SciencesTehranIran
| | - Samira Derakhshan
- Department of Oral and Maxillofacial PathologySchool of DentistryTehran University of Medical SciencesTehranIran
| | - Neda Kardouni Khoozestani
- Department of Oral and Maxillofacial PathologySchool of DentistryTehran University of Medical SciencesTehranIran
- Cancer InstituteTehran University of Medical SciencesTehranIran
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9
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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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10
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de Arruda JAA, Abrantes TDC, Cunha JLS, Roza ALOC, Agostini M, Abrahão AC, Canedo NHS, Ramos DD, Milito CB, Pontes FSC, Pontes HAR, Barra MB, Zanella VG, Martins MAT, Martins MD, Israel MS, Freire NDA, Barreto MEZ, Sánchez-Romero C, Carlos R, Abreu LG, Vargas PA, de Almeida OP, Fonseca FP, Romañach MJ, Mesquita RA, de Andrade BAB. Mature T/NK-Cell lymphomas of the oral and maxillofacial region: A multi-institutional collaborative study. J Oral Pathol Med 2021; 50:548-557. [PMID: 34091947 DOI: 10.1111/jop.13205] [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: 06/02/2021] [Accepted: 06/02/2021] [Indexed: 12/25/2022]
Abstract
BACKGROUND The diagnosis of oral and maxillofacial mature T/NK-cell neoplasms is challenging because of their rarity, morphological heterogeneity and complex immunophenotype with scarce available data describing their clinical and microscopic aspects. Therefore, in this study, we investigated a series of mature T/NK-cell neoplasms affecting this anatomical region and provided an updated literature review. METHODS Cases diagnosed as mature T/NK-cell lymphomas affecting the oral and maxillofacial region were retrospectively retrieved from six pathology files and their diagnoses were confirmed using haematoxylin and eosin-stained slides, immunohistochemical reactions and in situ hybridization for Epstein-Barr virus (EBV) detection. Patients' clinical data were collected from their pathology forms. RESULTS A total of 22 cases were included in this study. Eleven (50%) consisted of extranodal NK/T-cell lymphomas, nasal type; eight (36.4%) were peripheral T-cell lymphomas, NOS; two (9.1%) were adult T-cell leukaemia/lymphomas, and one (4.5%) was an ALK-positive anaplastic large cell lymphoma. Overall, males predominated, with a mean age of 55.7 years. The palate was the most affected site (50%), and tumours usually presented as destructive and painful ulcers. EBV was present in all cases of extranodal NK/T-cell lymphoma nasal type but was absent in the other subtypes. CONCLUSION Among mature T/NK-cell lymphomas of the oral and maxillofacial region, extranodal NK/T-cell lymphoma, nasal type and peripheral T-cell lymphoma, NOS predominated. Older men were the most affected patients, and this heterogeneous group of neoplasms has a very aggressive clinical behaviour.
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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
| | - Thamiris de Castro Abrantes
- Department of Oral Surgery and Pathology, School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - John Lennon Silva Cunha
- Department of Oral Diagnosis, Piracicaba Dental School, Universidade Estadual de Campinas, Piracicaba, Brazil
| | | | - Michelle Agostini
- Department of Oral Diagnosis and Pathology, School of Dentistry, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Aline Corrêa Abrahão
- Department of Oral Diagnosis and Pathology, School of Dentistry, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Nathalie Henriques Silva Canedo
- Department of Pathology, School of Medicine, Clementino Fraga Filho University Hospital, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Denize D'Azambuja Ramos
- Department of Pathology, School of Medicine, Clementino Fraga Filho University Hospital, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Cristiane Bedran Milito
- Department of Pathology, School of Medicine, Clementino Fraga Filho University Hospital, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| | | | - Hélder Antônio Rebelo Pontes
- Service of Oral Pathology, Hospital Universitário João de Barros Barreto, Universidade Federal do Pará, Belém, Brazil
| | - Marinez Bizarro Barra
- Service of Pathology, Santa Rita Hospital, Santa Casa de Misericórdia, Porto Alegre, Brazil
| | - Virgilio Gonzales Zanella
- Department of Head and Neck Surgery, Santa Rita Hospital, Santa Casa de Misericórdia de Porto Alegre, Porto Alegre, Brazil
| | - Marco Antonio Trevizani 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
| | - 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
| | - Mônica Simões Israel
- Department of Diagnosis and Therapeutics, School of Dentistry, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, Brazil.,Postgraduate Program of Oral Medicine, Faculdade São Leopoldo Mandic, Rio de Janeiro, Brazil
| | | | | | - Celeste Sánchez-Romero
- Department of Oral Diagnosis, Piracicaba Dental School, Universidade Estadual de Campinas, Piracicaba, Brazil
| | - Román Carlos
- Pathology Section, Centro Clínico de Cabeza y Cuello/Hospital Herrera Llerandi, Guatemala City, Guatemala
| | - Lucas Guimarães Abreu
- Department of Children's and Adolescents Oral Health, School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Pablo Agustin Vargas
- Department of Oral Diagnosis, Piracicaba Dental School, Universidade Estadual de Campinas, Piracicaba, Brazil
| | - Oslei Paes de Almeida
- Department of Oral Diagnosis, Piracicaba Dental School, Universidade Estadual de Campinas, Piracicaba, Brazil
| | - Felipe Paiva Fonseca
- Department of Oral Surgery and Pathology, School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Mário José Romañach
- Department of Oral Diagnosis and Pathology, School of Dentistry, Universidade Federal do Rio de Janeiro, Rio de Janeiro, 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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Iversen L, Eriksen PRG, Andreasen S, Clasen-Linde E, Homøe P, Wessel I, von Buchwald C, Heegaard S. Lymphoma of the Uvula: Clinical, Morphological, Histopathological, and Genetic Characterization. A Nationwide Danish Study From 1980 to 2019. Front Surg 2021; 8:675279. [PMID: 33996890 PMCID: PMC8119646 DOI: 10.3389/fsurg.2021.675279] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2021] [Accepted: 04/08/2021] [Indexed: 01/13/2023] Open
Abstract
Background: In the head and neck region the uvula is a rare site for extranodal lymphomas to develop. In this national study, we present six cases and provide an overview of the current literature, characterizing the clinical and histopathological features of lymphomas involving this location. Materials and Methods: Clinical information was obtained retrospectively from patient records in a nationwide Danish study covering from 1980 through 2019. In order to validate the diagnoses, uvular tissue specimens were examined histologically and immunohistochemically and if relevant for subtyping, cytogenetic rearrangements were investigated. Results: We present six cases of lymphomas involving the uvula, of which four of the cases were diagnosed with a B-cell lymphoma (two diffuse large B-cell lymphomas, one extranodal marginal zone B-cell lymphoma and one Mantle cell lymphoma), while two were diagnosed with a T-cell lymphoma (one peripheral T-cell lymphoma and one natural killer/T-cell lymphoma). Presenting symptoms included swelling, pain and ulceration of the uvula. Treatment was comprised of radiotherapy and/or chemotherapy, with T-cell lymphomas showing a poorer outcome than B-cell lymphomas. Conclusion: Lymphoma of the uvula is rare, with few case reports being reported in the literature. The most frequent histological subtypes reported are extranodal marginal zone B-cell lymphoma and peripheral T-cell lymphoma. When encountering a swollen, painful and/or ulcerated uvula, the clinician should always consider malignancy as a possible cause. Lymphoma of the uvula is a possible diagnosis and if this is the case, there is a high risk of disseminated disease at the time of diagnosis.
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Affiliation(s)
- Lars Iversen
- Department of Ophthalmology, Rigshospitalet-Glostrup, Glostrup, Denmark.,Department of Pathology, Rigshospitalet, Copenhagen, Denmark
| | | | - Simon Andreasen
- Department of Pathology, Rigshospitalet, Copenhagen, Denmark.,Department of Otorhinolaryngology and Maxillofacial Surgery, Zealand University Hospital, Køge, Denmark
| | | | - Preben Homøe
- Department of Otorhinolaryngology and Maxillofacial Surgery, Zealand University Hospital, Køge, Denmark
| | - Irene Wessel
- Department of Otorhinolaryngology Head and Neck Surgery and Audiology, Rigshospitalet, Copenhagen, Denmark
| | - Christian von Buchwald
- Department of Otorhinolaryngology Head and Neck Surgery and Audiology, Rigshospitalet, Copenhagen, Denmark
| | - Steffen Heegaard
- Department of Ophthalmology, Rigshospitalet-Glostrup, Glostrup, Denmark.,Department of Pathology, Rigshospitalet, Copenhagen, Denmark
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12
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Oral and Maxillo-Facial Manifestations of Systemic Diseases: An Overview. ACTA ACUST UNITED AC 2021; 57:medicina57030271. [PMID: 33809659 PMCID: PMC8002330 DOI: 10.3390/medicina57030271] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2021] [Revised: 03/12/2021] [Accepted: 03/12/2021] [Indexed: 12/12/2022]
Abstract
Many systemic (infective, genetic, autoimmune, neoplastic) diseases may involve the oral cavity and, more generally, the soft and hard tissues of the head and neck as primary or secondary localization. Primary onset in the oral cavity of both pediatric and adult diseases usually represents a true challenge for clinicians; their precocious detection is often difficult and requires a wide knowledge but surely results in the early diagnosis and therapy onset with an overall better prognosis and clinical outcomes. In the current paper, as for the topic of the current Special Issue, the authors present an overview on the most frequent clinical manifestations at the oral and maxillo-facial district of systemic disease.
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Rampi A, Lanzillotta M, Mancuso G, Vinciguerra A, Dagna L. IgG4-Related Disease of the Oral Cavity. Case Series from a Large Single-Center Cohort of Italian Patients. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17218179. [PMID: 33167472 PMCID: PMC7663930 DOI: 10.3390/ijerph17218179] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/05/2020] [Revised: 10/27/2020] [Accepted: 11/03/2020] [Indexed: 12/13/2022]
Abstract
A series of destructive and tumefactive lesions of the oral cavity are increasingly recognized as part of the IgG4-related disease (IgG4-RD) spectrum. We herein examined the clinical, serological, radiological, and histological features of a series of patients referred to our clinic because of oral cavity lesions ultimately attributed to IgG4-RD. In particular, we studied 6 consecutive patients out of 200 patients referred to the immunology outpatient unit who presented with erosive and/or tumefactive lesions of the oral cavity. All patients underwent serum IgG4 measurement, nasal endoscopy, radiological studies, and histological evaluation of tissue specimens. The histological studies included immunostaining studies to assess the number of IgG4+ plasma cells/High-Power Field (HPF) for calculation of the IgG4+/IgG+ plasma cell ratio. Six patients (3% of the entire cohort) were diagnosed with IgG4-RD of the oral cavity based on histological evaluation. A major complaint at presentation was oral discomfort due to bulging mass. A mild to no increase in serum IgG4 was observed. Different patterns of organ involvement were associated with oral lesions. Five patients were treated with immunosuppressive therapy and two patients promptly responded to B-cell depletion with rituximab. Watchful waiting was decided in one patient with no major clinical symptoms. Involvement of the oral cavity is an infrequent manifestation of IgG4-RD but should be taken into consideration as a possible differential diagnosis of tumefactive or erosive lesions once neoplastic conditions are excluded. A histological examination of biopsy samples from the oral cavity represents the mainstay for diagnosis of IgG4-RD.
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Affiliation(s)
- Andrea Rampi
- Otorhinolaryngology Unit, Division of Head and Neck Department, IRCCS San Raffaele Scientific Institute, 20132 Milan, Italy; (A.R.); (A.V.)
- School of Medicine, Vita-Salute San Raffaele University, 20132 Milan, Italy; (G.M.); (L.D.)
| | - Marco Lanzillotta
- School of Medicine, Vita-Salute San Raffaele University, 20132 Milan, Italy; (G.M.); (L.D.)
- Division of Immunology, Rheumatology, Allergy and Rare Disease (UnIRAR), IRCCS San Raffaele Scientific Institute, 20132 Milan, Italy
- Correspondence:
| | - Gaia Mancuso
- School of Medicine, Vita-Salute San Raffaele University, 20132 Milan, Italy; (G.M.); (L.D.)
- Division of Immunology, Rheumatology, Allergy and Rare Disease (UnIRAR), IRCCS San Raffaele Scientific Institute, 20132 Milan, Italy
| | - Alessandro Vinciguerra
- Otorhinolaryngology Unit, Division of Head and Neck Department, IRCCS San Raffaele Scientific Institute, 20132 Milan, Italy; (A.R.); (A.V.)
- School of Medicine, Vita-Salute San Raffaele University, 20132 Milan, Italy; (G.M.); (L.D.)
| | - Lorenzo Dagna
- School of Medicine, Vita-Salute San Raffaele University, 20132 Milan, Italy; (G.M.); (L.D.)
- Division of Immunology, Rheumatology, Allergy and Rare Disease (UnIRAR), IRCCS San Raffaele Scientific Institute, 20132 Milan, Italy
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14
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Oueslati Y, Chebil RB, Abidi I, Sriha B, Khochtali H, Oualha L, Douki N. Mandibular non-Hodgkin's lymphoma: two observations of a challenging disease. Pan Afr Med J 2020; 37:102. [PMID: 33425135 PMCID: PMC7757333 DOI: 10.11604/pamj.2020.37.102.23770] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2020] [Accepted: 05/26/2020] [Indexed: 11/30/2022] Open
Abstract
Lymphomas are a heterogeneous group of malignant tumours of the haematopoietic system characterized by an aberrant proliferation of mature lymphoid cells or their precursors and mainly represented by non-Hodgkin´s lymphomas (NHL). The aim of this paper was to report two cases of NHLs with mandibular locations by detailing their different clinical, radiological, and histopathological aspects, as well as the approach followed to diagnose these diseases and to provide patients with the appropriate therapeutic management. The first case is about a 72-year-old female patient who was diagnosed with a large B-cell lymphoma while the second one concerns a 16-year-old male patient who was diagnosed with a Burkitt’s lymphoma. These observations represent the two highly aggressive known NHLs according to the WHO classification. The mandibular locations of these diseases are rare and represent only 0.6% of all the reported cases. It is important to note that only a deep and good quality tumour biopsy can provide a diagnosis of certainty. The reference treatment is medical consisting in the introduction of chemo-immunotherapy. As oral surgeons, we have an important role in the early diagnosis of these malignancies and in the patient’s referral to specialized care in order to get the appropriate treatment.
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Affiliation(s)
- Yassine Oueslati
- Department of Oral Medicine and Oral Surgery, Sahloul Hospital, Dental Faculty of Monastir, University of Monastir, Monastir, Tunisia.,Laboratory of Oral Health and Maxillofacial Rehabilitation, University of Monastir, Monastir, Tunisia
| | - Raouaa Belkacem Chebil
- Department of Oral Medicine and Oral Surgery, Sahloul Hospital, Dental Faculty of Monastir, University of Monastir, Monastir, Tunisia.,Laboratory of Oral Health and Maxillofacial Rehabilitation, University of Monastir, Monastir, Tunisia
| | - Iyadh Abidi
- Department of Oral Medicine and Oral Surgery, Sahloul Hospital, Dental Faculty of Monastir, University of Monastir, Monastir, Tunisia.,Laboratory of Oral Health and Maxillofacial Rehabilitation, University of Monastir, Monastir, Tunisia
| | - Badreddine Sriha
- Cytology and Pathological Anatomy Department, Farhat Hached Hospital, University of Sousse, Sousse, Tunisia
| | - Habib Khochtali
- Department of Maxillofacial surgery, Sahloul Hospital, University of Sousse, Sousse, Tunisia
| | - Lamia Oualha
- Department of Oral Medicine and Oral Surgery, Sahloul Hospital, Dental Faculty of Monastir, University of Monastir, Monastir, Tunisia.,Laboratory of Oral Health and Maxillofacial Rehabilitation, University of Monastir, Monastir, Tunisia
| | - Nabiha Douki
- Department of Oral Medicine and Oral Surgery, Sahloul Hospital, Dental Faculty of Monastir, University of Monastir, Monastir, Tunisia.,Laboratory of Oral Health and Maxillofacial Rehabilitation, University of Monastir, Monastir, Tunisia
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