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Case Reports
. 2017 Jan 24:2017:bcr2016218686.
doi: 10.1136/bcr-2016-218686.

Lymphoma presenting as a toothache: a wolf in sheep's clothing

Yazan Hassona  1 , Ghadeer Almuhaisen  2 , Ahmed Almansour  2 , Crispian Scully  3
Affiliations
Case Reports

Lymphoma presenting as a toothache: a wolf in sheep's clothing

Yazan Hassona et al. BMJ Case Rep. .

Abstract

Although rare in the oral cavity, oral non-Hodgkin lymphoma frequently mimics odontogenic and other oral pathologies. The purpose of this report is to discuss the diagnostic difficulty in a case of a 75-year-old man with diffuse large B-cell lymphoma presenting initially as a toothache.

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Conflict of interest statement

Conflicts of Interest: None declared.

Figures

Figure 1
Figure 1
An orthopantogram showing widening of the apical periodontal ligament in the lower left premolars, and a prominent, but ill-defined radiolucency within the body of the left mandible.
Figure 2
Figure 2
Axial CT showing a lytic lesion in the left mandibular body with partial erosion of the lingual cortical plate.
Figure 3
Figure 3
Bone biopsy revealed jelly-like tissue occupying the left mandibular body. The tissue was soft and fragmented easily.
Figure 4
Figure 4
(A) Proliferation of large cells with moderate cytoplasm, large vesicular nuclei and prominent nucleoli (×200); (B) positive staining for PAX-5 (×200); (C) positive staining for BCL-2 (×200); (D) positive staining for CD-20 (×200); (E) negative staining for CD-3 (×200); (F) negative staining for CD-5 (×200); (G) negative staining for BCL-6 (×200); (H) negative staining for cyclin-D1(×200); (I) Ki67 immunostaining showed a proliferation index of ∼70% (×200).
See this image and copyright information in PMC

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References

    1. Swerdlow SH, Campo E, Pileri SA et al. . The 2016 revision of the World Health Organization classification of lymphoid neoplasms. Blood 2016;127:2375–90. 10.1182/blood-2016-01-643569 - DOI - PMC - PubMed
    1. Epstein JB, Epstein JD, Le ND et al. . Characteristics of oral and paraoral malignant lymphoma: a population-based review of 361 cases. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2001;92:519–25. 10.1067/moe.2001.116062 - DOI - PubMed
    1. Triantafillidou K, Dimitrakopoulos J, Iordanidis F et al. . Extranodal non-Hodgkin lymphomas of the oral cavity and maxillofacial region: a clinical study of 58 cases and review of the literature. J Oral Maxillofac Surg 2012;70:2776–85. 10.1016/j.joms.2012.01.018 - DOI - PubMed
    1. van der Waal RI, Huijgens PC, van der Valk P et al. . Characteristics of 40 primary extranodal non-Hodgkin lymphomas of the oral cavity in perspective of the new WHO classification and the International Prognostic Index. Int J Oral Maxillofac Surg 2005;34:391–5. 10.1016/j.ijom.2004.08.009 - DOI - PubMed
    1. Margiotta V, Franco V, Rizzo A et al. . Gastric and gingival localization of mucosa-associated lymphoid tissue (MALT) lymphoma. An immunohistochemical, virological and clinical case report. J Periodontol 1999;70:914–18. - PubMed

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