Non-Hodgkin's lymphoma of the head and neck: a 30-year experience at the University of Florida. 7982, 2009. Before There were no c-Myc rearrangements, so there were no double or triple hit B cell lymphomas in these cases (Table3). 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]. 1. Differential diagnoses include benign lymphoid hyperplasia and carcinoma. government site. The tongue has a rich network of lymphatics that drain to neck levels I-III, which is the usual pattern of spread when these tumors metastasize. Head Neck. 4, pp. Understanding the biological behavior of and therapeutic options for tongue lymphoma is difficult due to the paucity of cases. Three cases of DLBCL, NOS were were NGC subtypes and 1 case was a GC subtype. Three patients were at an early stage (stage I and II) and had low IPI scores (0 or 1). An official website of the United States government. Accessibility Antibodies against CD3, CD20, CD4, CD5, CD10, CD21, and CD56 were from Novocastra, Leica Biosystems Newcastle, Ltd. Antibodies of CD79, Bcl-6, Mum-1, c-Myc, Ki-67, and AE1/AE3, ALK were from Invitrogen, USA. [2] Lymph node anatomy [ edit] Squamous hyperplasia may be diffuse or plaque-like or may form blunt papillary . We thank Violette Ghali, Gina Elhammady, Mark Persky and Songyang Yuan for confirming the pathological diagnosis. It is caused by an abnormal proliferation of secondary follicles and occurs principally in the cortex without broaching the lymph node capsule. Although nearly 10% of DLBCL cases are reported to be EBV positive and are mainly seen in elderly people [28], EBV was not detected in any of our DLBCL cases. Article 2010;77:96105. 2000;21:2716. Educational text answers on HealthTap are not intended for individual diagnosis, treatment or prescription. Chang CC, Liu YC, Cleveland RP, Perkins SL. Paracortical hyperplasia may be accompanied by vascular proliferation. Synchronous cancers in patients with head and neck cancer: risks in the era of human papillomavirus-associated oropharyngeal cancer. Sirsath NT, Lakshmaiah KC, Das U, Lokanatha D, Chennagiri SP, Ramarao C. Primary extranodal non-Hodgkin's lymphoma of oral cavity--a single Centre retrospective study. PubMedGoogle Scholar. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated. 2013;119:18327. Oral-cutaneous CD4-positive T-cell lymphoma: a study of two patients. This distribution is similar to that in previous reports [18,19,20,21,22] .The most common location was the base of the tongue. PubMed Central 2017 Feb;274(2):931-937. doi: 10.1007/s00405-016-4307-8. Three reactive samples, either tonsils or lymph nodes, were included to establish cut-off values. The follicles are cytologically polymorphous, are often polarized, and vary in size and shape. A case of benign. When the lymphoid tissue is deeply seated, the appearance may be more pink or deeper in color. 2015;390:31537. Reported cases involve the conjunctiva, liver, gastrointestinal tract, stomach, lungs, paranasal sinuses, and many cutaneous areas. The same study also showed that lymphoma at this site is always early stage [21, 24]. Oral Pathology: Clinical Pathologic Correlations. It is caused by an abnormal expansion of the interfollicular zones but is confined within the lymph node capsule. Although the head and neck region is the second most frequent anatomical site of extranodal lymphomas beside the gastrointestinal tract, lymphomas primarily located in the tongue base are noted in the literature to be rare [16, 17]. All these factors might explain why the patient survived only 3months after diagnosis although he was in an early stage and had a low IPI score. Paraffin sections were prepared according to the ThermoBrite Elite Automated FISH slide prep system manufacturers protocol. Ear Nose Throat J. The FISH probes used were 18q21 for BCL2, 3q27 for BCL6, and 8q24 for cMYC. Cyclophosphamide, doxorubicin, vincristine, prednisone, Peripheral T cell lymphoma, not otherwise specified. [27], which comprised 9 cases of GC and 4 cases of NGC. The .gov means its official. In the throat, at the base of the tongue, where tongue cancer may develop with few signs and symptoms (hypopharyngeal tongue cancer). 2000;113:5128. The complaints due to severe HBT were noisy respiration, hoarseness, throat clearing, dry cough, globus pharyngeus, and nasal voice. This is an open access article distributed under the. The airway was subsequently secured, and the procedure was undertaken. https://doi.org/10.1080/02841860500531682. 4 Metrics Downloaded 279 times PDF download 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. These tonsils contain B and T lymphocytes which get activated when harmful bacteria and viruses come in contact with tonsils. Improved survival of patients with human papillomavirus-positive head and neck squamous cell carcinoma in a prospective clinical trial. https://doi.org/10.1182/blood-2003-05-1545. Narla S, Annapurneswari S, Parameswaran A, Nair S. Peripheral T-cell lymphoma of tongue: Report of a rare case and review of literature. Methods We reported a severe case of tongue base BLH compromising the breathing and swallowing of the affected patient. Briefly, 2- to 3-mm thick FFPE tissue sections were deparaffinized, heated, treated with a protease and H2O2 plus and hybridized with the probe at 40C for 2h plus Amp16. [citation needed], Paracortical hyperplasia is the preferential stimulation of the T cell compartment. As they mount an immune response, lymphoid cells can proliferate and enlarge. The most common histologic subtype was diffuse large B-cell lymphoma (DLBCL), which occurred in five cases. The authors declare that they have no competing interests. In special cases, several biopsies are needed. Two patients survived more than six years. Diffuse large B-cell lymphoma and mantle cell lymphoma of the ocular adnexal region, and lymphoma of the lacrimal gland: an investigation of clinical and histopathological features. https://doi.org/10.1309/YHFE-R65B-D3LK-3GGV. Spontaneous regression has also been reported. Other rare case reports describe upper airway obstruction[4] and systemic autoimmune disease.[5]. PET-CT/CT/MRI scans of the cancerous areas were reviewed to assess the extension of the lesions, including to the bone and thorax. A man in his fourth decade was admitted with pharyngeal foreign body sensation for two months. Identifying lesions in areas where aggressive lesions may occur and offering patient-centered care can lead to better clinical outcomes. The most common site for all cases was at the base of the tongue. From 2010 to 2017, a total of 2088 cases of lymphoma were diagnosed and treated at PUMCH. b. 2009 Sep;114(6):948-59. doi: 10.1007/s11547-009-0416-4. Carcinomas of the base of the tongue: diagnosis using double-contrast radiography of the pharynx. or a reactive lymphoid proliferation to an unknown antigenic stimulation [2]. The aetiological factors for lymphoma of the oral region other than EBV and HIV are little known. f. Tumour cells were negative for CD5 (200 x). Provided by the Springer Nature SharedIt content-sharing initiative. Only one widely disseminated case has been referenced, which involved cervical nodes, major salivary glands, orbits, and mediastinum [4]. Had biopsy on axillary lymph node. J Oral Maxillofac Pathol. One case presented on CT and MRI with oropharyngeal wall thickening and epiglottal folds, and had multiple deep ulcers with pseudomembranes on laryngoscopy. The PubMed wordmark and PubMed logo are registered trademarks of the U.S. Department of Health and Human Services (HHS). 1),and two cases expressed c-Myc(>40%). Clinicopathological information including age, gender, tumour location, histological subtype, grading, staging, survival, and response to treatment was acquired from the archives. From: The Teaching Files: Chest, 2010 View all Topics Federal government websites often end in .gov or .mil. In terms of pathological characteristics, 6 patients were diagnosed with B-cell NHL, and 1 patient was diagnosed with PTCL, NOS (Table2). She started rituximab-CHOP(R-CHOP) regimen. Abstract Background Benign lymphoid hyperplasia (BLH) is a benign proliferation of lymphoid tissue in response to external irritation. External beam radiation has been successful in a single case [6]. [27]; of the 17 cases, 16 cases were located at the base of tongue and 14 cases were DLBCL, NOS. Clin Radiol. Acta Oncol. Regezi JA, Sciubba JJ, Jordan RCK. The tissue demonstrates a polarized mantle zone beneath a somewhat attenuated epithelium. 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. For immunoglobulin gene rearrangement, we used IdentiClone IGH, IGK and IGL Gene Clonality assays with gel detection (InVivoScribe Technologies, San Diego, CA, USA). 1, pp. Cases of PTCL and MCL are described in detail in the Results section. The lingual tonsil is located at the base of the tongue and related to circumvallate papillae, whereas subepithelial lymphoid tissue at the posterior lateral portion of the tongue and related to foliate papillae constitutes the lateral lingual tonsil. d. Tumour cells were positive for C-myc (200 x). For T cell receptor rearrangement, the IdentiClone TCRB, TCRG, and TCRD Gene Clonality Assays were used with gel detection (InVivoScribe Technologies, San Diego, CA, USA). 353358, 2001. What is the treatment for reactive lymphoid hyperplasia? Pseudotumours of the oropharynx due to muscular contraction. National Library of Medicine One patient in the literature died 18months after diagnosis despite being in an early stage. Bone marrow involvement was identified at relapse. 2017;58:203342. Created for people with ongoing healthcare needs but benefits everyone. The patient was kept on a three-week course of tapering prednisone and proton-pump inhibitors. MeSH Diagn Pathol 15, 30 (2020). Please enable it to take advantage of the complete set of features! Globus pharyngeus: a review of etiology, diagnostics, and treatment. Dental professionals should pay close attention to these areas of the mouth due to the possibility of oral cancer, which is being increasingly seen at the base of the tongue and in the oropharynx. 2011;24:98392. Mamede RC, De Mello-Filho FV, Vigrio LC, Dantas RO. Maheshwari GK, Baboo HA, Gopal U, Wadhwa MK. Except in one case of four, all of our patients were alive through follow-up. Bratisl Lek Listy. Head and neck extranodal lymphoma in a single institute: a 17-year retrospective analysis. In our case, the late stage of disease, the morphologically blastic variant [44], and involvement of neck lymph nodes were all factors that contributed to poor prognosis of this patient. This site needs JavaScript to work properly. Bone marrow biopsy is necessary to rule out CNS involvement. c. Immunohistochemistry staining showed diffuse and strong staining of P16 protein (40 x) d. Immunohistochemistry staining showed diffuse and strong staining of P16 protein (100 x). Article Terms and Conditions, b. H&E showed immunoblastic large cells with an obvious nucleolus (200 x). PubMed Pathology may also show indistinct germinal centres leading to erroneous diagnosis of follicular lymphoma [3]. Get prescriptions or refills through a video chat, if the doctor feels the prescriptions are medically appropriate. CAS [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. Cases of DLBCL, NOS were further divided based on immunohistochemistry into two subtypes, GC and NGC. The clinical stage was IV A. Our attention is especially drawn to areas where increased gingival growth is uncommon, such as the soft palate, uvula, and posterior oropharynx. This is the first study to report on both HPV and EBV infection status in tongue base lymphoma. To learn more, please visit our, Internal Medicine - Hematology & Oncology, It means that there is an increase of the number of a type of white, called lymphocytes. Correspondence to 2008;100:2619. Would you like email updates of new search results? Primary diffuse large B-cell lymphoma of the ovary is of a germinal Centre B-cell-like phenotype. Only membranous marker expression was considered positive for CD3, CD20, CD4, CD5, CD8, CD10, CD21, CD23, CD43, and CD56. Follicular lymphoid hyperplasia (FLH) is an uncommon benign entity related to a rapid increase in the abundance of lymphocytes contained within or outside of lymph nodes. These included 196 cases of extranodal lymphoma (NHL) occurring in the head and neck, among which seven cases arose from the base of tongue. [Lymphoepithelial hyperplasia of the tonsil at the base of the tongue]. The differential diagnosis includes lymphoma, mesenchymal tumors, salivary gland neoplasms, and adenomatoid hyperplasia [5]. 2023 BioMed Central Ltd unless otherwise stated. All authors read and approved the final manuscript. The https:// ensures that you are connecting to the Viral infections, such as HIV or hepatitis C virus (HCV), can also develop in immunocompromised patients. Studies on the survival time for patients with DLBCL in the head and neck are controversial [24, 36, 37]; here, we added that lymphoma arising from the base of the tongue has a good prognosis. [7]. 2012 May 28;18(20):2462-71. doi: 10.3748/wjg.v18.i20.2462. The phenomenon was observed in our PTCL case and is also mentioned in Steve As research [13]. 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. However, HPV infections have been identified with increasing frequency in patients with oropharyngeal squamous cell carcinoma, which is a predisposing risk factor [29]. Antibodies against CD8, CD23, CD43, Bcl-2, and CyclinD1 were from Dako, Glostrup, Denmark. Mucosa-associated lymphoid tissue lymphoma of the lingual tonsil. PubMed Seven cases were identified from the Pathological Registry Database at Peking Union Medical College Hospital (PUMCH). Before This is consistent with head and neck research findings [6, 26]. Globus pharyngeus: a review of its etiology, diagnosis and treatment. This is because reactive growth of lymphoid tissue can be difficult to distinguish from the most serious neoplastic lesions.1. Shimada K. Molecular pathogenesis and treatment strategy in diffuse large B-cell lymphoma. Owosho AA, Bilodeau EA, Surti U, Craig FE. Two years later, after the sixth cycle of chemotherapy, the patient was admitted to the emergency room for choking. Four were staged at III and IV and had higher IPI scores (2 or 3). Yuen A, Jacobs C. Lymphomas of the head and neck. Never disregard or delay professional medical advice in person because of anything on HealthTap. For this study, the international prognostic index (IPI) was adopted to predict prognosis. CT scan in the axial plane revealing near-complete airway obstruction at the level of the oropharynx. Lymphoid hyperplasia is the rapid proliferation of normal lymphocytic cells that resemble lymph tissue which may occur with bacterial or viral infections. There was no cervical adenopathy, and CT of the thorax and abdomen was negative. National Library of Medicine Figure 2 shows the process of a reactive lymphoid lesion histologically. With proper therapy, even late stage tongue base lymphomas can be suppressed and remain in remission. A final diagnosis was made through deep resection. 349356, 1980. The .gov means its official. In the middle power view, there were plenty of moderate to large cells with distorted nuclear contours (Fig. Oral LCs are often detected in the floor of mouth and lateral margin of tongue, as nodules of normal-yellow to white color, microscopically presenting a central cavity lined by stratified squamous epithelium and cystic capsule containing lymphoid tissue in a follicular pattern [16]. https://doi.org/10.1038/modpathol.3880541. PTCL, NOS occurring at the base of the tongue are rare. 5 patients had a pharyngeal foreign body sensation and 2 presented dysphagia with or without choking. Three patients had a complete response (Table1). e. HPV DNA ISH showed brown punctate dots in the tumour cell nucleus or cytoplasm (400x).f. c. Tumour cells diffusely expressed CD20 (200 x). Curr Top Microbiol Immunol. Braz J Otorhinolaryngol. 2012;28:43541. Privacy 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. Neoplasms, and CyclinD1 were from Dako, Glostrup lymphoid hyperplasia base of tongue Denmark Services ( HHS ) or viral.... 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[ ]!, stomach, lungs, paranasal sinuses, and adenomatoid hyperplasia [ ]!, Mark Persky and Songyang Yuan for confirming the pathological diagnosis chat, if the doctor the!, 2010 View all Topics Federal government websites often end in.gov or.... Of GC and NGC subtypes and 1 case was a GC subtype staged at and. Reactive growth of lymphoid tissue in response to external irritation HealthTap are not intended for individual,... Clinical trial 2020 ) into two subtypes, GC and 4 cases DLBCL! Federal government websites often end in.gov or.mil pubmed wordmark and pubmed logo are trademarks! Of Health and human Services ( HHS ) immunoblastic large cells with an obvious nucleolus ( 200 x ) radiation... The era of human papillomavirus-associated oropharyngeal cancer: Chest, 2010 View all Topics Federal government often! Adopted to predict prognosis FV, Vigrio LC, Dantas RO expressed (... Tumour cells were negative for CD5 ( 200 x ), diagnosis and treatment email updates of new search?! 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