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Harrizi M, Ibourk A, Ben Yahya I. Non-Hodgkin's lymphoma in the jaw: A report of 3 cases. ADVANCES IN ORAL AND MAXILLOFACIAL SURGERY 2022. [DOI: 10.1016/j.adoms.2022.100280] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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de Andrade BAB, Fontes MD, Roza ALOC, Vargas PA, Agostini M, Canedo NHS, Ramos DD, Morais JC, Milito CB, Romañach MJ. Anaplastic Large Cell Lymphoma with Oral Manifestation: A Series of Four Cases and Literature Review. Head Neck Pathol 2020; 14:991-1000. [PMID: 32440751 PMCID: PMC7669931 DOI: 10.1007/s12105-020-01176-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/08/2020] [Accepted: 05/16/2020] [Indexed: 02/07/2023]
Abstract
The aim of this study was to describe the clinicopathological and immunohistochemical features of four cases of anaplastic large cell lymphoma (ALCL) diagnosed through oral manifestations. Clinical data were collected from charts of a single oral pathology laboratory over a 5-year period (2014-2019) and all cases were evaluated by conventional hematoxylin and eosin staining and an extended immunohistochemical panel comprising CD45, CD20, CD3, CD4, CD7, CD30, CD99, CD138, cytokeratin AE1/AE3, EMA, ALK, MUM-1 and Ki-67. The study included 3 male (75%) and 1 female (25%) patients, with a median age of 44 years. The most common intraoral affected site was the alveolar ridge (50%). Clinically, all cases were characterized as an ulcerated bleeding mass. Microscopically, proliferation of anaplastic large lymphoid cells with medium to large-sized, abundant amphophilic to eosinophilic cytoplasm and eccentric nuclei were observed. All cases were positive for CD30, while two cases strongly express ALK. Two patients died of the disease. Careful correlation of clinical, morphological and immunohistochemical data are necessary to establish the diagnosis of oral manifestation of ALCL since its microscopical features may mimic other malignant tumors. Clinicians and pathologists should consider ALCL in the differential diagnosis when evaluating oral ulcerated swellings exhibiting large lymphoid cells in patients with lymphadenopathy.
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Affiliation(s)
- Bruno Augusto Benevenuto de Andrade
- Department of Oral Diagnosis and Pathology, School of Dentistry, Federal University of Rio de Janeiro (UFRJ), Av. Carlos Chagas Filho 373, Prédio Do CCS, Bloco K, 2° andar, Sala 56, Ilha da Cidade Universitária, Rio de Janeiro, RJ, 21.941-902, Brazil.
| | - Maria Danielle Fontes
- Department of Oral Diagnosis and Pathology, School of Dentistry, Federal University of Rio de Janeiro (UFRJ), Av. Carlos Chagas Filho 373, Prédio Do CCS, Bloco K, 2° andar, Sala 56, Ilha da Cidade Universitária, Rio de Janeiro, RJ, 21.941-902, Brazil
| | | | - Pablo Agustin Vargas
- Department of Oral Diagnosis, Piracicaba Dental School, State University of Campinas (FOP-UNICAMP), Piracicaba, Brazil
| | - Michelle Agostini
- Department of Oral Diagnosis and Pathology, School of Dentistry, Federal University of Rio de Janeiro (UFRJ), Av. Carlos Chagas Filho 373, Prédio Do CCS, Bloco K, 2° andar, Sala 56, Ilha da Cidade Universitária, Rio de Janeiro, RJ, 21.941-902, Brazil
| | - Nathalie Henriques Silva Canedo
- Department of Pathology, School of Medicine, Clementino Fraga Filho University Hospital, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Denize D'Azambuja Ramos
- Department of Pathology, School of Medicine, Clementino Fraga Filho University Hospital, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - José Carlos Morais
- Department of Pathology, School of Medicine, Clementino Fraga Filho University Hospital, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Cristiane Bedran Milito
- Department of Pathology, School of Medicine, Clementino Fraga Filho University Hospital, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Mário José Romañach
- Department of Oral Diagnosis and Pathology, School of Dentistry, Federal University of Rio de Janeiro (UFRJ), Av. Carlos Chagas Filho 373, Prédio Do CCS, Bloco K, 2° andar, Sala 56, Ilha da Cidade Universitária, Rio de Janeiro, RJ, 21.941-902, Brazil
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Mortha N, Majumdar S, Uppala D, Kotina S. Lymphoma in an extraction socket. J Oral Maxillofac Pathol 2019; 23:12-16. [PMID: 30967716 PMCID: PMC6421927 DOI: 10.4103/jomfp.jomfp_215_18] [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] [Indexed: 11/04/2022] Open
Abstract
Non-Hodgkin's lymphoma (NHL) is a lymphoproliferative malignancy that can involve both lymph node and lymphoid organs as well as extranodal organs and tissues. The aim of presenting this case of NHL is to highlight the suspicion of its occurrence in the region of unhealed extraction sockets and the significance of its awareness. NHL can be presented in various forms; therefore, a thorough knowledge regarding this malignancy is essential for arriving at the earliest possible diagnosis and therapy for the patient.
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Affiliation(s)
- Neeharika Mortha
- Department of Oral and Maxillofacial Pathology, GITAM Dental College and Hospital, Visakhapatnam, Andhra Pradesh, India
| | - Sumit Majumdar
- Department of Oral and Maxillofacial Pathology, GITAM Dental College and Hospital, Visakhapatnam, Andhra Pradesh, India
| | - Divya Uppala
- Department of Oral and Maxillofacial Pathology, GITAM Dental College and Hospital, Visakhapatnam, Andhra Pradesh, India
| | - Sreekanth Kotina
- Department of Oral and Maxillofacial Pathology, GITAM Dental College and Hospital, Visakhapatnam, Andhra Pradesh, India
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Lapthanasupkul P, Songkampol K, Boonsiriseth K, Kitkumthorn N. Anaplastic large cell lymphoma of the palate: A case report. JOURNAL OF STOMATOLOGY, ORAL AND MAXILLOFACIAL SURGERY 2018; 120:172-175. [PMID: 30291889 DOI: 10.1016/j.jormas.2018.09.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/16/2018] [Revised: 08/27/2018] [Accepted: 09/26/2018] [Indexed: 01/31/2023]
Abstract
Anaplastic large cell lymphoma (ALCL) is a very rare subtype of T-cell non-Hodgkin's lymphoma (NHL). Similar to other types of NHL, ALCL primarily involves the nodal areas and sometimes it can involve several extranodal sites such as skin, lung and soft tissue. Primary oral involvement of systemic ALCL is very rare. We report a 55-year-old Thai female with anaplastic lymphoma kinase (ALK)-negative ALCL primarily occurring at the hard palate. The patient was referred to the Department of Oral and Maxillofacial Surgery, Mahidol University, complaining of a swelling on her left palate. An incisional biopsy was performed and revealed a diffuse infiltration of large pleomorphic cells with prominent nuclei and sometimes eccentric horseshoe-shaped nuclei. The tumor cells showed a positivity for CD30, CD2, CD4, CD43 and EMA. A few tumor cells were positive to CD45 and CD3. They were negative for CD5, CD8, CD20, AE1/AE3, HMB45, ALK, TCRαβ, TCRγδ, and EBER. The patient reported a decrease in lesionsize after two courses of chemotherapy. However, approximately six months after beginning chemotherapy the tumor metastasized to the nasal cavities and brain. This case represented another rare systemic ALK-negative ALCL case primarily involving the oral cavity.
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Affiliation(s)
- P Lapthanasupkul
- Department of Oral and Maxillofacial Pathology, Faculty of Dentistry, Mahidol University, 6, Yothi street, 10400 Bangkok, Thailand.
| | - K Songkampol
- Department of Oral and Maxillofacial Radiology, Faculty of Dentistry, Mahidol University, Bangkok, Thailand
| | - K Boonsiriseth
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Mahidol University, Bangkok, Thailand
| | - N Kitkumthorn
- Department of Oral Biology, Faculty of Dentistry, Mahidol University, Bangkok, Thailand
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Varun BR, Varghese NO, Sivakumar TT, Joseph AP. Extranodal Non-Hodgkin's Lymphoma of the Oral Cavity: A Case Report. IRANIAN JOURNAL OF MEDICAL SCIENCES 2017; 42:407-411. [PMID: 28761209 PMCID: PMC5523050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Lymphomas are solid malignant tumors having a wide spectrum of clinical and pathological features. Non-Hodgkin's lymphoma (NHL) is a subtype of lymphoma with two-thirds of the cases presenting as lymph node enlargement. The remaining one third of NHL cases has been reported in the extranodal sites, including the gastro intestinal tract, Waldeyer's ring, bone, skin, and brain. Intraoral non-Hodgkin's lymphoma is uncommon and may affect either the jaw bones or occur within the soft tissues of the oral cavity. Here we report a case of non-Hodgkin's lymphoma in a 65-year-old male patient who presented with a growth from the extraction socket. Non-Hodgkin's lymphoma presenting as a growth from the extraction socket is unusual. An orthopantamograph (OPG) was taken which revealed a diffuse radiolucent defect in relation to the extraction socket of the left lower molar region. Routine hemogram, urine analysis, and chest radiograph were normal. Incisional biopsy was performed and the tissue was subjected to histopathological examination. Histopathological and immunohistochemical analysis confirmed the diagnosis of B-cell lymphoma. The patient was referred to a regional cancer institute for further management, where chemotherapy was planned. However, prior to chemotherapy, the patient was diagnosed with brain metastasis and he expired in hospital within one month.
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Affiliation(s)
- Babyamma Raghavan Varun
- Department of Oral and Maxillofacial Pathology, PMS Institute of Dental Science and Research, Vattapara, Trivandrum, India,Correspondence: Babyamma Raghavan Varun, MDS; Department of Oral and Maxillofacial Pathology, PMS Institute of Dental Science and Research, Golden Hills, Vattapara, Trivandrum, Kerala 695028, India Tel: +91 999 5055999 Fax: +91 472 2587874
| | - Nettiyat Oommen Varghese
- Department of Conservative Dentistry, PMS Institute of Dental Science and Research, Vattapara, Trivandrum, India
| | - Trivandrum Thanappan Sivakumar
- Department of Oral and Maxillofacial Pathology, PMS Institute of Dental Science and Research, Vattapara, Trivandrum, India
| | - Anna Palliath Joseph
- Department of Oral and Maxillofacial Pathology, PMS Institute of Dental Science and Research, Vattapara, Trivandrum, India
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Pathological Mandibular Fracture Associated With Diffuse Large B-Cell Lymphoma in HIV-Positive Patient. J Craniofac Surg 2017; 27:2084-2087. [PMID: 28005758 DOI: 10.1097/scs.0000000000003058] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
This article describes the occurrence of diffuse large B-cell lymphoma in a 39-year-old human immunodeficiency virus-positive patient. The patient sought medical care complaining of increased volume in the right mandibular angle and imaging tests showed an extensive radiolucency with undefined boundaries compromising the mandibular border. After the incisional biopsy, the patient had a pathological fracture in the region, which was properly treated in a second surgical procedure using a 2.4-mm reconstruction plate. Immunohistochemical analysis revealed positive marking for CD3, CD79a, Ki67, and Epstein-Barr virus-encoded RNA. The treatment consisted of concurrent antiretroviral therapy with chemotherapy with rituximab combined with cyclophosphamide, doxorubicin, vincristine, and prednisone. Examinations of images (2 years postoperatively) revealed complete bone repair and absence of injury recurrence. This work is important because it describes an unusual location of diffuse large B-cell lymphoma and shows the importance of diagnosis and treatment of the injury at an early stage in order to promote the prognosis and survival of patients.
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Gingival Anaplastic Large-Cell Lymphoma Mimicking Hyperplastic Benignancy as the First Clinical Manifestation of AIDS: A Case Report and Review of the Literature. Case Rep Dent 2013; 2013:852932. [PMID: 23840974 PMCID: PMC3697140 DOI: 10.1155/2013/852932] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2013] [Accepted: 05/26/2013] [Indexed: 12/21/2022] Open
Abstract
This paper presents an unusual case of gingival ALCL, which mimicked a benign hyperplastic lesion that occurred in a 57-year-old white man representing the first clinical manifestation of acquired immunodeficiency syndrome (AIDS). The patient was referred to the Dental Clinic of PUCPR complaining of a lobulated nodule on the gingiva of his upper central incisors. The presence of advanced chronic periodontitis and dental plaque raised suspicion for a benignancy. An excisional biopsy was performed, and large pleomorphic cells with an abundant cytoplasm, sometimes containing prominent nucleoli and “Hallmark” cells, were observed through hematoxylin and eosin staining. The tumor cells showed strong CD30 expression, EMA, Ki-67, and LCA, and negative stain for p80NPM/ALK, CKAE1/AE3, CD20, CD3, CD56, and CD15. The final diagnosis was ALCL (ALK-negative). Further laboratory tests revealed positivity for human immunodeficiency virus (HIV). The patient was submitted to chemotherapy, but four months after diagnosis, the patient died due to pneumonia and respiratory failure. Oral anaplastic large-cell lymphoma (ALCL) is a rare disorder. Only 5 cases involving the gingiva have been reported, and to our knowledge, this is the first case reported of the ALCL, which mimicked a hyperplastic benignancy as the first clinical manifestation of AIDS.
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Grandhi A, Boros AL, Berardo N, Reich RF, Freedman PD. Two cases of CD30+, anaplastic lymphoma kinase (ALK)-negative anaplastic large cell lymphoma with oral manifestations. Oral Surg Oral Med Oral Pathol Oral Radiol 2013; 115:e41-7. [DOI: 10.1016/j.oooo.2012.04.010] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2012] [Revised: 04/19/2012] [Accepted: 04/19/2012] [Indexed: 10/27/2022]
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EB-virus associated primary CD30-positive lymphoproliferative disease of the maxillary gingival in an immunocompetent woman. Oral Oncol 2012; 48:e11-2. [DOI: 10.1016/j.oraloncology.2011.10.013] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2011] [Accepted: 10/25/2011] [Indexed: 11/24/2022]
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Shah GH, Panwar SK, Chaturvedi PP, Kane SN. Isolated primary extranodal lymphoma of the oral cavity: A series of 15 cases and review of literature from a tertiary care cancer centre in India. Indian J Med Paediatr Oncol 2011; 32:76-81. [PMID: 22174494 PMCID: PMC3237184 DOI: 10.4103/0971-5851.89776] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Non-Hodgkin's lymphomas (NHL) have a great tendency to affect organs and tissues that do not ordinarily contain lymphoid cells. Involvement of the oral cavity by NHL is very rare. MATERIALS AND METHODS Retrospective analysis was carried out by chart review of patients who presented to our hospital between 1990 and 2008. All those patients whose histopathology at our hospital was confirmed as lymphoma were included. RESULTS Although we register nearly 2000 new oral cancers every year, most of which are squamous cell cancers, we could trace only 15 cases of oral lymphoma in the last 18 years. Of these, hard palate and alveolus were most common sites (5 each). The median age at presentation was 42.6 years. A vast majority (12/15) were NHL. Most patients (70%) reported with painless progressive swelling without systemic signs, such as fever, weight loss, and so on. Only 2 patients were HIV positive. Nearly two thirds received combinations of CT and RT. Cyclophosphamide, hydroxydaunorubicin, oncovin (vincristine), prednisolone regime was the most common regime offered (12/15). Most of them (67%) had good response to 6 cycles of CT that was followed by RT. 10/15 patients completed treatment. Follow-up data of more than 2 years of follow-up was present in 11/15 patients. With median follow-up of 27 months, 5 were disease free, 5 died, and 1 controlled following 2nd line of CT, 2 were lost to follow-up and 2 were alive with disease. DISCUSSION Head and neck lymphoma is the second most common region for extranodal lymphoma. The nasopharynx, tonsils, and base tongue are most often involved. Unlike the western world, oral cavity involvement is extremely rare. Interestingly, only 2 patients tested positive for HIV and most were young patients. Oral lymphoma may mimic benign oral conditions that often lead to misdiagnosis. CONCLUSION Although oral cavity may be the preferred site of NHL in immunocompromised patients it does occur in immunocompetent patients as well. Isolated oral lymphoma is extremely rare and from our data we can say that oral NHL in Indian sub population is more aggressive compared with western literature.
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Affiliation(s)
- Gunjan H. Shah
- Departments of Head & Neck Oncology and Pathology, Tata Memorial Hospital, Parel, Mumbai, Maharashtra, India
| | - Sajid Khan Panwar
- Departments of Head & Neck Oncology and Pathology, Tata Memorial Hospital, Parel, Mumbai, Maharashtra, India
| | - Pankaj P. Chaturvedi
- Departments of Head & Neck Oncology and Pathology, Tata Memorial Hospital, Parel, Mumbai, Maharashtra, India
| | - Shubhada N. Kane
- Departments of Head & Neck Oncology and Pathology, Tata Memorial Hospital, Parel, Mumbai, Maharashtra, India
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Perez K, Castillo J, Dezube BJ, Pantanowitz L. Human immunodeficiency virus-associated anaplastic large cell lymphoma. Leuk Lymphoma 2010; 51:430-8. [PMID: 20141444 DOI: 10.3109/10428190903572201] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Affiliation(s)
- Kimberly Perez
- Division of Hematology/Oncology, The Warren Alpert Medical School of Brown University, The Miriam Hospital, Providence, RI 02906, USA
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12
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Keogh PV, Fisher V, Flint SR. Resolution of oral non-Hodgkin's lymphoma by reduction of immunosuppressive therapy in a renal allograft recipient: a case report and review of the literature. ORAL SURGERY, ORAL MEDICINE, ORAL PATHOLOGY, ORAL RADIOLOGY, AND ENDODONTICS 2002; 94:697-701. [PMID: 12464893 DOI: 10.1067/moe.2002.126889] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
A case of oral non-Hodgkin's lymphoma arising in a patient with insulin-dependent diabetes who had undergone renal allograft transplantation is described. The resolution of the disease was achieved by a reduction in her immunosuppressive therapy. The differential diagnosis is discussed, and the management of posttransplantation lymphoproliferative disorders is reviewed.
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Affiliation(s)
- Paul V Keogh
- Department of Oral Surgery, Oral Medicine and Oral Pathology, Dublin Dental School and Hospital, Trinity College, Ireland.
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Leong IT, Fernandes BJ, Mock D. Epstein-Barr virus detection in non-Hodgkin's lymphoma of the oral cavity: an immunocytochemical and in situ hybridization study. ORAL SURGERY, ORAL MEDICINE, ORAL PATHOLOGY, ORAL RADIOLOGY, AND ENDODONTICS 2001; 92:184-93. [PMID: 11505266 DOI: 10.1067/moe.2001.116155] [Citation(s) in RCA: 32] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
OBJECTIVE The purpose of this study was to histologically characterize a series of oral non-Hodgkin's lymphomas (NHLs) and to investigate latent and lytic Epstein-Barr virus (EBV) infection in these. STUDY DESIGN The revised European-American Lymphoma classification system (41) was used to categorize 58 cases of oral NHL, which included 9 immunosuppression-related NHLs. EBV infection was determined by in situ hybridization for Epstein-Barr virus-encoded RNA and by immunohistochemistry for the EBV antigens latency membrane protein, Epstein-Barr nuclear antigen-2 (EBNA2) and Z EBV replication activator protein. RESULTS Most tumors were B-cell lymphomas (78%), but the proportion of T-cell lymphomas was surprisingly high (22%). The most common histologic subtypes were diffuse large B-cell lymphomas (45%), peripheral T-cell lymphomas (19%), and follicle center lymphomas (14%). Two thirds of the known immunosuppression-related NHLs were T-cell lymphomas. All of the immunosuppression-related tumors were EBV-infected, whereas the EBV infection rate in the NHLs of the remaining patients presumed to be immunocompetent was only 9%. Most EBV-positive tumors expressed neither of the latent antigens (ie, latency membrane protein and Epstein-Barr nuclear antigen-2), and coexpression of the 2 was observed only in immunosuppressed patients. Z EBV replication activator protein expression, which is indicative of replicative infection, occurred only in immunosuppressed individuals. CONCLUSIONS Diffuse large B-cell lymphomas were the most common histologic subtype of oral NHLs, but T-cell lymphomas were relatively common and frequently occurred in states of immunosuppression. EBV may play a limited role in the initiation of lymphoma in the immunocompetent patient, but the virus may be of importance in progression of the disease in those patients with more aggressive tumors, as immunosuppression occurs.
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MESH Headings
- Adult
- Age Factors
- Aged
- Aged, 80 and over
- Antigens, Viral/analysis
- Chi-Square Distribution
- DNA Replication
- DNA-Binding Proteins/analysis
- Epstein-Barr Virus Infections/diagnosis
- Epstein-Barr Virus Nuclear Antigens/analysis
- Female
- Herpesvirus 4, Human/classification
- Herpesvirus 4, Human/genetics
- Herpesvirus 4, Human/immunology
- Humans
- Immunocompromised Host
- Immunohistochemistry
- In Situ Hybridization
- Lymphoma, B-Cell/virology
- Lymphoma, Follicular/virology
- Lymphoma, Large B-Cell, Diffuse/virology
- Lymphoma, Non-Hodgkin/virology
- Lymphoma, T-Cell/virology
- Lymphoma, T-Cell, Peripheral/virology
- Male
- Middle Aged
- Mouth Neoplasms/virology
- RNA, Viral/genetics
- Replication Protein A
- Statistics as Topic
- Trans-Activators/analysis
- Viral Matrix Proteins/analysis
- Viral Proteins/analysis
- Virus Latency
- Virus Replication
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Affiliation(s)
- I T Leong
- Department of Oral Pathology, University of Toronto, Ontario, Canada.
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Savarrio L, Gibson J, Dunlop DJ, O'Rourke N, Fitzsimons EJ. Spontaneous regression of an anaplastic large cell lymphoma in the oral cavity: first reported case and review of the literature. Oral Oncol 1999; 35:609-13. [PMID: 10705098 DOI: 10.1016/s1368-8375(99)00034-2] [Citation(s) in RCA: 35] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Lymphomas account for 2-5% of all oral malignancies and are the third most common in this site. This case report appears to be the first in the world literature describing spontaneous regression in the oral cavity of a subset of non-Hodgkins lymphomas known as Ki-1 anaplastic large cell lymphomas (ALCL). Ki-1 ALCL account for 2-7% of all non-Hodgkins lymphomas and the clinical presentation is variable; they may arise de novo or in the setting of a separate primary lymphoma and commonly present in the extra-nodal location. Disease severity is also variable with waxing and waning lesions at one extreme which may spontaneously regress to bone marrow involvement in around 12% of cases. This case is especially interesting since the patient is a farmer, given the recent evidence that there may be a link between non-Hodgkins lymphoma and this occupation.
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Affiliation(s)
- L Savarrio
- Department of Oral Medicine, Glasgow Dental Hospital and School NHS Trust, 378 Sauchiehall Streert, Glasgow, UK
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Jordan RC, Chong L, Dipierdomenico S, Satira F, Main JH. Oral lymphoma in human immunodeficiency virus infection: a report of six cases and review of the literature. Otolaryngol Head Neck Surg 1998; 119:672-7. [PMID: 9852547 DOI: 10.1016/s0194-5998(98)70033-6] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Affiliation(s)
- R C Jordan
- Department of Dentistry, Sunnybrook Health Sciences Centre, University of Toronto, Ontario, Canada
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Abstract
We report a case of primary CD30-positive anaplastic large cell lymphoma of the lip. While extranodal involvement is not uncommon in Ki-1(CD30) anaplastic large cell lymphoma, this is the first reported case of primary lip involvement. The clinical features and clinical outcome in Ki-1 anaplastic large cell lymphoma are discussed.
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Affiliation(s)
- C S Chim
- Department of Medicine, Queen Mary Hospital, Hong Kong.
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17
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Lynch DP. Oral manifestations of HIV disease: an update. SEMINARS IN CUTANEOUS MEDICINE AND SURGERY 1997; 16:257-64. [PMID: 9421216 DOI: 10.1016/s1085-5629(97)80014-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
More than 40 different oral diseases and conditions have been described in patients infected with human immunodeficiency virus (HIV). The recognition of the oral manifestations of HIV disease is of great significance because they may represent the first signs of the disease and have been shown to be highly predictive markers of severe immune deterioration and disease progression. Although some oral diseases and conditions have a weak association with HIV disease, others are strongly linked with the disorder, and a few are acquired immune deficiency syndrome (AIDS)-defining in nature. The spectrum of oral manifestations of HIV disease is reviewed with emphasis on clinical recognition, diagnosis, and treatment.
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Affiliation(s)
- D P Lynch
- Department of Biologic and Diagnostic Sciences, College of Dentistry, University of Tennessee, Memphis 38163, USA
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Vázquez-Piñeiro T, Viana de Frías L, Cristóbal E, Cosín J, Menárguez J. HIV-associated oral pleomorphic B-cell malignant lymphoma. ORAL SURGERY, ORAL MEDICINE, ORAL PATHOLOGY, ORAL RADIOLOGY, AND ENDODONTICS 1997; 84:142-5. [PMID: 9269014 DOI: 10.1016/s1079-2104(97)90059-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
A 48-year-old HIV-seropositive homosexual patient presented with an ulcerative lesion in the left side of the soft palate, extensively involving local soft tissue structures. On histologic evaluation the lesions appeared to be a large-cell high-grade B-cell pleomorphic lymphoma with anaplastic and plasmacytoid features harboring Epstein-Barr virus genome in the tumor cells. Although known to be associated with HIV infection, this is a rare subtype of a malignant lymphoma arising in a patient positive for HIV. Its meaning is yet unknown in biologic and prognostic terms.
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Affiliation(s)
- T Vázquez-Piñeiro
- Department of Oral Medicine, Hospital General Universitario Gregorio Marañón, Madrid, Spain
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Abstract
Specific pathologic processes, particularly oral, esophageal, and intestinal infections, are common in the alimentary tract of AIDS patients. Many of these diseases are adequately assessed only by biopsy with histologic examination. Most are rare or unreported in immunocompetent hosts and are easily missed by those not familiar with them. This article describes the gross or endoscopic and histologic appearances and the diagnostic criteria for enteric pathologic processes seen in HIV-infected individuals.
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Hicks MJ, Flaitz CM, Cohen PR. Perioral and cutaneous umbilicated papular lesions in acquired immunodeficiency syndrome. ORAL SURGERY, ORAL MEDICINE, ORAL PATHOLOGY, ORAL RADIOLOGY, AND ENDODONTICS 1997; 83:189-91. [PMID: 9117749 DOI: 10.1016/s1079-2104(97)90004-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Affiliation(s)
- M J Hicks
- Baylor College of Medicine, University of Texas-Houston Health Science Center, USA
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Lozada-Nur F, de Sanz S, Silverman S, Miranda C, Regezi JA. Intraoral non-Hodgkin's lymphoma in seven patients with acquired immunodeficiency syndrome. ORAL SURGERY, ORAL MEDICINE, ORAL PATHOLOGY, ORAL RADIOLOGY, AND ENDODONTICS 1996; 82:173-8. [PMID: 8863307 DOI: 10.1016/s1079-2104(96)80221-6] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
Since the appearance of AIDS, there has been a significant increase in the number of cases of oral non-Hodgkin's lymphoma. Rarely seen in the oral cavity before, non-Hodgkin's lymphoma is now seen with some frequency in HIV-positive patients. Oral HIV-related lymphomas exhibit an aggressive course and can mimic other oral tumors and infections, which makes early recognition and diagnosis important and difficult. We report on the clinical findings in seven homosexual men in whom the oral cavity was the first site in which non-Hodgkin's lymphoma appeared and the only site involved at the time of diagnosis. Treatment consisted of chemotherapy with or without radiation therapy. The relatively short survival in these patients averaged 8 months. All patients died of complications from their tumor.
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Affiliation(s)
- F Lozada-Nur
- Department of Stomatology, School of dentistry, University of California at San Francisco, USA
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Flaitz CM, Nichols CM, Hicks MJ. Herpesviridae-associated persistent mucocutaneous ulcers in acquired immunodeficiency syndrome. A clinicopathologic study. ORAL SURGERY, ORAL MEDICINE, ORAL PATHOLOGY, ORAL RADIOLOGY, AND ENDODONTICS 1996; 81:433-41. [PMID: 8705589 DOI: 10.1016/s1079-2104(96)80019-9] [Citation(s) in RCA: 50] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
Persistent mucocutaneous ulcers in AIDS represent a variety of disease entities. The purpose of this study was to characterize clinicopathologic features of persistent oral ulcers associated with cytomegalovirus and herpes simplex virus in AIDS. Forty-seven persons infected with HIV with persistent ulcers (mean, 2.4 ulcers/person) were included in this study. A biopsy specimen from a representative ulcer was taken from each patient. Hematoxylin-eosin, periodic acid-Schiff, cytomegalovirus, and herpes simplex virus immunocytochemical stains were performed on tissue sections. The most common sites of involvement were the buccal/labial mucosa (27%), tongue (25%), and gingiva (18%). Mean ulcer size was 1.8 cm with a mean duration of 5.6 weeks. The ulcerogenic viral agents were cytomegalovirus alone in 53% of cases, cytomegalovirus and herpes simplex virus coinfection in 28% of cases, and herpes simplex virus alone in 19% of cases. Treatment response to ganciclovir with or without topical steroids resulted in lesion resolution in the cytomegalovirus and cytomegalovirus/herpes simplex virus groups; however, recurrence/resistance was relatively high (23%). Herpes simplex virus/cytomegalovirus ulcers responded to oral acyclovir in combination with systemic ganciclovir. Increasing the oral acyclovir dosage resulted in resolution of herpes simplex virus-only ulcers in all but one case. Cytomegalovirus and herpes simplex virus are associated with persistent mucocutaneous ulcers in AIDS. These lesions responded to systemic antiviral therapy but are difficult to differentiate from other ulcerogenic diseases such as aphthous major, necrotizing stomatitis, and ulcerations not otherwise specified without biopsy and histopathologic examination.
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Affiliation(s)
- C M Flaitz
- University of Texas-Houston Health Science Center, Bering Service Foundation Dental Clinic, Baylor College of Medicine, Houston, USA
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Ríos-Martín JJ, Villar-Rodríguez JL, Vázquez-Ramírez FJ, Illanes-Moreno M, Parra-Martín JA, González-Cámpora R, Galera-Davidson H. Mandibular lymphomas with sclerosis. ORAL SURGERY, ORAL MEDICINE, ORAL PATHOLOGY, ORAL RADIOLOGY, AND ENDODONTICS 1996; 81:321-7. [PMID: 8653466 DOI: 10.1016/s1079-2104(96)80332-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
Two cases of non-Hodgkin's lymphoma that show a sarcomatoid pattern within the jaw are described. Their primary origin in bone was demonstrated by radiologic studies. In one case, diagnosis was delayed because the clinical picture suggested inflammatory periodontal disease. In both cases, the histologic picture was similar to that of a sarcomatoid neoplasm with intense stromal sclerosis; hemimandibulectomy was performed in one case. The tumor contained cells with large, irregular, sometimes lobulated nuclei and high mitotic activity, and perforated mandibular bone with infiltration into adjacent soft tissues. The lymphoid nature of these neoplasms was demonstrated by immunohistochemical and ultrastructural study.
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Affiliation(s)
- J J Ríos-Martín
- Department of Pathology, Hospital Universitario Virgen Macarena, Seville, Spain
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Abstract
OBJECTIVE To describe lymphoma associated with human immunodeficiency virus (HIV) infection. DESIGN A review of HIV-related lymphoma and its associated epidemiology, etiopathogenesis, and clinicopathologic characteristics is presented. Major studies of therapeutic regimens for HIV-related lymphoma are discussed. Factors that could contribute to a poor prognosis are summarized. RESULTS Malignant lymphoma that develops in patients with HIV infection fulfills diagnostic criteria for the acquired immunodeficiency syndrome (AIDS). The incidence is increasing and varies by subtype of lymphoma, age, sex, race, and risk factors. B-cell hyperactivation is thought to contribute to the development of lymphoma. The mechanisms that may show transformed cell hyperproliferation and clonal expansion are HIV itself or other viruses (for example, Epstein-Barr virus), growth factors, aberrant oncogene or tumor-suppressor gene expression, and factors that induce genetic instability or DNA damage or alter host or viral genome repair. Treatment of HIV-related lymphoma is associated with toxicity, infectious complications, low rate of complete response, and brief median survival time. CONCLUSION Persons with HIV-induced immune dysregulation have a high risk for the development of aggressive non-Hodgkin's lymphoma characterized by histologic evidence of a high-grade malignant process, B-cell phenotype, an unusual extranodal involvement, and a poor prognosis. The potential role of specific viruses, antiviral treatments, and other therapeutic strategies are future areas of investigation.
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Affiliation(s)
- C Y Wang
- Department of Dermatology, Mayo Clinic Rochester, MN 55905, USA
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Willard CC, Foss RD, Hobbs TJ, Auclair PL. Primary anaplastic large cell (KI-1 positive) lymphoma of the mandible as the initial manifestation of acquired immunodeficiency syndrome in a pediatric patient. ORAL SURGERY, ORAL MEDICINE, ORAL PATHOLOGY, ORAL RADIOLOGY, AND ENDODONTICS 1995; 80:67-70. [PMID: 7552865 DOI: 10.1016/s1079-2104(95)80018-2] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Affiliation(s)
- C C Willard
- Department of Oral Pathology, Armed Forces Institute of Pathology, Washington, D.C., USA
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Flaitz CM, Nichols CM, Adler-Storthz K, Hicks MJ. Intraoral squamous cell carcinoma in human immunodeficiency virus infection. A clinicopathologic study. ORAL SURGERY, ORAL MEDICINE, ORAL PATHOLOGY, ORAL RADIOLOGY, AND ENDODONTICS 1995; 80:55-62. [PMID: 7552863 DOI: 10.1016/s1079-2104(95)80016-6] [Citation(s) in RCA: 38] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
The purpose of this study was to characterize the clinical and histological features of intraoral squamous cell carcinoma in men who were seropositive for the human immunodeficiency virus and to evaluate viral cofactors (human papillomavirus, herpes simplex virus, Epstein-Barr virus), proliferative index (proliferating cell nuclear antigen), a factor associated with invasion (cathepsin D), and mutated tumor suppressor gene and proto-oncogene products (mutated p53, c-erbB-2). Four men who were seropositive for the human immunodeficiency virus and had acquired immunodeficiency syndrome presented with painful oral lesions of variable duration. Oral cancer risk factors included heavy tobacco use (four of four), heavy alcohol use (three of four), and previous radiotherapy (one of four). The lesions consisted of ulcers (two of four), a fungating mass (one of four), and papillary erythroplakia (one of four). Incisional biopsy specimens were obtained. High-stringency in situ hybridization was performed with DNA probes to the human papillomavirus (types 6/11; 16/18; 31/33/35) and Epstein-Barr virus: Immunocytochemical studies for the herpes simplex virus, proliferating cell nuclear antigen, cathepsin D, mutated p53, and c-erbB-2 were performed. Two lesions were moderately differentiated squamous cell carcinoma, one lesion was a basaloid squamous cell carcinoma, and one was carcinoma in situ. Stage of disease at diagnosis was II (one of four), III (two of four), and IV (one of four). Three cases were positive for the human papillomavirus, one case was positive for Epstein-Barr virus, and three cases were positive for the herpes simplex virus. C-erbB-2 was focally positive in one case, and mutated p53 was positive in a separate case.(ABSTRACT TRUNCATED AT 250 WORDS)
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Affiliation(s)
- C M Flaitz
- Department of Stomatology, University of Texas Health Science Center-Houston, USA
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