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Hyrcza MD, Lindenmuth TR, Auerbach A. Top Ten Lymphoproliferative Lesions Not to Miss When Evaluating Oral Ulcer Biopsies. Head Neck Pathol 2023; 17:99-118. [PMID: 36928739 PMCID: PMC10063747 DOI: 10.1007/s12105-023-01532-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/15/2022] [Accepted: 01/12/2023] [Indexed: 03/18/2023]
Abstract
BACKGROUND Oral ulcers represent a full thickness loss of the mucosal epithelium leading to exposure of the submucosal connective tissue. These are common and usually self-limited lesions, although they may sometimes result from neoplasms, most commonly squamous cell carcinoma. Lymphoproliferative disorders may be difficult to diagnose in apthous ulcers since they mimic reactive inflammation. METHODS This review presents ten rare oral lymphoid proliferations which should not be missed when assessing oral ulcer biopsies. RESULTS The ten lesions include several with diagnostic cells which look similar to the histiocytes of a reactive inflammatory ulcer, including Rosai-Dorfman disease, reticulohistiocytoma, Langerhans cell histiocytosis, and traumatic ulcerative granuloma. Other lesions, such as EBV-positive mucocutaneous ulcer, extranodal marginal zone lymphoma of mucosal-associated lymphoid tissue, and plasmablastic lymphoma have lymphoid and/or plasma cell differentiation that mimic the reactive lymphocytes and plasma cells found in reactive ulcers. Two dendritic cell lesions, follicular dendritic cell sarcoma and blastic plasmacytoid dendritic cell neoplasm, both have distinct phenotypes which are required to make an accurate diagnosis. CONCLUSION Each of these lesions are diagnosed by evaluating their histology, along with their phenotypic profile, which is sometimes enhanced by pertinent molecular findings.
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Affiliation(s)
- Martin D. Hyrcza
- Department of Pathology and Laboratory Medicine, University of Calgary, Arnie Charbonneau Cancer Institute, Calgary, AB Canada
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Mutalik VS, Neppalli V, Dale C, Penner C. Multiple painful ulcerated lesions in a 73-year-old patienti. Oral Surg Oral Med Oral Pathol Oral Radiol 2021; 133:3-7. [PMID: 34518139 DOI: 10.1016/j.oooo.2021.06.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2021] [Revised: 05/11/2021] [Accepted: 06/07/2021] [Indexed: 10/21/2022]
Affiliation(s)
- Vim S Mutalik
- Assistant Professor, Department of Dental Diagnostic and Surgical Science, Dr. Gerald Niznick College of Dentistry, Winnipeg, Manitoba, Canada.
| | - Vishala Neppalli
- Assistant Professor, Department of Pathology, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Catherine Dale
- Assistant Professor, Dental Diagnostic and Surgical Sciences, Dr. Gerald Niznick College of Dentistry, Max Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Carla Penner
- Pathologist and Assistant Professor, Department of Pathology, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
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Ishikawa S, Kato Y, Kabasawa T, Yoshioka C, Kitabatake K, Yamakawa M, Ishizawa K, Iino M. A case of myeloid sarcoma of the mandibular gingiva as extramedullary relapse of acute myeloid leukemia. Oral Maxillofac Surg 2020; 24:121-126. [PMID: 31788742 DOI: 10.1007/s10006-019-00812-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2018] [Accepted: 10/25/2019] [Indexed: 06/10/2023]
Abstract
PURPOSE Myeloid sarcoma (MS) is defined as a tumorous mass of myeloblasts or immature myeloid cells involving an extramedullary anatomic site. MS occurs in 3 to 8% of patients with acute myeloid leukemia. The overwhelming majority of MS occurs in the skin, bones, and gastrointestinal tract; intraoral MS (IMS) is extremely rare. METHODS We describe a case of MS of the mandibular gingiva in a patient with acute myeloid leukemia that was in remission. We also present a review of the English and Japanese literature with a special focus on the management and prognosis of intraoral MS. RESULTS The patient was discharged while in remission 8 months after the initial examination. CONCLUSION The prognosis of IMS is extremely poor in general, and a diagnostic delay can prevent adequate therapy by hematologists and oncologists. All dental clinicians must keep the possibility of IMS in mind and carefully examine all patients with AML.
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Affiliation(s)
- Shigeo Ishikawa
- Department of Dentistry, Oral and Maxillofacial-Plastic and Reconstructive Surgery, Faculty of Medicine, Yamagata University, 2-2-2 Iida-nishi, Yamagata, 990-9585, Japan.
| | - Yuichi Kato
- Department of Neurology, Hematology, Metabolism, Endocrinology and Diabetology, Faculty of Medicine, Yamagata University, 2-2-2 Iida-nishi, Yamagata, 990-9585, Japan
| | - Takanobu Kabasawa
- Department of Hematology, Department of Pathological Diagnosis, Faculty of Medicine, Yamagata University, 2-2-2 Iida-nishi, Yamagata, 990-9585, Japan
| | - Chiho Yoshioka
- Department of Dentistry, Oral and Maxillofacial-Plastic and Reconstructive Surgery, Faculty of Medicine, Yamagata University, 2-2-2 Iida-nishi, Yamagata, 990-9585, Japan
| | - Kenichiro Kitabatake
- Department of Dentistry, Oral and Maxillofacial-Plastic and Reconstructive Surgery, Faculty of Medicine, Yamagata University, 2-2-2 Iida-nishi, Yamagata, 990-9585, Japan
| | - Mitsunori Yamakawa
- Department of Hematology, Department of Pathological Diagnosis, Faculty of Medicine, Yamagata University, 2-2-2 Iida-nishi, Yamagata, 990-9585, Japan
| | - Kenichi Ishizawa
- Department of Neurology, Hematology, Metabolism, Endocrinology and Diabetology, Faculty of Medicine, Yamagata University, 2-2-2 Iida-nishi, Yamagata, 990-9585, Japan
| | - Mitsuyoshi Iino
- Department of Dentistry, Oral and Maxillofacial-Plastic and Reconstructive Surgery, Faculty of Medicine, Yamagata University, 2-2-2 Iida-nishi, Yamagata, 990-9585, Japan
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Elad S, Zadik Y, Caton JG, Epstein JB. Oral mucosal changes associated with primary diseases in other body systems. Periodontol 2000 2019; 80:28-48. [DOI: 10.1111/prd.12265] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Affiliation(s)
- Sharon Elad
- Department of Oral MedicineEastman Institute for Oral Health Rochester New York USA
- Hospital DentistryStrong Memorial Hospital Rochester New York USA
| | - Yehuda Zadik
- Oral Medicine for Hematologic and Oncologic PatientsDepartment of Oral Medicine, Sedation and Maxillofacial ImagingHebrew University‐Hadassah School of Dental Medicine Jerusalem Israel
- Department of Oral MedicineOral and Maxillofacial InstituteMedical CorpsIsrael Defense Forces Tel Hashomer Israel
| | - Jack G. Caton
- Department of PeriodontologyEastman Institute for Oral Health Rochester New York USA
| | - Joel B. Epstein
- Samuel Oschin Comprehensive Cancer InstituteCedars‐Sinai Medical Center Los Angeles California USA
- Division of Otolaryngology and Head and Neck Surgery City of HopeCity of Hope National Medical Center Duarte California USA
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Nunes LFM, Rocha AL, Magalhães GHR, de Melo FHC, Travassos DV, Mesquita RA, Silva TA. Intraoral granulocytic sarcoma as a manifestation of myelofibrosis: A case report and review of the literature. SPECIAL CARE IN DENTISTRY 2018; 38:409-420. [DOI: 10.1111/scd.12325] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2018] [Revised: 07/09/2018] [Accepted: 07/13/2018] [Indexed: 12/25/2022]
Affiliation(s)
| | - Amanda Leal Rocha
- Department of Oral Surgery and Pathology; Faculty of Dentistry; Universidade Federal de Minas Gerais; Minas Gerais Brazil
| | - Gustavo Henrique Romani Magalhães
- Department of Hematology and Oncology; Ambulatory of Chronic Myeloproliferative Diseases; Universidade Federal de Minas Gerais; Minas Gerais Brazil
| | | | - Denise Vieira Travassos
- Department of Community and Preventive Dentistry; Faculty of Dentistry; Universidade Federal de Minas Gerais; Minas Gerais Brazil
| | - Ricardo Alves Mesquita
- Department of Oral Surgery and Pathology; Faculty of Dentistry; Universidade Federal de Minas Gerais; Minas Gerais Brazil
| | - Tarcília Aparecida Silva
- Department of Oral Surgery and Pathology; Faculty of Dentistry; Universidade Federal de Minas Gerais; Minas Gerais Brazil
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Gaal A, Chisholm KM, Egbert M. How Rare Is an Oral Presentation of Myeloid Sarcoma in the Infant? J Oral Maxillofac Surg 2018; 76:561-568. [DOI: 10.1016/j.joms.2017.08.034] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2017] [Revised: 08/26/2017] [Accepted: 08/26/2017] [Indexed: 10/18/2022]
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Shen Y, Zhao L, Wu Y, Huang P. Multifocal occurrence of intraoral isolated MS in a patient without leukemic presentation: A case report and literature review. Oral Surg Oral Med Oral Pathol Oral Radiol 2018; 125:e42-e48. [DOI: 10.1016/j.oooo.2017.11.013] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2017] [Revised: 10/27/2017] [Accepted: 11/08/2017] [Indexed: 11/25/2022]
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Carvalho FSR, Costa FWG, Chaves FN, Alves APNN, Sousa FB, do Patrocínio RMDSV, Pereira KMA. Intraoral mass in the posterior maxillary vestibule. J Am Dent Assoc 2017; 146:544-8. [PMID: 26113102 DOI: 10.1016/j.adaj.2015.02.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2014] [Revised: 01/21/2015] [Accepted: 02/09/2015] [Indexed: 01/27/2023]
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Sharma A, Singh HP, Gupta AA, Garg P, Moon NJ, Chavan R. Granulocytic sarcoma in non-leukaemic child involving maxillary sinus with long term follow up: A rare case report. Ann Maxillofac Surg 2014; 4:90-5. [PMID: 24987607 PMCID: PMC4073472 DOI: 10.4103/2231-0746.133078] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Granulocytic sarcoma (GS) is a rare extramedullary malignant tumor composed of immature myeloid cells. It is strongly associated with acute myeloid leukaemia, chronic myeloproliferative diseases. Occurrence of GS in the oral cavity is extremely uncommon. Present case reported an unusual occurrence of GS without leukemia involving maxillary sinus of a child. The patient underwent chemotherapy followed by radiotherapy with complete remission. A long-term follow-up of the patient was carried without any evidence of recurrence with special focus on diagnostic difficulties. The present case highlights the perplexity in diagnosing such lesions with emphasis on the need of careful interpretation of all clinical, radiographic, histopathological and immunohistochemical details as it is one of the most frequently misdiagnosed disorder.
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Affiliation(s)
- Aman Sharma
- Departments of Oral and Maxillofacial Pathology and Microbiology, Swami Devi Dyal Hospital and Dental College, Panchkula, Haryana, India
| | | | | | - Parveen Garg
- Department of Oral and Maxillofacial Surgery, Krishna Dental College, Mohan Nagar, Uttar Pradesh, India
| | - Ninad Joshirao Moon
- Departments of Periodontics, RKDF Dental College and Research Centre, Bhopal, Madhya Pradesh, India
| | - Rahul Chavan
- Shri Guru Gobind Singh Educational and Welfare Society, Lal Bagh Road, Burhanpaur, Madhya Pradesh, India
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Abstract
CONTEXT Myeloid sarcoma of the head and neck region can pose diagnostic challenges because of the low frequency of myeloid sarcoma and the potential for tumors of almost any lineage to occur in the head and neck. OBJECTIVE To study the clinicopathologic and immunohistochemical characteristics of myeloid sarcoma in the head and neck region and to review the differential diagnosis. DESIGN We searched for cases of myeloid sarcoma involving the head and neck region for a 24-year period at our institution. The medical records and pathology slides were reviewed. Additional immunohistochemical stains were performed. RESULTS We identified 17 patients, age 17 to 85 years. Most tumors involved the oral cavity. Myeloid sarcoma was the initial diagnosis in 9 patients (53%); the remaining 8 patients (47%) had a history of bone marrow disease. Immunohistochemical analysis using antibodies specific for lysozyme, CD43, and CD68 were highly sensitive for diagnosis but were not specific. By contrast, assessment for myeloperoxidase in this study was less sensitive but more specific. We also used antibodies specific for CD11c and CD33 in a subset of cases, and these reagents seem helpful as well. CONCLUSIONS The clinical presentation of myeloid sarcoma involving the head and neck, particularly the mouth, is often nonspecific, and a high degree of suspicion for the possibility of myeloid sarcoma is needed. Immunohistochemistry is very helpful for establishing the diagnosis.
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Affiliation(s)
- Jane Zhou
- From the Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston
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Kirnbauer B, Wölfler A, Sill H, Beham A, Prettenhofer U, Jakse N. Myeloid sarcoma in the oral cavity. INTERNATIONAL JOURNAL OF STOMATOLOGY & OCCLUSION MEDICINE 2013. [DOI: 10.1007/s12548-012-0071-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
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