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Case Reports
. 2019 Feb;23(Suppl 1):17-22.
doi: 10.4103/jomfp.JOMFP_7_18.

Physical torment: A predisposition for diffuse B-cell lymphoma

H K Puneeth  1 , S Ravi Raja Kumar  2 , Anuradha Ananthaneni  1 , Ananth Nag Jakkula  3
Affiliations
Case Reports

Physical torment: A predisposition for diffuse B-cell lymphoma

H K Puneeth et al. J Oral Maxillofac Pathol. 2019 Feb.

Abstract

Lymphomas of the oral cavity are rare and represent only 3%-5% of all lymphomas. Diffuse large B-cell lymphomas (DLBCLs) are a heterogeneous group of tumor and the most common type of all non-Hodgkin's lymphomas (NHLs). They mostly arise from soft tissue as asymptomatic swelling and involvement of jaw bones is infrequent. We present a case of a 23-year-old patient who developed DLBCL in oral cavity region 4 months after blunt trauma. The patient lacked other physical symptoms at the time of presentation. Histopathology, bone marrow and immunohistochemistry revealed DLBCL. After chemotherapy of eight cycles, swelling was totally reduced and no relapse observed in 10 months' follow-up period. Thus, the present report represents an example of possible rapport between trauma and unresolved soft-tissue swelling which may be caused by NHLs.

Keywords: Diffuse large B-cell lymphoma; non-Hodgkin's lymphoma; trauma.

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Conflict of interest statement

There are no conflicts of interest.

Figures

Figure 1
Figure 1
(a) Clinical image showing dome shaped swelling on the left side of the face. (b) Intraoral image showing left vestibular obliteration
Figure 2
Figure 2
Computed tomography scan of paranasal sinuses showing soft-tissue swelling in left maxillary region
Figure 3
Figure 3
Histopathological image shows diffuse proliferation of round cells in the form of sheet in the background of loose fibrillar stroma (H&E, ×100) (inset image: [a] Showing centrocytes [red arrow], [b] showing centroblasts [yellow arrow] H&E, ×1000)
Figure 4
Figure 4
Histopathological image showing tumor cells infiltrating muscle (abnormal mitotic figure-black arrow) (H&E, ×200)
Figure 5
Figure 5
(a and b) Histopathological image of fine-needle aspiration cytology showing centrocytes and centroblasts (H&E, ×400) (abnormal mitotic figure-black arrow)
Figure 6
Figure 6
(a) Immunohistochemical image shows strong positivity for CD20 indicating B-cell origin of lymphocytes (×100). (b and c) Immunohistochemical image shows strong membranous B-cell lymphoma-2 positivity ([b] × 200) and nuclear positivity of Ki-67 showing <70% ([c] ×100)
See this image and copyright information in PMC

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