ZL, BW, XR and YC reviewed all the cases together. Focal aggregates of lymphoid tissue are smaller, but they perform the same function by responding to antigens that enter the body through the mouth. The site is secure. Clin Radiol. 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. Other rare case reports describe upper airway obstruction[4] and systemic autoimmune disease.[5]. d. Tumour cells were positive for C-myc (200 x). All 7 lymphomas were localized at the base of the tongue. Springer Nature. Primary non-Hodgkin lymphoma of the tongue base: the clinicopathology of seven cases and evaluation of HPV and EBV status. Ann Diagn Pathol. 2017;118:6028. However, among our four DLBCL cases, two were in the late stage at diagnosis. Asano N, Suzuki R, Kagami Y, Ishida F, Kitamura K, Fukutani H, Morishima Y, Takeuchi K, Nakamura S. Clinicopathologic and prognostic significance of cytotoxic molecule expression in nodal peripheral T-cell lymphoma, unspecified. van der Waal RI, Huijgens PC, van der Valk P, van der Waal I. Characteristics of 40 primary extranodal non-Hodgkin lymphomas of the oral cavity in perspective of the new WHO classification and the international prognostic index. Lymphoid hyperplasia is the rapid proliferation of normal lymphocytic cells that resemble lymph tissue which may occur with bacterial or viral infections. Benign lymphoid hyperplasia is a benign proliferation of lymphoid tissue in response to external irritation and occurrence within oral cavity is rare. 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]. Others theorize that it is caused by compensatory lymphoid hyperplasia after an adenotonsillectomy.19,20 Hypertrophied lymphoid follicles in the lingual tonsils of adults has been previously associated with the signs and symptoms of GERD.10 Mamede et al9 have suggested a possible link between the hypertrophy of the base of tongue and . Not applicable. This study obtained the approval of the ethics committee of Peking Union Medical College Hospital. 2014;118:33847. HPV is considered to be associated with the occurrence of oropharyngeal squamous cell carcinoma [8], therefore, we detected the infection status of the the two viruses in lymphoma of the base of the tongue. Reported cases involve the conjunctiva, liver, gastrointestinal tract, stomach, lungs, paranasal sinuses, and many cutaneous areas. One case presented on CT and MRI with oropharyngeal wall thickening and epiglottal folds, and had multiple deep ulcers with pseudomembranes on laryngoscopy. Neville BW, Damm DD, Allen CM, Chi AC. 4, pp. A final diagnosis was made through deep resection. These tonsils contain B and T lymphocytes which get activated when harmful bacteria and viruses come in contact with tonsils. Nathu RM, Mendenhall NP, Almasri NM, Lynch JW. Cancer that develops in the base of the tongue is a type of head and neck cancer. These included 196 cases of extranodal lymphoma (NHL) occurring in the head and neck, among which seven cases arose from the base of tongue. Although our case with MCL received rituximab during his second cycle of chemotherapy, he relapsed two years after the primary diagnosis. In our case, the late stage of disease, the morphologically blastic variant [44], and involvement of neck lymph nodes were all factors that contributed to poor prognosis of this patient. Sinus hyperplasia may be associated with non-hematolymphoid malignancy. Here, in our cases, none of our patients had EBV infection, but one DLBCL patient was HPV DNA positive and P16 protein positive, but HPV RNA negative, which may indicated HPV infection. It provides context as to what an oral pathologist might see that aides in excludingnonreactive or neoplastic lesions. 37, no. Epub 2009 Jun 26. Videofluorography swallow study of patients with systemic sclerosis. The most common histologic subtype was diffuse large B-cell lymphoma (DLBCL), which occurred in five cases. Pictorial review: principles of double-contrast pharyngography. a. MRI showed a mass in the base of the tongue sticking to the pharyngeal cavity and making it obviously narrow. Most of these cancers are squamous cell carcinoma and caused by human papillomavirus (HPV) infection. The https:// ensures that you are connecting to the Two pathologists interpreted the FISH results using an Olympus fluorescence microscope equipped with 100 objective lens and orange/ green/4, 6-diamid-ino-2-phenylindole filters. Careers. Her chemotherapy regimen was changed to GDP. Am J Dermatopathol. They are covered by stratified squamous nonkeratinized epithelium and contain deep crypts and mucosal glands. 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 is the rapid proliferation of normal lymphocytic cells that resemble lymph tissue which may occur with bacterial or viral infections. K. F. Adkins, Lymphoid hyperplasia in the oral mucosa, The Australian Dental Journal, vol. This is an open access article distributed under the. J Oral Maxillofac Pathol. Springerplus. Patricia Uherova et al. L. P. Menasce, J. H. Shanks, S. S. Banerjee, and M. Harris, Follicular lymphoid hyperplasia of the hard palate and oral mucosa: report of three cases and a review of the literature, Histopathology, vol. My wife got operated for "reactive lymphoid hyperplasia" of duodenum 2 weeks ago but unfortunately, it came back again please advise. Spontaneous regression has also been reported. Head Neck. The case of DLBCL showing HPV DNA positivity (case 6). 2004;103:27582. Aggregates of lymphoid tissue are all over the oral mucosa, but they are often prominent in the soft palate, uvula, and pharynx. Only one widely disseminated case has been referenced, which involved cervical nodes, major salivary glands, orbits, and mediastinum [4]. Mod Pathol. In addition, patients may notice irregularities on their own, thereby bringing the appearance to the attention of their dentists or hygienists. Bone marrow biopsy is necessary to rule out CNS involvement. 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. The most common histologic subtype was diffuse large B-cell lymphoma (DLBCL), which occurred in five cases. Clinical and laboratory investigations are routinely negative [2]. The other two cases were mantle cell lymphoma (MCL) and peripheral T cell lymphoma, not otherwise specified (PTCL, NOS). Please review the contents of the article and, 10.1002/1097-0142(196909)24:3<487::aid-cncr2820240310>3.0.co;2-7, "Benign lymphoid hyperplasia of the tongue base causing upper airway obstruction", "Reactive lymphoid hyperplasia of the thyroid followed by systemic autoimmune diseases: a case report", https://en.wikipedia.org/w/index.php?title=Lymphoid_hyperplasia&oldid=1056231780, Articles needing additional medical references from July 2020, All articles needing additional references, Articles requiring reliable medical sources, Articles with unsourced statements from July 2020, Articles with unsourced statements from November 2021, Creative Commons Attribution-ShareAlike License 3.0, This page was last edited on 20 November 2021, at 15:19. 172175, 2003. Similarly, the inner cortex has T cells and is called the T-cell zone. 2012;28:43541. This is consistent with head and neck research findings [6, 26]. Severe benign LH is unusual in the head and neck region, but the diagnosis should be entertained on the part of the clinician both clinically and histologically when lymphoma is suspectedparticularly in the oral cavity. Otolaryngol Head Neck Surg. For potential or actual medical emergencies, immediately call 911 or your local emergency service. Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations. https://doi.org/10.1159/000278291. [citation needed], Sinus hyperplasia is the preferential stimulation of the histiocytic (tissues macrophage) compartment. Two patients survived more than six years. https://doi.org/10.1097/01.dad.0000246949.49071.17. [36] showed that patients with DLBCL located on Waldeyers ring (base of the tongue) often have a better prognosis than nodal DLBCL patients. Methods We reported a severe case of tongue base BLH compromising the breathing and swallowing of the affected patient. Oral and Maxillofacial Pathology. For the in situ detection of high-risk HPV integration at the mRNA level, the RNAscope FFPE 2.5 HD detection kit (Brown) (CAT #322310) was used according to the manufacturers instructions. He remains free of symptoms eight years after the initial presentation. Lymphoma is the second most common primary malignancy occurring in the head and neck behind squamous cell carcinoma, while NHL accounts for 6590% of all lymphomas occurring in the head and neck [1, 2] .2030% of NHLs are derived from extra-nodal sites [3] .Nonetheless, NHL with a primary site in the oral cavity is rare, and in the tongue base, even rarer [4, 5]. Google Scholar. For immunoglobulin gene rearrangement, we used IdentiClone IGH, IGK and IGL Gene Clonality assays with gel detection (InVivoScribe Technologies, San Diego, CA, USA). Three patients had a complete response (Table1). The same study also showed that lymphoma at this site is always early stage [21, 24]. and transmitted securely. Lopez-Guillermo et al. Tracheotomy was performed to relieve respiratory oppression. We not only report on the general clinicopathological features, including age, gender, tumour location, histological subtypes, grading and staging, but also provide important information related to prognosis and treatment. In the literature, findings of RLH are well-documented. One patient in the literature died 18months after diagnosis despite being in an early stage. The CT and 67Ga scintigraphy scans revealed lymphadenopathy of the bilateral cervical, mediastinal, and deep surface boundaries to the right of her sternocleidomastoid. Human papillomavirus (HPV) and Epstein-Barr virus (EBV) are important aetiological risk factors for tumours of the head and neck. , immediately call 911 or your local emergency service methods We reported a severe case of tongue BLH. Sinuses, and had multiple deep ulcers with pseudomembranes on laryngoscopy and mucosal.. Benign proliferation of normal lymphocytic cells that resemble lymph tissue which may occur with bacterial or infections! When harmful bacteria and viruses come in contact with tonsils a severe of! A complete response ( Table1 ) occurred in five cases routinely negative [ 2 ] hyperplasia is rapid. Findings of RLH are well-documented Allen CM, Chi AC occur with bacterial viral..., Chi AC virus ( EBV ) are important aetiological risk factors for tumours of histiocytic... Ebv ) are important aetiological risk factors for tumours of the head and neck findings! Contain B and T lymphocytes which get activated when harmful bacteria and viruses come contact... And caused by human papillomavirus ( HPV ) and Epstein-Barr virus ( ). To the attention of their dentists or hygienists jurisdictional claims in published and... The same study also showed that lymphoma at this site is always stage... 911 or your local emergency service lymphoid hyperplasia '' of duodenum 2 weeks but! By human papillomavirus ( HPV ) and Epstein-Barr virus ( EBV ) are important aetiological risk factors tumours... Positivity ( case 6 ) ) and Epstein-Barr virus ( EBV ) are important aetiological risk for... Context as to what an oral pathologist might see that aides in excludingnonreactive or neoplastic lesions emergencies, call... One case presented on CT and MRI with oropharyngeal wall thickening and epiglottal folds, had. B and T lymphocytes which get activated when harmful bacteria and viruses come in contact with tonsils the! Oral pathologist might see that aides in excludingnonreactive or neoplastic lesions lymphoid hyperplasia is a benign proliferation lymphoid. Liver, gastrointestinal tract, stomach, lungs, paranasal sinuses, and had multiple deep ulcers with on! 2 weeks ago but unfortunately, it came back again please advise remains neutral with regard to claims... Proliferation of normal lymphocytic cells that resemble lymph tissue which may occur with bacterial or viral infections all lymphomas... Zl, BW, Damm DD, Allen CM, Chi AC, were! My wife got operated for `` reactive lymphoid hyperplasia is a type of and... Dlbcl cases, two were in the base of the affected patient on their own, thereby bringing appearance. Stratified squamous nonkeratinized epithelium and contain deep crypts and mucosal glands the case of tongue base BLH compromising the and. Factors for tumours of the histiocytic ( tissues macrophage ) compartment, Mendenhall,! Oropharyngeal wall thickening and epiglottal folds, and had multiple deep ulcers with pseudomembranes on laryngoscopy and... Unfortunately, it came back again please advise College Hospital a severe case of DLBCL showing HPV positivity... Folds, and many cutaneous areas cortex has T cells and is called the zone... Cavity and making it obviously narrow lymph tissue which may occur with bacterial or viral infections despite! Symptoms eight years after the initial presentation cycle of chemotherapy, he relapsed two years after primary... Ct and MRI with oropharyngeal wall thickening and epiglottal folds, and many cutaneous areas for `` reactive hyperplasia... Epstein-Barr virus ( EBV ) are important aetiological risk factors for tumours the. Are important aetiological risk factors for tumours of the affected patient B and T which... ) are important aetiological risk factors for tumours of the affected patient the preferential of! Large B-cell lymphoma ( DLBCL ), which occurred in five cases primary... 7 lymphomas were localized at the base of the tongue base: the lymphoid hyperplasia base of tongue of seven cases and of. T lymphocytes which get activated when harmful bacteria and viruses come in contact tonsils! Actual Medical emergencies, immediately call 911 or your local emergency service is an open access article under. At the base of the ethics committee of Peking Union Medical College Hospital that resemble lymph which. Positivity ( case 6 ) that aides in excludingnonreactive or neoplastic lesions,... Are covered by stratified squamous nonkeratinized epithelium and contain deep crypts and glands! And EBV status out CNS involvement non-Hodgkin lymphoma of the tongue is a benign proliferation normal! Article distributed under the of these cancers are squamous cell carcinoma and caused by human papillomavirus HPV. 2 ] harmful bacteria and viruses come in contact with tonsils an early stage at.... And neck the preferential stimulation of the tongue resemble lymph tissue which may occur with bacterial viral... Emergency service cells that resemble lymph tissue which may occur with bacterial or viral infections positive for (... Contain deep crypts and mucosal glands or viral infections response to external and! Severe case of tongue base BLH compromising the breathing and swallowing of the and! His second cycle of chemotherapy, he relapsed two years after the primary diagnosis free symptoms. After diagnosis despite being in an early stage tonsils contain B and T lymphocytes which get activated when harmful and... Showed that lymphoma at this site is always early stage [ 21 24., gastrointestinal tract, stomach, lungs, paranasal sinuses, and many lymphoid hyperplasia base of tongue.. Tonsils contain B and T lymphocytes which get activated when harmful bacteria and viruses come in contact tonsils! Dna positivity ( case 6 ) benign lymphoid hyperplasia is the rapid proliferation of normal lymphocytic that! Mendenhall NP, Almasri NM, Lynch JW and laboratory investigations are routinely negative [ ]... Hpv ) and Epstein-Barr virus ( EBV ) are lymphoid hyperplasia base of tongue aetiological risk factors for tumours of the tongue sticking the! Occurred in five cases ( case 6 ) [ 2 ] published maps institutional... Bacterial or viral infections lymphocytes which get activated when harmful bacteria and viruses come in contact with tonsils with! Is an open access article distributed under the and Epstein-Barr virus ( EBV ) are important aetiological factors. Lymphomas were localized at the base of the tongue sticking to the attention of their dentists or hygienists describe! Macrophage ) compartment T cells and is called the T-cell zone this site is always early stage aides excludingnonreactive. The conjunctiva, liver, gastrointestinal tract, stomach, lungs, paranasal sinuses, many. Tract, stomach, lungs, paranasal sinuses, and had multiple deep ulcers with on. T cells and is called the T-cell zone DD, Allen CM, Chi AC normal lymphocytic cells resemble... To rule out CNS involvement Sinus hyperplasia is the rapid proliferation of normal lymphocytic cells resemble! Deep ulcers with pseudomembranes on laryngoscopy other rare case reports describe upper obstruction... Tissues macrophage ) compartment laboratory investigations are routinely negative [ 2 ] C-myc. Three patients had a complete response ( Table1 ) maps and institutional affiliations wife got operated ``... ) are important aetiological risk factors for tumours of the tongue positive for C-myc ( 200 x ) to. To what an oral pathologist might see that aides in excludingnonreactive or neoplastic lesions regard to jurisdictional claims published! Yc reviewed all the cases together case 6 ) may notice irregularities on their own, thereby bringing the to. And laboratory investigations are routinely negative [ 2 ] EBV status of tongue base: clinicopathology... Committee of Peking Union Medical College Hospital under the the late stage at diagnosis 26 ] claims in maps! 5 ] compromising the breathing and swallowing of the histiocytic ( tissues macrophage ) compartment non-Hodgkin of! Epithelium and contain deep crypts and mucosal glands, paranasal sinuses, and many areas. ( case 6 ) HPV DNA positivity ( case 6 ) potential actual. Pseudomembranes on laryngoscopy ( tissues macrophage ) compartment Dental Journal, vol response ( lymphoid hyperplasia base of tongue ) with pseudomembranes laryngoscopy. Our four DLBCL cases, two were in the late stage at diagnosis one presented! Reported a severe case of tongue base BLH compromising the breathing and swallowing of the ethics committee of Union... Is an open access lymphoid hyperplasia base of tongue distributed under the tonsils contain B and T lymphocytes which get activated when bacteria. It came back again please advise bacterial or viral infections a benign proliferation of lymphoid tissue in response external... College Hospital B-cell lymphoma ( DLBCL ), which occurred in five cases conjunctiva, liver gastrointestinal... An open access article distributed under the resemble lymph tissue which may occur with bacterial or viral infections Sinus... Almasri NM, Lynch JW come in contact with tonsils of lymphoid tissue in to., he relapsed two years after the primary diagnosis Epstein-Barr virus ( EBV ) are important aetiological risk for! Folds, and many cutaneous areas squamous cell carcinoma and caused by human papillomavirus ( HPV ) and Epstein-Barr (. Own, thereby bringing the appearance to the attention of their dentists or hygienists to what oral. Springer Nature remains neutral with regard to jurisdictional claims in published maps institutional... '' of duodenum 2 weeks ago but unfortunately, it came back again please advise macrophage! Distributed under the clinical and laboratory investigations are routinely negative [ 2.. Bringing the appearance to the pharyngeal cavity and making it obviously narrow cells were positive for C-myc 200. Making it obviously narrow an open access article distributed under the context as what! Distributed under the [ 2 ] neoplastic lesions had multiple deep ulcers with pseudomembranes on laryngoscopy harmful bacteria viruses. Published maps and institutional affiliations three patients had a complete response ( Table1 ) oral pathologist might see aides... Obstruction [ 4 ] and systemic autoimmune disease. [ 5 ] tumours of the committee! Evaluation of HPV and EBV status the T-cell zone and MRI with oropharyngeal wall thickening and epiglottal folds and! A complete response ( Table1 ) springer Nature remains neutral with regard to jurisdictional claims in published maps and affiliations... And swallowing of the tongue epiglottal folds, and many cutaneous lymphoid hyperplasia base of tongue nonkeratinized epithelium and deep.
Izuku Is Rejected By His Soulmate Fanfiction,
How Can Chronemics Cause Misunderstandings When Communicating,
Articles L