But when areas of focal nodular lymphoid hyperplasiawhich are well-known to occur in other areas of the bodyoccur in the mouth, they create a perplexing dilemma for dental professionals. 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 . DLBCL with high risk factors and MCL may have unfavourable outcomes. Under the microscope, normal tissue was replaced by diffuse large atypical lymphocytes with relatively abundant cytoplasm. Google Scholar. All 7 lymphomas were localized at the base of the tongue. Braz J Otorhinolaryngol. Methods We reported a severe case of tongue base BLH compromising the breathing and swallowing of the affected patient. This study obtained the approval of the ethics committee of Peking Union Medical College Hospital. Epub 2009 Jun 26. Normal lymphoid tissue is found in your lymph nodes and tonsils. Google Scholar. Expression and alteration of p16 in diffuse large B cell lymphoma. When the lymphoid tissue is deeply seated, the appearance may be more pink or deeper in color. An abstract is unavailable. The https:// ensures that you are connecting to the 2013 Dec;137(12):1837-42. doi: 10.5858/arpa.2012-0678-RS. A mass was identified in the right base of the tongue that caused breathing difficulties. Google Scholar. Severe HBT was considered to be present when the follicles prevented the view of the epiglottis or were massively distributed through the pharynx and larynx. The PubMed wordmark and PubMed logo are registered trademarks of the U.S. Department of Health and Human Services (HHS). Asian Pac J Cancer Prev. PMC Never disregard or delay professional medical advice in person because of anything on HealthTap. Expression of c-Myc and p53 correlates with clinical outcome in diffuse large B-cell lymphomas. FOIA 1997;36:41320. Reference Sands and Tewfik 1 The aetiology is poorly understood, . https://doi.org/10.1016/j.oooo.2014.06.002. Squamous cell hyperplasia is characterized by increased cell numbers, which usually results in increased thickness of the squamous epithelium. Int J Oral Maxillofac Surg. Bookshelf Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. Polyclonal lymphoid proliferation with immunohistochemistry stains for kappa or lambda light chains are diagnostic. What are chaces of malignancy?What precautions for future shud i take? Educational text answers on HealthTap are not intended for individual diagnosis, treatment or prescription. The clinical stage was IV A. Of the 6 B-cell NHL cases, 5 were DLBCLs and 1 was MCL. J Oral Maxillofac Pathol. Most lymphomas of the tongue base manifest as an endogenous mass without membranous change. Our HPV-infected patient indeed had a favourable prognosis, and he was alive and free of disease when this manuscript was prepared (68months). Rasmussen PK. MeSH Lee JT, Paquette R, Sercarz JA, Wang MB. Results came back "lymphoid hyperplasia". Springerplus. Immunohistochemically, the atypical lymphoid cells were positive for CD20, CD79a, PAX-5, CD5, CyclinD1 protein, and Ki-67 antigen (labelling 25%). Lymphoid hyperplasia is the rapid proliferation of normal lymphocytic cells that resemble lymph tissue which may occur with bacterial or viral infections. Positive staining was indicated by brown punctate dots in the cytoplasm. Tumours in this site are predominantly DLBCL subtypes in histology. 2017;58:203342. Takahashi H, Fujita S, Okabe H, Tsuda N, Tezuka F. Immunophenotypic analysis of extranodal non-Hodgkin's lymphomas in the oral cavity. The most common histologic subtype was diffuse large B-cell lymphoma (DLBCL), which occurred in five cases. Spontaneous regression has also been reported. 1970 Dec;8(3):413-24. 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. Clinical information and disease characteristics are described in Table1. The patient was decannulated and discharged home 14 days after tracheotomy. c. Tumour cells diffusely expressed CD20 (200 x). Postoperatively the patient was deemed unsafe for extubation and transferred to the intensive care unit while placed on high-dose intravenous dexamethasone. A man in his fourth decade was admitted with pharyngeal foreign body sensation for two months. 8600 Rockville Pike Most DLBCL cases of the tongue base had no Bcl-2, Bcl-6, or c-Myc rearrangement and they were sensitive to rituximab. Clinicopathological information including age, gender, tumour location, histological subtype, grading, staging, survival, and response to treatment was acquired from the archives. Roentgen examination of the oropharynx and oral cavity. 4 Metrics Downloaded 279 times PDF download Review of the preoperative anaesthesia records revealed no features of airway obstruction nor B symptoms on clinical history. These cells are designed to fight infections, particularly viral infections .. Another reason might be HPV is not transcriptionally active in this patient; the virus integrated into the host DNA and remained inactive. FOIA d. Tumour cells were positive for C-myc (200 x). Imaging and pathological findings of DLBCL (case 5). In this paper we present a case of severe pharyngeal lymphoid hyperplasia causing airway obstruction and requiring tracheotomy and subsequent surgical debulking. In the literature, findings of RLH are well-documented. 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. Except in one case, all patients exhibited a tongue base mass with smooth and intact membrane surface. The pathological diagnosis was MCL. Lymphoid hyperplasia is a rapid increase in the number of normal cells (called lymphocytes) that are contained in lymph nodes. Follicular lymphoid hyperplasia (FLH) is a benign lymphoproliferative process of unknown etiology, uncommon in the head and neck region. 2010;39:86972. Vega F, Lin P, Medeiros LJ. [1] The growth is termed hyperplasia which may result in enlargement of various tissue including an organ, or cause a cutaneous lesion. 2004;103:27582. CAS The most common symptoms are varying degrees of discomfort in the pharynx, such as the sensation of a foreign body or choking while drinking. https://doi.org/10.2214/ajr.149.3.575. Cookies policy. 2001;23:54758. As stated before, the depth of invasion is a major prognostic indicator. The .gov means its official. Two patients survived more than six years. What does prominent lymphoid tissue at base of tongue on an MRI report mean. SW and XZ did the BCL-2, BCL-6, c-MYC FISH examination. This site needs JavaScript to work properly. However, HPV infections have been identified with increasing frequency in patients with oropharyngeal squamous cell carcinoma, which is a predisposing risk factor [29]. 2023 Endeavor Business Media, LLC. b. H&E showed moderate to large cells with distorted nuclear contours (200 x). [2] Lymph node anatomy [ edit] e. Tumour cells were positive for CD4 (200x). The site is secure. b. Tumour cells diffusely expressed CD20 (200 x). All DLBCL cases were positive for CD20, Mum1,Bcl-2 and Bcl-6 and negative for CD5. [citation needed], Cutaneous lymphoid lesions may be observed in follicular, granulomatous or lymphoreticular pathologic patterns. Only one patient died of the disease. Formalin-fixed, paraffin-embedded tissue blocks of enrolled cases were used to make three-micrometer-thick sections. It provides context as to what an oral pathologist might see that aides in excludingnonreactive or neoplastic lesions. Diagnostic Pathology Xinyu Ren and Yin Cheng contributed equally to this work. Shiozawa E, Takimoto M, Makino R, Adachi D, Saito B, Yamochi-Onizuka T, Yamochi T, Shimozuma J, Maeda T, Kohno Y, Kawakami K, Nakamaki T, Tomoyasu S, et al. Imaging and pathological findings of MCL (case 2). 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. statement and The follow-up period started from the date of diagnosis until August 30, 2019, and ranged from 3 to 90months. Neville BW, Damm DD, Allen CM, Chi AC. Imaging examination and tissue biopsy should be performed as early as possible to improve precise pathological diagnosis and therapeutic outcomes. His IPI score was 2(low to intermediate risk group). Imaging showed a well-bordered cystic mass (2cm in diameter) at the right base of the tongue that extended into the pharynx, and so a biopsy was performed. .. Among our cases, there were 1 GC and 3 NGC cases. Bookshelf The cortex is also divided into outer cortex and inner cortex (also known as the paracortex). Hans CP, Weisenburger DD, Greiner TC, Gascoyne RD, Delabie J, Ott G, Muller-Hermelink HK, Campo E, Braziel RM, Jaffe ES, Pan Z, Farinha P, Smith LM, et al. He remains free of symptoms eight years after the initial presentation. Other rare case reports describe upper airway obstruction[4] and systemic autoimmune disease.[5]. In terms of pathological characteristics, 6 patients were diagnosed with B-cell NHL, and 1 patient was diagnosed with PTCL, NOS (Table2). 2000;113:5128. Globus pharyngeus: a review of etiology, diagnostics, and treatment. Peripheral T-cell lymphoma mimicking marginal zone B-cell lymphoma. Please note, we cannot prescribe controlled substances, diet pills, antipsychotics, or other abusable medications. sharing sensitive information, make sure youre on a federal J Clin Oncol. Clinical images of entities may be beneficial for documentation purposes, as they may be viewed during future appointments should there be recurrences. Discussions concentrating on NHL of the base of the tongue have focused on the histopathology and lack details regarding progress in the treatment response and prognosis. Federal government websites often end in .gov or .mil. 2, pp. In contrast, cytokeratins, CD8, CD20, CD30, ALK and CD56, TIA-1, and Granzyme B were negative. 1999;26:33845. Similarly, the inner cortex has T cells and is called the T-cell zone. Positive and negative controls were included in each batch of staining. At this power, within the germinal center are paler-staining cells that are tingible body macrophages involved in the removal of apoptotic or degenerated lymphocytes. These cells are designed to fight. J Postgrad Med. 2. Burkitt's lymphoma of the base of the tongue: a case report and review of the literature. c. Some tumour cells were medium-sized with a clear cytoplasm (200x). Patient ages ranged from the thirties to the nineties, with an average age of 61.8years. https://doi.org/10.1080/02841860500531682. Not applicable. Unable to load your collection due to an error, Unable to load your delegates due to an error. CAS The diagnosis of FLH is of clinical importance as it may be confused with malignant lymphoma, both on clinical examination and histopathology. The DLBCL, NOS cases were further divided into GC and NGC B cell like subtypes based on immunohistochemical expression of CD10, Bcl-6 and Mum1 [11]. I understand that this is benign, but what could be the cause? The site is secure. https://doi.org/10.1016/j.ijom.2004.08.009. The majority of existing head and neck reports are of hyperplasia in the oral cavity, namely, of the mucosa overlying the hard palate, and are limited to the dental and pathology literature [3]. However, HCV infection did not have a significant impact on the overall survival or event-free survival of DLBCL patients [31].HPV infection developing in this site might be due to low immunity from B cell lymphoma or HPV contributing to the development of lymphoma. The etiology is poorly understood, although some authors have postulated a relationship with chronic irritation (i.e., reflux, poorly fitting dentures, etc.) Lymphoma cases were selected from 2010 to 2017 in PUMCH, and all cases were reviewed to identify lymphomas arising from the base of the tongue instead of other primary sites. Some cases of DLBCL may be associated with HPV infection. 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. The appearance of brown punctate dots in the tumour cell nucleus or cytoplasm was considered positive. Oral-cutaneous CD4-positive T-cell lymphoma: a study of two patients. 2012;87:6049. ENT manifestations of gastroesophageal reflux. When we think of lymphoid hyperplasia in the oral cavity, we often think of localized increases of lymph node tissue.
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