Primary intraosseous non-Hodgkin lymphoma in the mandible is uncommon, representing about 0.6% of all extranodal lymphomas. We present the case of a 51-year-old male with a 4-month complaint of mandibular swelling and paresthesia, which had been previously submitted to an unsuccessful periodontal treatment. The intra-oral evaluation showed an extensive swelling with teeth mobility in the right mandible body. The panoramic radiography and computed tomography images showed an extensive osteolytic lesion. An incisional biopsy was performed and the histopathological and immunohistochemical analysis established the diagnosis of diffuse large B-cell lymphoma. The treatment included six cycles of chemotherapy with complete remission. The patient is under the seventh month of follow-up with no evidence of relapse. Although uncommon in the oral cavity, lymphoma should be considered in the differential diagnosis.
Head and Neck Neoplasms, Lymphoma, Large B-Cell, Diffuse, Oral Medicine
JessriM, AbdulMajeedAA, MatiasMA, FarahCS. A case of primary diffuse large B-cell non-Hodgkin’s lymphoma misdiagnosed as chronic periapical periodontitis. Aust Dent J. 2013;58(2):250-5. [https://doi.org/10.1111/adj.12056]. [PMID:23713648]
BrayF, FerlayJ, SoerjomataramI, SiegelRL, TorreLA, JemalA. Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin. 2018;68(6):394-424. [https://doi.org/10.3322/caac.21492]. [PMID:30207593]
HaradaS, SuzukiR, UehiraK, et al. Molecular and immunological dissection of diffuse large B cell lymphoma: CD5+, and CD5-with CD10+groups may constitute clinically relevant subtypes. Leukemia. 1999;13(9):1441-7. [https://doi.org/10.1038/sj.leu.2401487]. [PMID:10482997]
LinP, DickasonTJ, FayadLE, et al. Prognostic value of MYC rearrangement in cases of B-cell lymphoma, unclassifiable, with features intermediate between diffuse large B-cell lymphoma and Burkitt lymphoma. Cancer. 2012;118(6):1566-73. [https://doi.org/10.1002/cncr.26433]. [PMID:21882178]
ThakralB, MedeirosLJ, DesaiP, et al. Prognostic impact of CD5 expression in diffuse large B-cell lymphoma in patients treated with rituximab-EPOCH. Eur J Haematol. 2017;98(4):415-21. [https://doi.org/10.1111/ejh.12847]. [PMID:28039906]
MiyazakiK, YamaguchiM, SuzukiR, et al. CD5-positive diffuse large B-cell lymphoma: A retrospective study in 337 patients treated by chemotherapy with or without rituximab. Ann Oncol. 2011;22(7):1601-7. [https://doi.org/10.1093/annonc/mdq627]. [PMID:21199885]