Follicular lymphoid hyperplasia of the posterior maxillary site presenting as uncommon entity: a case report and review of the literature

An evidence based immunohistochemical panel for diagnosing oral lymphoma along with a case series

Oral lymphomas are rare and present a diagnostic challenge. Immunophenotyping is essential to decipher their biology and identify therapeutic targets. Histopathology can prove to be diagnostically difficult to type these lesions, and hence, immunohistochemistry (IHC) proves useful in deciphering their biology. Here, we present an evidence-based approach using a novel immunohistochemical marker panel to diagnose oral lymphomas by discussing four unique cases.

Head and neck follicular lymphoma with marginal zone differentiation and BCL2 translocation t(14;18) in both nodular and extranodular sites: a case report with mini-review

OBJECTIVE

Head and neck follicular lymphoma (FL) with marginal zone (MZ) differentiation is a rare high-risk B-cell composite variant that has been reported in nodular but not extranodular sites in the parotid glands. Here we summarize the literature on FL with MZ differentiation in head and neck nodular sites and describe a rare case of extranodular FL with MZ differentiation in the parotid gland.

STUDY DESIGN

We examined both the germinal center and MZ components of the parotid and bone-marrow biopsies of a 65-year-old female histologically, immunohistochemically, and molecularly to identify B-cell, germinal center, and follicular dendritic cell markers.

RESULTS

The immunohistochemical and molecular analysis provided evidence that the FL and the MZ components derived from the same B-cell clone with a similar BCL2/IGH t(14;18) translocation site. The differentiated cells in the MZ did not express germinal center markers BCL6 and CD10. Both the parotid and bone-marrow proliferative B cells showed BCL6, CD2O, and CD79a positivity.

CONCLUSIONS

Head and neck FL with MZ differentiation can develop in both nodular and extranodular sites and is characterized by BCL2 translocation t(14;18). Although the mechanism of MZ differentiation is unclear, the characterization of this rare histopathologic phenomenon might be clinically important.

An intriguing case report of follicular lymphoid hyperplasia of tongue with the detailed review of literature

Follicular lymphoid hyperplasia is a rare reactive benign lesion of the oral mucosa. This is also known as pseudolymphoma as the features mimic the malignant counterpart Follicular lymphoma. In present case, a 34 year old male patient came with a nodular swelling in the posterior-lateral left side of tongue. Medical or dental history was non contributory. Swelling was painless, well demarcated, and about peanut sized. The swelling was provisionally diagnosed as either neurilemmoma, mucocele, or traumatic fibroma. Complete excision was performed, and tissue was sent to a private laboratory. Histopathological findings seen were germinal centers having a core of monotonous cells of the same size and demarcated mantle area mimicking the lymphoma. Immunophenotyping revealed diffused positivity for kappa and lambda expressions. CD10 was diffusely positive in germinal centers and BCl 2 was positive in the mantle area while negative in germinal centers. The final diagnosis given was follicular lymphoid hyperplasia. The entity mentioned in the present paper is an unusual variant of the benign lymphoproliferative lesion and very few cases are reported in the tongue area. Thus, it is important to understand the nature of this benign lesion in all aspects to avoid diagnostic dilemmas due to its malignant mirroring characteristics.