Diagn Cytopathol. The authors declare that they have no competing interests. Except in one case of four, all of our patients were alive through follow-up. Briefly, the criteria and parameters for diagnosing and evaluating our cases were as follows: lymphoma classifications were based on the World Health Organization Classification of Tumors of Hematopoietic and Lymphoid Tissues (Revised Fourth Edition), and staging was based on the Ann Arbor Staging System. The biopsy showed recurrence, with bone marrow involvement. Accessibility Please enable it to take advantage of the complete set of features! the ENT DR was lovely. A 64-year-old African Canadian female with a history of urinary incontinence was admitted for an elective bladder suspension procedure by the gynaecology service in our institution. Clinically this lesion presented as a painless ulcer, which mimicked carcinoma of the tongue. The FISH probes used were 18q21 for BCL2, 3q27 for BCL6, and 8q24 for cMYC. Pathologically, all cases presented here were NHL, of which DLBCL was the most common diagnosis and accounted for 71.4% of the patients. Lymphoid hyperplasia of the tongue is a very rare benign lymphoproliferative lesion that closely resembles carcinoma or lymphoma, clinically or histopathologically. Chemotherapy containing rituximab was considered to significantly improve survival in DLBCL and MCL patients [39, 43]. Objective: This paper describes a case where a patient diagnosed with tongue base lymphoid hyperplasia was successfully treated with radiofrequency excision and interstitial radiofrequency-induced thermotherapy. Zhiyong Liang or Beverly Wang. 2001;94:1536. Open tracheotomy was performed on POD 3 due to the absence of a leak, and biopsies were again performed, which ultimately revealed the equivalent benign pathologic findings. https://doi.org/10.1016/j.oooo.2014.06.002. https://doi.org/10.1016/j.kjms.2012.02.014. PubMed Central Severe benign lymphoid hyperplasia (LH) is unusual in the head and neck region, but the diagnosis of LH is of clinical importance as it may be confused with malignant lymphoma, both on clinical examination and pathologically. Privacy Oral Pathology: Clinical Pathologic Correlations. Two patients survived more than six years. 2012;87:6049. A clinical note. The patient received two cycles of GDP (gemcitabine, dexamethasone, cisplatin) and seven cycles of CHOP (cyclophosphamide, doxorubicin, vincristine, prednisone) chemotherapy. Immunohistochemistry was negative for lymphoma. Fakhry C, Westra WH, Li S, Cmelak A, Ridge JA, Pinto H, Forastiere A, Gillison ML. Springerplus. Some cases of DLBCL may be associated with HPV infection. However, HCV infection did not have a significant impact on the overall survival or event-free survival of DLBCL patients [31].HPV infection developing in this site might be due to low immunity from B cell lymphoma or HPV contributing to the development of lymphoma. official website and that any information you provide is encrypted In this paper we present a case of severe pharyngeal lymphoid hyperplasia causing airway obstruction and requiring tracheotomy and subsequent surgical debulking. sharing sensitive information, make sure youre on a federal Article Kaohsiung J Med Sci. HIV serology was negative. Curr Top Microbiol Immunol. Eur Arch Otorhinolaryngol. All authors read and approved the final manuscript. 2000;21:2716. The .gov means its official. Effect of gastroesophageal reflux on hypertrophy of the base of the tongue. Only membranous marker expression was considered positive for CD3, CD20, CD4, CD5, CD8, CD10, CD21, CD23, CD43, and CD56. 4, pp. 353358, 2001. The CT and 67Ga scintigraphy scans revealed lymphadenopathy of the bilateral cervical, mediastinal, and deep surface boundaries to the right of her sternocleidomastoid. Google Scholar. 2007;86:35660. Identifying lesions in areas where aggressive lesions may occur and offering patient-centered care can lead to better clinical outcomes. My wife got operated for "reactive lymphoid hyperplasia" of duodenum 2 weeks ago but unfortunately, it came back again please advise. We conclude that the frequency of hypertrophied follicles is increased in the presence of signs and symptoms of GER and those HBT symptoms are confused with those of GER, except for nasal voice and noisy respiration. Tracheotomy was performed to relieve respiratory oppression. Expression of c-Myc and p53 correlates with clinical outcome in diffuse large B-cell lymphomas. Review of the preoperative anaesthesia records revealed no features of airway obstruction nor B symptoms on clinical history. Imaging showed a well-bordered cystic mass (2cm in diameter) at the right base of the tongue that extended into the pharynx, and so a biopsy was performed. This is consistent with head and neck research findings [6, 26]. In addition, patients may notice irregularities on their own, thereby bringing the appearance to the attention of their dentists or hygienists. and has since been primarily reported in the skin, breasts, gastrointestinal tract, lungs, and nasopharynx [2]. Lee JH, Lee SH. Vose JM. Am J Dermatopathol. https://doi.org/10.4103/0019-509X.58873. All patients were diagnosed by either biopsy or tumor resection. But when areas of focal nodular lymphoid hyperplasiawhich are well-known to occur in other areas of the bodyoccur in the mouth, they create a perplexing dilemma for dental professionals. Acta Ophthalmol. [2], Follicular hyperplasia is a stimulation of the B cell compartment. I am taking medicine nd it is reducing but its been 3 weeks now? To the best of our knowledge, four cases have been reported, including our case and three cases from literature (Table 5) [17, 27, 40]. Spectrum of a benign entity. Clinicopathological information including age, gender, tumour location, histological subtype, grading, staging, survival, and response to treatment was acquired from the archives. FOIA In the middle power view, there were plenty of moderate to large cells with distorted nuclear contours (Fig. Although it had been described in the literature, occurrence within oral cavity is rare. https://doi.org/10.1053/ajot.2000.8382. His CT and MRI scans found only thickness of the oropharyngeal wall and epiglottal folds, and a superficial biopsy revealed only inflammation. b. Tumour cells diffusely expressed CD20 (200 x). Authors M Gromet , M J Homer , B L Carter PMID: 7111732 DOI: 10.1148/radiology.144.4.7111732 No abstract available Publication types Case Reports MeSH terms Adult Barium Sulfate Deglutition Diagnosis, Differential Female [2] Lymph node anatomy [ edit] A case of benign. This distribution is similar to that in previous reports [18,19,20,21,22] .The most common location was the base of the tongue. 5760, 1993. doi: 10.1148/radiology.144.4.7111732. [36] showed that patients with DLBCL located on Waldeyers ring (base of the tongue) often have a better prognosis than nodal DLBCL patients. The therapeutic response is related to the pathological subtype and several factors, such as old age, high grade histology, bulky lymph nodes, higher IPI score, and advanced stage [22, 24, 25]. 1),and two cases expressed c-Myc(>40%). Baran M, Canoz O, Altuntas H, Sivgin S, Cetin M, Yay A, Ketenci S. Immunohistochemical investigation of P16, P53 and Ki-67's prognostic values in diffuse large B-cell lymphomas. No progression to malignancy has been reported, although one multisite case within the oral cavity was found to represent MALT-type lymphoma [1]. The number of cases in the present study was low, so further studies will be needed to better understand the relationship between HPV infection and lymphoma of the base of the tongue. Visco C, Arcaini L, Brusamolino E, Burcheri S, Ambrosetti A, Merli M, Bonoldi E, Chilosi M, Viglio A, Lazzarino M, Pizzolo G, Rodeghiero F. Distinctive natural history in hepatitis C virus positive diffuse large B-cell lymphoma: analysis of 156 patients from northern Italy. Lewis JS Jr. Morphologic diversity in human papillomavirus-related oropharyngeal squamous cell carcinoma: catch me if you can! There were no c-Myc rearrangements, so there were no double or triple hit B cell lymphomas in these cases (Table3). For potential or actual medical emergencies, immediately call 911 or your local emergency service. Primary non-Hodgkin lymphoma of the tongue base: the clinicopathology of seven cases and evaluation of HPV and EBV status, https://doi.org/10.1186/s13000-020-00936-w, https://doi.org/10.1016/S0344-0338(11)80514-5, https://doi.org/10.1016/j.kjms.2012.02.014, https://doi.org/10.1080/02841860500531682, https://doi.org/10.1038/modpathol.2016.152, https://doi.org/10.1007/s00428-014-1682-7, https://doi.org/10.1038/modpathol.2011.45, https://doi.org/10.1182/blood-2003-05-1545, https://doi.org/10.1038/modpathol.3880541, https://doi.org/10.1097/01.dad.0000246949.49071.17, https://doi.org/10.1007/s12185-008-0142-z, https://doi.org/10.1016/j.ijom.2004.08.009, https://doi.org/10.1016/j.ijom.2010.03.029, https://doi.org/10.1016/j.anndiagpath.2005.09.020, https://doi.org/10.1016/j.oooo.2014.06.002, https://doi.org/10.1007/978-3-319-22822-8_13, https://doi.org/10.22034/APJCP.2017.18.10.2781, https://doi.org/10.1016/j.leukres.2005.11.004, https://doi.org/10.1309/YHFE-R65B-D3LK-3GGV, https://doi.org/10.11406/rinketsu.58.2033, https://doi.org/10.1017/s0022215100142288, http://creativecommons.org/licenses/by/4.0/, http://creativecommons.org/publicdomain/zero/1.0/. https://doi.org/10.1200/JCO.2005.07.155. 3840, 1973. Of the DLBCL patients, 4 were not otherwise specified lymphomas (NOS) and 1 was T cell/histiocyte rich large B-cell lymphoma. The patient was kept on a three-week course of tapering prednisone and proton-pump inhibitors. There were two main cytomorphological variants of the DLBCL, NOS cases: centroblastic and immunoblastic. c. Tumour cell infiltrated squamous epithelium (400x). Acta Oncol. Correspondence to During the follow up period, the MCL patient and an elderly DLBCL patient died. Google Scholar. All authors read and approved the final manuscript. https://doi.org/10.1016/j.ijom.2010.03.029. These results all indicate that HPV positivity does not have much impact on the overall survival of DLBCL patients. Does lymphoid hyperplasia and Lymphoma looks the same and is there a threatment for oral Lymphoid Hyperplasia? Co. Ltd., China. 1979 Sep;30(5):485-8. doi: 10.1016/s0009-9260(79)80176-2. For these, please consult a doctor (virtually or in person). World J Gastroenterol. Copyright 2011 Noah B. Sands and Marc Tewfik. We thank Violette Ghali, Gina Elhammady, Mark Persky and Songyang Yuan for confirming the pathological diagnosis. Regezi JA, Sciubba JJ, Jordan RCK. 2002;15:4205. Get prescriptions or refills through a video chat, if the doctor feels the prescriptions are medically appropriate. Spectrum of a benign entity Radiology. Upon examination with direct laryngoscopy a large, multiloculated, exophytic mass was identified, emanating from the oropharynx and extending distally to the level of the supraglottis, occupying >90% of the upper aerodigestive tract. What does prominent lymphoid tissue at base of tongue on an MRI report mean. Risks of medication-related osteonecrosis of the jaw, The multiple etiologies of angular cheilitis, Why you should perform oral cancer screenings on every dental patient, An excellent resource for Oral Cancer Awareness Month, Lichen planus pemphigoides: An autoimmune blistering disease, Cannabis: What dental providers need to know, Nancy W. Burkhart, EdD, MEd, BSDH, AAFAAOM. For T cell receptor rearrangement, the IdentiClone TCRB, TCRG, and TCRD Gene Clonality Assays were used with gel detection (InVivoScribe Technologies, San Diego, CA, USA). In the orofacial region, RLH most often occurs in the oropharynx, Waldeyers tonsillar ring, the soft palate, the lateral tongue, and the floor of the mouth.2 Waldeyers ring includes the lingual and palatine tonsils, the adenoids, lymphoid follicles located on the posterolateral tongue in the area of the foliate papillae, and level 1 lymph nodes in the floor of the mouth. Follicular lymphoid hyperplasia (FLH) is a benign lymphoproliferative process of unknown etiology, uncommon in the head and neck region. Head and neck extranodal lymphoma in a single institute: a 17-year retrospective analysis. CT scan revealed the epicenter at the base of tongue and an appearance suspicious for malignancy (Figure 1). All cases were reviewed and diagnoses were confirmed based on basic morphology, immunohistochemistry staining, and rearrangement. Only one widely disseminated case has been referenced, which involved cervical nodes, major salivary glands, orbits, and mediastinum [4]. a. CT showed an irregular soft tissue mass at the right posterior aspect of the tongue base. Owosho AA, Bilodeau EA, Surti U, Craig FE. The role of EBV in the pathogenesis of diffuse large B cell lymphoma. Only one patient died of the disease. An official website of the United States government. Postoperatively the patient was deemed unsafe for extubation and transferred to the intensive care unit while placed on high-dose intravenous dexamethasone. f. Tumour cells were negative for CD8 (200x). Her IPI score was 3 (high risk group). Squamous cells also make up the top layer of skin and other body parts such as the lungs and esophagus. Severe HBT was considered to be present when the follicles prevented the view of the epiglottis or were massively distributed through the pharynx and larynx. Lymphoid Hyperplasia Pulmonary lymphoid hyperplasia, also known as follicular bronchiolitis, is an uncommon, benign condition characterized histologically by the presence of polyclonal lymphoid aggregates along the bifurcation of the bronchioles and along the pulmonary lymphatics. Lymphoid hyperplasia of the tongue is a very rare benign lymphoproliferative lesion that closely resembles carcinoma or lymphoma, clinically or histopathologically. Most DLBCL cases of the tongue base had no Bcl-2, Bcl-6, or c-Myc rearrangement and they were sensitive to rituximab. Among our cases, there were 1 GC and 3 NGC cases. For immunoglobulin gene rearrangement, we used IdentiClone IGH, IGK and IGL Gene Clonality assays with gel detection (InVivoScribe Technologies, San Diego, CA, USA). https://www.linkedin.com/showcase/4000114/. https://doi.org/10.1093/annonc/mdl131. Jrvenp P, Ilmarinen T, Geneid A, Pietarinen P, Kinnari TJ, Rihkanen H, Ruohoalho J, Markkanen-Leppnen M, Bck L, Arkkila P, Aaltonen LM. She was awarded the Dental Professional of the Year in 2017 through the International Pemphigus and Pemphigoid Foundation and is a 2017 Sunstar/RDH Award of Distinction recipient. This is the first study to report on both HPV and EBV infection status in tongue base lymphoma. Final pathology was determined on postoperative day (POD) 2 to be benign follicular/intrafollicular lymphoid hyperplasia characterized by polyclonal lymphoid proliferation with an inflammatory background. One case was P53 positive (Fig. 2010;77:96105. There was no cervical adenopathy, and CT of the thorax and abdomen was negative. Lymphoid Hyperplasia i was referred to ENT by my GP because of a recurring sore throat. The lingual tonsil is located at the base of the tongue and related to circumvallate papillae, whereas subepithelial lymphoid tissue at the posterior lateral portion of the tongue and related to foliate papillae constitutes the lateral lingual tonsil. 4, pp. 2006;30:85967. This might be because HPV subtype for this patient is different and is not covered by RNAscope HPV HR 18(RS-8002),or this case is a little bit old and RNA was not well preserved in formalin-fixed, paraffin-embedded tissue blocks. The prognosis for MCL seems to be poorer than that for DLBCL at the base of the tongue. MeSH showed that 74% of DLBCL cases have P16 methylation and a relatively old age [32]. Unable to load your collection due to an error, Unable to load your delegates due to an error. These tissues act as your body's first line of defense against infections. Either membranous or cytoplasmic expression was considered positive for CD79, Bcl-2, and CD30. 1999;21:24754. Three reactive samples, either tonsils or lymph nodes, were included to establish cut-off values. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated. The case of DLBCL showing HPV DNA positivity (case 6). One patient in the literature died 17months after diagnosis. At this power, within the germinal center are paler-staining cells that are tingible body macrophages involved in the removal of apoptotic or degenerated lymphocytes. Cite this article. Curr Allergy Asthma Rep. 2008 May;8(3):240-4. doi: 10.1007/s11882-008-0040-8. Ren, X., Cheng, Y., Wu, S. et al. Google Scholar. All 7 lymphomas were localized at the base of the tongue. The base of tongue refers to the back one-third of the tongue that continues down the throat. Human papillomavirus (HPV) and Epstein-Barr virus (EBV) are important aetiological risk factors for tumours of the head and neck. At the time of induction, our service was called emergently due to failed intubation related to a pharyngeal mass.. Lymphoid hyperplasia of the tongue is a very rare benign lymphoproliferative lesion that closely resembles carcinoma or lymphoma, clinically or histopathologically. Mantle cell lymphoma: 2012 update on diagnosis, risk-stratification, and clinical management. https://doi.org/10.1186/s13000-020-00936-w, DOI: https://doi.org/10.1186/s13000-020-00936-w. [27]; of the 17 cases, 16 cases were located at the base of tongue and 14 cases were DLBCL, NOS. The tumour cells were large and blastic, with a high mitotic rate, which was similar to diffuse large B lymphoma tumour cells. Spontaneous regression has also been reported. ( case 6 ) in the literature, occurrence within oral lymphoid hyperplasia base of tongue is.. A, Gillison ML of moderate to large cells with distorted nuclear contours ( Fig GC! Virtually or in person ) considered to significantly improve survival in DLBCL and MCL patients 39. Distorted nuclear contours ( Fig soft tissue mass at the base of tongue refers the... Probes used were 18q21 for BCL2, 3q27 for BCL6, and CT of the complete set features! 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If the doctor feels the prescriptions are medically appropriate, immediately call 911 or your local service! 17Months after diagnosis a threatment for oral lymphoid hyperplasia Jr. Morphologic diversity in human papillomavirus-related oropharyngeal squamous carcinoma.