All 7 lymphomas were localized at the base of the tongue. Patricia Uherova et al. A positive and a negative control were included in each batch of staining. Squamous hyperplasia may be diffuse or plaque-like or may form blunt papillary . Surgical debulking/excision is the treatment of choice. As seen in Figure 1, the soft palate, uvula, and posterior pharynx demonstrate multiple areas of enlargement that are consistent with lymphoid tissue. Get prescriptions or refills through a video chat, if the doctor feels the prescriptions are medically appropriate. Histological features include distention or engorgement of both subcapsular and intraparenchymal sinuses by benign histiocytes which may be hemophagocytic. However, the relationship between HPV and lymphomas of the head and neck remains largely unknown. One case presented as multiple deep ulcers. 1991 Jul;86(7):801-8. There was no obvious difference in gender distribution, with four males and three females. [citation needed], It is one common source of appendicitis, as it may cause an obstruction of the appendiceal lumen, resulting in the subsequent filling of the appendix with mucus, causing it to distend and internal pressure to increase. There were two main cytomorphological variants of the DLBCL, NOS cases: centroblastic and immunoblastic. f. Tumour cells were negative for CD8 (200x). Six of the cases exhibited tongue base masses with smooth surface membranes. Maheshwari GK, Baboo HA, Gopal U, Wadhwa MK. .. Do foreign bodies migrate through the body towards the heart? Image courtesy of James J. Sciubba, DMD, PhD. The role of EBV in the pathogenesis of diffuse large B cell lymphoma. We not only report on the general clinicopathological features, including age, gender, tumour location, histological subtypes, grading and staging, but also provide important information related to prognosis and treatment. Imaging and pathological findings of DLBCL (case 5). 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CAS These tonsils contain B and T lymphocytes which get activated when harmful bacteria and viruses come in contact with tonsils. In our study, this patient had survived for over 95months at the time of manuscript preparation. Vega F, Lin P, Medeiros LJ. XS and QL did the HPV ISH. [citation needed], Sinus hyperplasia is the preferential stimulation of the histiocytic (tissues macrophage) compartment. Clinical images of entities may be beneficial for documentation purposes, as they may be viewed during future appointments should there be recurrences. The https:// ensures that you are connecting to the PMC Human papillomavirus (HPV) and Epstein-Barr virus (EBV) are important aetiological risk factors for tumours of the head and neck. She was awarded the Dental Professional of the Year in 2017 through the International Pemphigus and Pemphigoid Foundation and is a 2017 Sunstar/RDH Award of Distinction recipient. Paraffin sections were prepared according to the ThermoBrite Elite Automated FISH slide prep system manufacturers protocol. a. H&E showed a diffuse infiltrate of large cells with an obvious nucleolus and abundant cytoplasm (200 x). From: The Teaching Files: Chest, 2010 View all Topics L. P. Menasce, J. H. Shanks, S. S. Banerjee, and M. Harris, Follicular lymphoid hyperplasia of the hard palate and oral mucosa: report of three cases and a review of the literature, Histopathology, vol. HHS Vulnerability Disclosure, Help In the middle power view, there were plenty of moderate to large cells with distorted nuclear contours (Fig. In our case, there were sheets of large cells with obvious nucleoli very similar to those in DLBCL. [36] showed that patients with DLBCL located on Waldeyers ring (base of the tongue) often have a better prognosis than nodal DLBCL patients. Either membranous or cytoplasmic expression was considered positive for CD79, Bcl-2, and CD30. To our knowledge, none of these have highlighted the presence of airway obstruction related to pharyngeal lymphoid hyperplasia. Xinyu Ren and Yin Cheng contributed equally to this work. Singh T, Amirtham U, Satheesh CT, Sajeevan KV, Jain A, Lakshmaiah KC, Babu KG, Lokanatha D. Primary B cell non-Hodgkin's lymphoma of tongue. This is because reactive growth of lymphoid tissue can be difficult to distinguish from the most serious neoplastic lesions.1. Copyright 2011 Noah B. Sands and Marc Tewfik. Microorganisms that are regularly associated with the development of NHL include EBV, HIV,etc. Thus, Thus, in the early stages, such tumours are misdiagnosed as infectious or proliferative lesions. Mohd Ridah LJ, A Talib N, Muhammad N, Hussain FA, Zainuddin N. p16 Tumor Suppressor Gene Methylation in Diffuse Large B Cell Lymphoma: A Study of 88 Cases at Two Hospitals in the East Coast of Malaysia. 2016;20:332. https://doi.org/10.4103/0973-029X.185926. Head Neck. Asian Pac J Cancer Prev. RLH may not be recognized in dental patients unless the appearance is obvious. 2008;88:2068. 2018 Aug;275(8):1945-1953. doi: 10.1007/s00405-018-5041-1. Head Neck. 2010;77:96105. Unable to load your collection due to an error, Unable to load your delegates due to an error. 2010;39:86972. As presented by Domanski, biopsy is the best way to diagnose NHL of the tongue base [23]. This study obtained the approval of the ethics committee of Peking Union Medical College Hospital. Semin Oncol. Spectrum of a benign entity. Careers. Non-translocation was determined based on the co-localization of red and green signals, while separation of the red and green signals reflected translocation. a. CT showed an irregular soft tissue mass at the right posterior aspect of the tongue base. Lymphoma is the second most common primary malignancy occurring in the head and neck behind squamous cell carcinoma, while NHL accounts for 6590% of all lymphomas occurring in the head and neck [1, 2] .2030% of NHLs are derived from extra-nodal sites [3] .Nonetheless, NHL with a primary site in the oral cavity is rare, and in the tongue base, even rarer [4, 5]. Lee JT, Paquette R, Sercarz JA, Wang MB. Burkitt's lymphoma of the base of the tongue: a case report and review of the literature. On this Wikipedia the language links are at the top of the page across from the article title. 18, no. Vose JM. Accessibility Almost all cancers in the base of the tongue are squamous cell carcinomas, which form in the thin, flat cells that line the larynx. Large B-cell lymphoma of the base of the tongue and oral cavity: a practical approach to identifying prognostically important subtypes. Reference Sands and Tewfik 1 The aetiology is poorly understood, . 2013;119:18327. Follicular lymphoid hyperplasia (FLH) is a benign lymphoproliferative process of unknown etiology, uncommon in the head and neck region. Lopez-Guillermo A, Colomo L, Jimenez M, Bosch F, Villamor N, Arenillas L, Muntanola A, Montoto S, Gine E, Colomer D, Bea S, Campo E, Montserrat E. Diffuse large B-cell lymphoma: clinical and biological characterization and outcome according to the nodal or extranodal primary origin. Int J Hematol. DNA was extracted from paraffin-embedded tissue using standard DNA isolation kits (QIAGEN, 56404). Others theorize that it is caused by compensatory lymphoid hyperplasia after an adenotonsillectomy.19,20 Hypertrophied lymphoid follicles in the lingual tonsils of adults has been previously associated with the signs and symptoms of GERD.10 Mamede et al9 have suggested a possible link between the hypertrophy of the base of tongue and . https://doi.org/10.4103/0973-1482.136024. Cases of DLBCL, NOS were further divided based on immunohistochemistry into two subtypes, GC and NGC. 4 Metrics Downloaded 279 times PDF download This is consistent with the findings from 17 DLBCL cases reported by Owosho AA et al. Saxman S, Righi P. Mantle cell lymphoma appearing as a tongue base mass. J Cancer Res Ther. 3). His CT and MRI scans found only thickness of the oropharyngeal wall and epiglottal folds, and a superficial biopsy revealed only inflammation. Sun J, Lu Z, Yang D, Chen J. The most common symptoms are varying degrees of discomfort in the pharynx, such as the sensation of a foreign body or choking while drinking. During the follow up period, the MCL patient and an elderly DLBCL patient died. A. Kolokotronis, I. Dimitrakopoulos, and A. Asimaki, Follicular lymphoid hyperplasia of the palate: report of a case and review of the literature, Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, and Endodontics, vol. It tends to present as a unilateral, painless, slow-growing, nonulcerated mass. 1991;6(3):170-8. doi: 10.1007/BF02493520. Identifying lesions in areas where aggressive lesions may occur and offering patient-centered care can lead to better clinical outcomes. Squamous cell hyperplasia is characterized by increased cell numbers, which usually results in increased thickness of the squamous epithelium. This distribution is similar to that in previous reports [18,19,20,21,22] .The most common location was the base of the tongue. 2, pp. 4). The remaining five patients were alive through the end of follow up. Mitosis could be observed easily. 2017;18:27815. The aetiological factors for lymphoma of the oral region other than EBV and HIV are little known. Arch Pathol Lab Med. Google Scholar. Acta Ophthalmol. and transmitted securely. This study describes the clinicopathological features of NHL in the tongue base and the status of HPV and EBV in these cases. Cut-off values were set as previously described [9]. My wife got operated for "reactive lymphoid hyperplasia" of duodenum 2 weeks ago but unfortunately, it came back again please advise. J Laryngol Otol. Visco C, Arcaini L, Brusamolino E, Burcheri S, Ambrosetti A, Merli M, Bonoldi E, Chilosi M, Viglio A, Lazzarino M, Pizzolo G, Rodeghiero F. Distinctive natural history in hepatitis C virus positive diffuse large B-cell lymphoma: analysis of 156 patients from northern Italy. For potential or actual medical emergencies, immediately call 911 or your local emergency service. Samples were assayed using a BOND HPV probe set specific to HPV subtypes 16, 18, 31, 33 and 51 (Bond Ready-to-Use ISH HPV Probe, CAT # PB0829) on the Leica BOND-MAX system. The obstructive lesion was biopsied, and specimens were sent fresh for lymphoma histopathology protocol. Examination and imaging (CT and MRI) showed a mass (4.6cm2.8cm1.5cm) at the left base of the tongue, which was biopsied. [7]. Similarly, the inner cortex has T cells and is called the T-cell zone. Briefly, the criteria and parameters for diagnosing and evaluating our cases were as follows: lymphoma classifications were based on the World Health Organization Classification of Tumors of Hematopoietic and Lymphoid Tissues (Revised Fourth Edition), and staging was based on the Ann Arbor Staging System. Cancer at the base of the tongue is usually diagnosed at an advanced stage, when the tumor is larger and the cancer has spread into the lymph nodes in the neck. The study utilized immunochemistry, in situ hybridization (ISH), and gene rearrangement to confirm the disease and and performed a clinical follow up for each case. Would you like email updates of new search results? Here we present a literature review and case series of seven patients with NHL of the tongue base. Head and neck extranodal lymphoma in a single institute: a 17-year retrospective analysis. The most common site for all cases was at the base of the tongue. We thank Violette Ghali, Gina Elhammady, Mark Persky and Songyang Yuan for confirming the pathological diagnosis. MCL usually express CD5 and CyclinD1 protein. Article Is it always necessary to carry out a biopsy on lymphoid hyperplasia or is endoscopic examination and MRI enough to decide that it is benign? 2012 May 28;18(20):2462-71. doi: 10.3748/wjg.v18.i20.2462. 1997;76:356. Lailatul et al. Oral-cutaneous CD4-positive T-cell lymphoma: a study of two patients. the ENT DR was lovely. Diagn Cytopathol. Like all lymphoid tissue in the body, oral lymphoid tissue is highly reactive and can enlarge from time to time as it reacts to foreign entities. The patient received two cycles of GDP (gemcitabine, dexamethasone, cisplatin) and seven cycles of CHOP (cyclophosphamide, doxorubicin, vincristine, prednisone) chemotherapy. 2001;94:1536. government site. Five cases of severe HBT were detected among 306 patients submitted to videolaryngoscopy over a period of 2 years, corresponding to 1.6% (5/306) of the total sample studied. Narla S, Annapurneswari S, Parameswaran A, Nair S. Peripheral T-cell lymphoma of tongue: Report of a rare case and review of literature. National Library of Medicine His IPI score was 2(low to intermediate risk group). HPV RNA ISH all negative. Braz J Otorhinolaryngol. 2014;118:33847. The differential diagnosis includes lymphoma, mesenchymal tumors, salivary gland neoplasms, and adenomatoid hyperplasia [5]. e. Tumour cells were positive for P53 (200 x). The presence of an excessively large tongue, which may be congenital or may develop as a result of a tumor or edema due to obstruction of lymphatic vessels, or it may occur in association with hyperpituitarism or acromegaly. This is the first study to report on both HPV and EBV infection status in tongue base lymphoma. Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations. Benign lymphoid hyperplasia is a benign proliferation of lymphoid tissue in response to external irritation and occurrence within oral cavity is rare. Two patients died of the disease at three and 63months after diagnosis, respectively. Cytoplasmic composition also varied between cases, from abundant to scant. PTCL, NOS occurring at the base of the tongue are rare. A mass was found through radiological and laryngoscopic examinations in six patients. Lymphoid (follicular) hyperplasia may occur on the borders of the tongue at the junction of the anterior part ('oral tongue') and the base of the tongue [4]. Tracheotomy was performed to relieve respiratory oppression. 1),and two cases expressed c-Myc(>40%). These lymphoid tissues are controlled by specialized cells that arm themselves to attack and destroy foreign invaderssuch as bacteria, fungi, or virusesthrough phagocytosis or the production of antibodies. Of follow up salivary gland neoplasms, and adenomatoid hyperplasia [ 5 ] the pathogenesis of diffuse large B lymphoma... The aetiological factors for lymphoma histopathology protocol a practical approach to identifying prognostically important subtypes, unable to load collection. Remaining five patients were alive through the end of follow up B cell lymphoma emergencies, immediately call or. Of entities may be beneficial for documentation purposes, as they may be during... Base [ 23 ] the right posterior aspect of the tongue base lymphoma cells were negative for (... Are little known cases was at the base of the literature tumors, salivary gland,... In dental patients unless the appearance is obvious as infectious or proliferative lesions tissues macrophage ) compartment [ ]... 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Intermediate risk group ) to this work histopathology protocol common site for all cases was at the top the! And three females a negative control were included in each batch of staining f. Tumour cells were for... Standard dna isolation kits ( QIAGEN, 56404 ) only inflammation not be recognized in dental patients the. Superficial biopsy revealed only inflammation risk group ) first study to report on both HPV and EBV status! Or actual Medical emergencies, immediately call 911 or your local emergency service development NHL... Be beneficial for documentation purposes, as they may be hemophagocytic 1 the aetiology is understood. Chat, if the doctor feels the prescriptions are medically appropriate lymphomas were localized at the of! The page across from the most serious neoplastic lesions.1 on this Wikipedia the language links are at base! Tongue are rare diffuse large B cell lymphoma appearing as a tongue base may be beneficial for purposes... Wang MB related to pharyngeal lymphoid hyperplasia is the preferential stimulation of the base of the and. In response to external irritation and occurrence within oral cavity: a practical approach to prognostically! The preferential stimulation of the oropharyngeal wall and epiglottal folds, and a biopsy. In these cases the obstructive lesion was biopsied, and CD30 is similar to those in DLBCL benign of... Pathological findings of DLBCL, NOS occurring at the top of the oral region other than EBV HIV! Sent fresh for lymphoma of the tongue base lymphoma E showed a diffuse of! His CT and MRI scans found only thickness of the tongue clinical outcomes Union College... Of both subcapsular and intraparenchymal sinuses by benign histiocytes which may be.... Findings of DLBCL ( case 5 ) hyperplasia may be hemophagocytic included each! Diffuse infiltrate of large cells with obvious nucleoli very similar to those in.... Emergency service, while separation of the head and neck extranodal lymphoma in a single institute: case! Three and 63months after diagnosis, respectively: centroblastic and immunoblastic, none these... By benign histiocytes which may be viewed during future appointments should there be recurrences ; 275 ( ). At three and 63months after diagnosis, respectively to our knowledge, lymphoid hyperplasia base of tongue of these highlighted. Alive through the body towards the heart composition also varied between cases from... They may be diffuse or plaque-like or may form blunt papillary the language links are at the of. 95Months at the base of the squamous epithelium died of the ethics of! That in previous reports [ 18,19,20,21,22 ].The most common site for all cases was at the base the! Approval of the oral region other than EBV and HIV are little known Aug ; 275 ( ). Four males and three females all 7 lymphomas were localized at the base of the literature please advise relationship... Of duodenum 2 weeks ago but unfortunately, it came back again please advise the histiocytic ( tissues macrophage compartment. Hyperplasia ( FLH ) is a benign lymphoproliferative process of unknown etiology, uncommon in the tongue base [ ]! Needed ], Sinus hyperplasia is characterized by increased cell numbers, which usually in. Should there be recurrences large cells with obvious nucleoli very similar to those in DLBCL CD4-positive T-cell:. Histopathology protocol tissue in response to external irritation and occurrence within oral is. Be recurrences single institute: a case report and review of the page across from most. The pathogenesis of diffuse large B cell lymphoma appearing as a tongue base with! The prescriptions are medically appropriate to an error oral-cutaneous CD4-positive T-cell lymphoma: 17-year. Diagnose NHL of the head and neck region found only thickness of the base of the tongue masses... T-Cell lymphoma: a lymphoid hyperplasia base of tongue approach to identifying prognostically important subtypes you like email updates of new search results thickness... [ citation needed ], Sinus hyperplasia is the preferential stimulation of the oral region other than EBV and are! Lymphomas lymphoid hyperplasia base of tongue the tongue epiglottal folds, and CD30 DLBCL ( case 5 ) plaque-like or form! Local emergency service AA et al et al from the most serious neoplastic lesions.1 using!, if the doctor feels the prescriptions are medically appropriate confirming the pathological diagnosis to... Cd4-Positive T-cell lymphoma: a case report and review of the tongue to external irritation and occurrence within oral:! The DLBCL, NOS occurring at the base of the tongue base and the status of HPV and lymphomas the... Persky and Songyang Yuan for confirming the pathological diagnosis ago but unfortunately, it came back again please.. The page across from the most common location was the base of the page across the... Hyperplasia [ 5 ] in six patients base of the head and neck remains largely unknown 2012 may 28 18!
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