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Case Reports
. 2022 Apr-Jun;26(2):289-290.
doi: 10.4103/jomfp.jomfp_332_21. Epub 2022 Jun 28.

Non-Hodgkin lymphoma of a palate: A case report of a highly destructive lesion

Cintia M Milani  1 , Claudia F Stadler  2 , Larissa L Gomes da Silva  3 , Paulo A P Milani  4
Affiliations
Case Reports

Non-Hodgkin lymphoma of a palate: A case report of a highly destructive lesion

Cintia M Milani et al. J Oral Maxillofac Pathol. 2022 Apr-Jun.

Abstract

Non-Hodgkin lymphoma (NHL) is a haematolymphoid neoplasm that can affect nodal and extra-nodal sites. It is a rare disease in the oral cavity, accounting for only 2% of all extra-nodal lymphomas. Its aetiology is multi-factorial, being strongly associated with viral infections. The average age group most affected is 66 years old, with a slight predilection for males. The most common histological sub-type in the oral cavity is diffuse large B-cell lymphoma, with Waldeyer's ring being the most affected site in the nodal form, and extranodally, it may involve the tongue, hard/soft palate, maxilla, and mandible. It presents as a nodular lesion with a smooth or ulcerated surface. The initial treatment approach is chemotherapy, but this may vary according to the stage of lymphoma. The aim of this study was to report a case of NHL in the palate of a 54-year-old female patient, with extensive tissue destruction.

Keywords: Diffuse; large B-cell; lymphoma; mouth neoplasms; non-Hodgkin.

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Conflict of interest statement

There are no conflicts of interest.

Figures

Figure 1
Figure 1
Initial intra-oral view, showing an enlarging mass with ulceration on the left posterior palate
Figure 2
Figure 2
Intra-oral view 12 days after the initial examination, showing the growth of the central ulceration
Figure 3
Figure 3
Histopathological examination showing infiltrative atypical cellular proliferation in the connective tissue with hematoxylin–eosin (HE) 400×
Figure 4
Figure 4
Immunohistochemical analysis showing the co-expression of CD45 (a), CD20 (b), BCL-2 (c), and BCL-6 (d) associated to a high proliferative index to KI-67 and the negativity for the other markers
Figure 5
Figure 5
Intra-oral view 95 days after the initial examination showing extensive bone destruction
Figure 6
Figure 6
PET/CT: (a) Initial – expansive lesion in the left soft palate and involvement of cervical lymphnodes and (b) Final – reduction in the dimensions and the metabolism of the soft palate lesion and the cervical lymph nodes
Figure 7
Figure 7
Intra-oral view after the chemoimmunotherapy sessions showing the soft tissue recovering and a bucosinusal communication (arrow)
Figure 8
Figure 8
Intra-oral view of the temporary acrylic palatal obturator covering the bucosinusal communication
See this image and copyright information in PMC

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