Extra-nodal Diffuse Large B-cell Lymphoma (Germinal Center Type) Manifesting as Non-healing Extraction Socket

Abstract

Lymphomas occurring in the oral cavity are rare. They account only for about 2% of extra-nodal sites. Most of the lymphomas occur in the lymph nodes and in the oral cavity, the most commonly affected region is the Waldeyer's ring. Its occurrence in the mandibular gingiva is rare. Here, we describe a case of Diffuse Large B-cell Lymphoma manifested as a non-healing extraction socket in the mandibular right posterior region in a 62-year-old male patient.

Keywords: Diabetic; Lymph nodes; Lymphadenitis; Sialadenitis.

[Table/Fig-1]:

Extra-oral photograph showing gross facial asymmetry and swelling on right side of patient’s face.

[Table/Fig-2]:

Intra-oral photograph showing non-healing extraction socket and inflamed surrounding mucosa in relation to 45, 46 region.

[Table/Fig-3]:

OPG showing ill-defined radiolucency in relation to 45.

[Table/Fig-5]:

The photomicrograph of the H & E stained section shows dysplastic epithelium and diffuse proliferation of cells in underlying connective tissue[10X].

[Table/Fig-6]:

The photomicrograph of the H & E stained section shows large atypical lymphoid cells having round to oval vesicular nucleus and scant amount of pale cytoplasm [40X].

[Table/Fig-7]:

Atypical lymphoid cells showing positivity for ki-67 marker.

[Table/Fig-8]:

Atypical lymphoid cells showing positivity for CD-20 marker.

[Table/Fig-9]:

Atypical lymphoid cells stained negative for CD-3 marker.

[Table/Fig-10]:

Atypical lymphoid cells showing positivity for CD-10 marker.

[Table/Fig-11]:

Few atypical lymphoid cells showing positivity for Bcl-6 marker.

[Table/Fig-12]:

Atypical lymphoid cells stained negative for MUM-1 marker.

[Table/Fig-13]:

Flow chart for classifying DLBCL into GCB and Non-GCB types using immunohistochemical markers [5].