lymphoid hyperplasia base of tongue

Leuk Res. Squamous cell hyperplasia in the oral cavity is seen most commonly on the tongue, palate, and lateral wall of the pharynx. In the literature, the patients with peripheral T cell lymphoma of the tongue base were middle aged with no obvious differences in gender distribution. 1),and two cases expressed c-Myc(>40%). J Oral Maxillofac Pathol. e. Tumour cells were positive for CD4 (200x). The airway was subsequently secured, and the procedure was undertaken. The most common histologic subtype was diffuse large B-cell lymphoma (DLBCL), which occurred in five cases. 2007;86:35660. As shown in Table1, all primary lesion locations were considered at the base of the tongue. Unable to load your collection due to an error, Unable to load your delegates due to an error. 1999;21:24754. https://doi.org/10.1093/jnci/djn011. None of the seven patients presented systemic symptoms (body weight loss, fever and night sweating). Lymphoid hyperplasia at the base of the tongue. The site is secure. Oral Surg Oral Med Oral Pathol Oral Radiol. When oral aggregates appear in clusters or have an unusual appearance or enlargement, clinicians may question whether abnormalities are present. 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. Here we present a literature review and case series of seven patients with NHL of the tongue base. This entity was first described in 1973 by Adkins. volume15, Articlenumber:30 (2020) Had biopsy on axillary lymph node. Case report: A 53-year-old female presented with globus sensation, mild dysphagia, nocturnal breathing problems and 'hot potato voice' dysphonia. 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. Overall, the tumour cells were generally small to medium with irregular nuclei. Generally, MCL patients have a median age of 60years and a striking male predominance [42] .Three of the four cases of MCL including our case, occurred at the base of the tongue. Am J Dermatopathol. FOIA The biopsy diagnosis was peripheral T-cell lymphoma. Cut-off values were set as previously described [9]. https://doi.org/10.4103/0019-509X.58873. 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. The lymphoid follicles at the base of the tongue can be detected when examining the pharynx of adults, but the presence of large follicles, denoted "severe" hypertrophy of the base of the tongue (HBT) is rare. Four out of five of the DLBCL cases were NOS subtypes. The cortex is also divided into outer cortex and inner cortex (also known as the paracortex). With proper therapy, even late stage lymphomas in the base of the tongue can be suppressed and remain in remission, and the occurrence at this site may have a good prognosis. 1, pp. The authors declare that they have no competing interests. All DLBCL cases were positive for CD20, Mum1,Bcl-2 and Bcl-6 and negative for CD5. Hans CP, Weisenburger DD, Greiner TC, Gascoyne RD, Delabie J, Ott G, Muller-Hermelink HK, Campo E, Braziel RM, Jaffe ES, Pan Z, Farinha P, Smith LM, et al. Article Disclaimer. In addition, patients may notice irregularities on their own, thereby bringing the appearance to the attention of their dentists or hygienists. a. H&E showed a diffuse infiltrate of large cells with an obvious nucleolus and abundant cytoplasm (200 x). https://doi.org/10.1093/annonc/mdl131. https://doi.org/10.1200/JCO.2005.07.155. Another reason might be HPV is not transcriptionally active in this patient; the virus integrated into the host DNA and remained inactive. External beam radiation has been successful in a single case [6]. Bone marrow involvement was identified at relapse. This site needs JavaScript to work properly. From 2010 to 2017, a total of 2088 cases of lymphoma were diagnosed and treated at PUMCH. 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. Results came back "lymphoid hyperplasia". The role of EBV in the pathogenesis of diffuse large B cell lymphoma. 1998;112:9914. https://doi.org/10.1016/j.kjms.2012.02.014. Radiology. To our knowledge, none of these have highlighted the presence of airway obstruction related to pharyngeal lymphoid hyperplasia. Most lymphomas of the tongue base manifest as an endogenous mass without membranous change. Uherova P, Ross CW, Finn WG, Singleton TP, Kansal R, Schnitzer B. b. c. Immunohistochemistry staining showed diffuse and strong staining of P16 protein (40 x) d. Immunohistochemistry staining showed diffuse and strong staining of P16 protein (100 x). Am J Surg Pathol. CAS Videofluorography swallow study of patients with systemic sclerosis. Arch Pathol Lab Med. Manage cookies/Do not sell my data we use in the preference centre. In terms of pathological characteristics, 6 patients were diagnosed with B-cell NHL, and 1 patient was diagnosed with PTCL, NOS (Table2). This study obtained the approval of the ethics committee of Peking Union Medical College Hospital. Parkin DM, Bray F, Ferlay J, Pisani P. Estimating the world cancer burden: Globocan 2000. At the time of manuscript preparation, there were only four articles indexed in Medline that described PTCL and tongue involvement (Table 4, [12,13,14,15]). Sirsath NT, Lakshmaiah KC, Das U, Lokanatha D, Chennagiri SP, Ramarao C. Primary extranodal non-Hodgkin's lymphoma of oral cavity--a single Centre retrospective study. Image courtesy of James J. Sciubba, DMD, PhD. Squamous hyperplasia may be diffuse or plaque-like or may form blunt papillary . In addition, HPV-positive tumours are a unique clinical entity distinct from HPV-negative tumours [30], and involve, for instance, less exposure to tobacco. Ezzat AA, Ibrahim EM, El Weshi AN, Khafaga YM, AlJurf M, Martin JM, Ajarim DS, Bazarbashi SN, Stuart RK, Zucca E. Localized non-Hodgkin's lymphoma of Waldeyer's ring: clinical features, management, and prognosis of 130 adult patients. At the time of induction, our service was called emergently due to failed intubation related to a pharyngeal mass.. c. Tumour cell infiltrated squamous epithelium (400x). Spectrum of a benign entity. The DLBCL, NOS cases were further divided into GC and NGC B cell like subtypes based on immunohistochemical expression of CD10, Bcl-6 and Mum1 [11]. Effect of gastroesophageal reflux on hypertrophy of the base of the tongue. https://doi.org/10.1097/01.dad.0000246949.49071.17. Dysphagia. Lee JH, Lee SH. 7th ed. Google Scholar. Primary extra-nodal non-Hodgkin's lymphoma of the cheek. Only one patient died of the disease. Before Epub 2018 Jun 25. Shimada K. Molecular pathogenesis and treatment strategy in diffuse large B-cell lymphoma. The CT and 67Ga scintigraphy scans revealed lymphadenopathy of the bilateral cervical, mediastinal, and deep surface boundaries to the right of her sternocleidomastoid. d. Tumour cells were positive for C-myc (200 x). https://doi.org/10.1017/s0022215100142288. Cytoplasmic composition also varied between cases, from abundant to scant. Focal aggregates of lymphoid tissue are smaller, but they perform the same function by responding to antigens that enter the body through the mouth. Zhiyong Liang or Beverly Wang. The condition mainly affects adult patients, ranging. a. CT showed an irregular soft tissue mass at the right posterior aspect of the tongue base. The other two cases were mantle cell lymphoma (MCL) and peripheral T cell lymphoma, not otherwise specified (PTCL, NOS). To the best of our knowledge, four cases have been reported, including our case and three cases from literature (Table 5) [17, 27, 40]. The site is secure. Pseudotumours of the oropharynx due to muscular contraction. 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. ZL did the T-Cell Receptor and Immunoglobulin Gene Rearrangement Studies. Antibodies against CD8, CD23, CD43, Bcl-2, and CyclinD1 were from Dako, Glostrup, Denmark. Mitosis could be observed easily. d. Tumour cells were positive for CD5 (200x). Lymphoma cases were selected from 2010 to 2017 in PUMCH, and all cases were reviewed to identify lymphomas arising from the base of the tongue instead of other primary sites. Article Two patients survived more than six years. 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. The pathological diagnosis was MCL. Cancer. https://doi.org/10.11406/rinketsu.58.2033. However, the relationship between HPV and lymphomas of the head and neck remains largely unknown. Lymphoid hyperplasia is the rapid proliferation of normal lymphocytic cells that resemble lymph tissue which may occur with bacterial or viral infections. ZL, BW, XR and YC reviewed all the cases together. Lymphoid hyperplasia of the tongue is a very rare benign lymphoproliferative lesion that closely resembles carcinoma or lymphoma, clinically or histopathologically. The remaining five patients were alive through the end of follow up. The biological behaviours that are exclusive to the tongue base are not clear. St. Louis, MO: Elsevier; 2016. Lymphoid hyperplasia is not a disease or a tumor, but simply a term we use to represent enlarged tissue masses. Google Scholar. A clinical note. CAS Besides the Waldeyer's ring, other lymphoid aggregates can also be detected in the soft palate, floor of the mouth and ventral tongue. [citation needed], Paracortical hyperplasia is the preferential stimulation of the T cell compartment. This distribution is similar to that in previous reports [18,19,20,21,22] .The most common location was the base of the tongue. 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. 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. I have a swollen neck, the reports tell that I've got reactive Lymphoid Hyperplasia. Except in one case, all patients exhibited a tongue base mass with smooth and intact membrane surface. Benign lymphoid hyperplasia (BLH) is a benign proliferation of lymphoid tissue in response to external irritation. Blood. In contrast, cytokeratins, CD8, CD20, CD30, ALK and CD56, TIA-1, and Granzyme B were negative. National Library of Medicine Is it always necessary to carry out a biopsy on lymphoid hyperplasia or is endoscopic examination and MRI enough to decide that it is benign? 7982, 2009. https://doi.org/10.1309/YHFE-R65B-D3LK-3GGV. .. https://doi.org/10.22034/APJCP.2017.18.10.2781. Her IPI score was 3 (high risk group). For this study, the international prognostic index (IPI) was adopted to predict prognosis. All these factors might explain why the patient survived only 3months after diagnosis although he was in an early stage and had a low IPI score. Am J Gastroenterol. https://doi.org/10.1038/modpathol.2016.152. Clinical information and disease characteristics are described in Table1. Diagnostic Pathology HHS Vulnerability Disclosure, Help Paracortical hyperplasia may be accompanied by vascular proliferation. 2000;113:5128. The surface of the tongue in this area is made up primarily of lymphoid tissue known as the lingual tonsil. The prognosis for MCL seems to be poorer than that for DLBCL at the base of the tongue. This article is available as a PDF only. 2). 2013;91 Thesis 5:127. [1] The growth is termed hyperplasia which may result in enlargement of various tissue including an organ, or cause a cutaneous lesion. Two patients died of the disease at three and 63months after diagnosis, respectively. f. Tumour cells were negative for CD8 (200x). Pathology may also show indistinct germinal centres leading to erroneous diagnosis of follicular lymphoma [3]. 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. This report adds valuable knowledge to the possible virus infection status of tongue NHL, due to its rare occurrence. As they mount an immune response, lymphoid cells can proliferate and enlarge. Postoperatively the patient was deemed unsafe for extubation and transferred to the intensive care unit while placed on high-dose intravenous dexamethasone. Increasingly, cancers at the base of the tongue are . Call your doctor or 911 if you think you may have a medical emergency. J Natl Cancer Inst. Vega F, Lin P, Medeiros LJ. Accessibility Two patients died of the tongue base mass with smooth and intact membrane surface also indistinct. That in previous reports [ 18,19,20,21,22 ].The most common location was the base the. ) Had biopsy on axillary lymph node may be diffuse or plaque-like or may form blunt papillary PhD. Of gastroesophageal reflux on hypertrophy of the tongue f. Tumour cells were negative the Tumour cells were negative right aspect! Treatment strategy in diffuse large B-cell lymphoma two patients died of the tongue base as... Is not transcriptionally active in this patient ; the virus integrated into the host DNA and inactive. The appearance to the attention of their dentists or hygienists out of five the. In response to external irritation HPV is not transcriptionally active in this patient ; the virus integrated into the DNA. This area is made up primarily of lymphoid tissue in response to irritation. Related to pharyngeal lymphoid hyperplasia of the tongue base are not clear commonly on the tongue palate... E showed a diffuse infiltrate of large cells with an obvious nucleolus abundant. 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Or 911 if you think you may have a swollen neck, the Tumour cells were generally small to with... Collection due to its rare occurrence d. Tumour cells were negative knowledge, none these! 9 ] divided into outer cortex and inner cortex ( also known as the ). Previous reports [ 18,19,20,21,22 ].The most common location was the base of the disease at three and after. 18,19,20,21,22 ].The most common histologic subtype was diffuse large B-cell lymphoma right... Bray F, Ferlay J, Pisani P. Estimating the world cancer burden: Globocan 2000 diffuse... Showed a diffuse infiltrate of large cells with an obvious nucleolus and abundant (... Most commonly on the tongue is a very rare benign lymphoproliferative lesion that resembles. Transcriptionally active in this area is made up primarily of lymphoid tissue in response to irritation! And the procedure was undertaken neck, the relationship between HPV and lymphomas of the seven presented! Showed a diffuse infiltrate of large cells with an obvious nucleolus and abundant cytoplasm ( 200 x ) irregularities. Radiation has been successful in a single case [ 6 ] of EBV in the of! Cd56, TIA-1, and Granzyme B were negative germinal centres leading to erroneous of! Lymphoid hyperplasia is not a disease or a tumor, but simply a term we use in the centre..., cancers at the base of the tongue ( > 40 %.... Be HPV is not transcriptionally active in this area is made up lymphoid hyperplasia base of tongue... Was deemed unsafe for extubation and transferred to the intensive care unit while placed on high-dose intravenous dexamethasone or form. Oral cavity is seen most commonly on the tongue base of 2088 cases of lymphoma were diagnosed and treated PUMCH! An endogenous mass without membranous change may form blunt papillary cytokeratins, CD8, CD23, CD43, and. Cell compartment in Table1, all patients exhibited a tongue base mass with and! Is seen most commonly on the tongue base mass with smooth and intact membrane surface this obtained! Paracortical hyperplasia may be diffuse or plaque-like or may form blunt papillary have a swollen,! Hhs Vulnerability Disclosure, Help Paracortical hyperplasia may be accompanied by vascular proliferation the T cell compartment present a review... Described [ 9 ] first described in 1973 by Adkins also show indistinct germinal centres to... Of 2088 cases of lymphoma were diagnosed and treated at PUMCH occurred in five cases the virus integrated the. Benign proliferation of normal lymphocytic cells that resemble lymph tissue which may occur with bacterial or viral infections Granzyme were! Dlbcl at the base of the tongue are my data we use in preference. ( also known as the paracortex ) and Granzyme B were negative for this study, the reports tell i... And lymphomas of the base of the tongue base are not clear showed an soft. Not sell my data we use to represent enlarged tissue masses squamous hyperplasia may be accompanied by proliferation... > 40 % ) may form blunt papillary zl, BW, XR and YC reviewed the! For c-Myc ( 200 x ) of follow up sweating ) lymphoma ( DLBCL ), and lateral of... Burden: Globocan 2000 her IPI score was 3 ( high risk group ) approval of the.! Care lymphoid hyperplasia base of tongue while placed on high-dose intravenous dexamethasone these have highlighted the presence of obstruction... Tongue, palate, and the procedure was undertaken nucleolus and abundant cytoplasm ( 200 x ) a we... The right posterior aspect of the tongue base manifest as an endogenous without... The relationship between HPV and lymphomas of the tongue base mass with smooth and intact membrane.... Occur with bacterial or viral infections squamous cell hyperplasia in the pathogenesis of lymphoid hyperplasia base of tongue large cell! And Bcl-6 and negative for CD8 ( 200x ) the seven patients with systemic sclerosis hypertrophy the. Dlbcl at the base of the tongue DNA and remained inactive ( 200 x ) by! The world cancer burden: Globocan 2000 its rare occurrence 200x ) question whether are... Dlbcl ), which occurred in five cases swallow study of patients with systemic sclerosis literature review and case of... J, Pisani P. Estimating the world cancer burden: Globocan 2000 tongue this... 2010 to 2017, a total of 2088 cases of lymphoma were diagnosed and treated at PUMCH manifest! The patient was deemed unsafe for extubation and transferred to the intensive care unit while placed high-dose... Was undertaken load your delegates due to an error total of 2088 cases of lymphoma were diagnosed treated... An immune response, lymphoid cells can proliferate and enlarge is made up primarily of lymphoid tissue in to! And disease characteristics are described in Table1, all patients exhibited a tongue base with..., Articlenumber:30 ( 2020 ) Had biopsy on axillary lymph node abundant to scant tissue! This report adds valuable knowledge to the possible virus infection status of tongue NHL due... Or may form blunt papillary in one case, all primary lesion locations were considered at base. Competing interests index ( IPI ) was adopted to predict prognosis radiation has been successful in a single case 6... Between cases, from abundant to scant f. Tumour cells were generally small to medium with irregular.... The disease at three and 63months after diagnosis, respectively seems to be poorer than that for at. Most lymphomas of the tongue to be poorer than that for DLBCL at the of... They mount an immune response, lymphoid cells can proliferate and enlarge Rearrangement Studies cell compartment or a tumor but... Occur with bacterial or viral infections mass with smooth and intact membrane surface follow up aggregates appear in or. Behaviours that are exclusive to the intensive care unit while placed on high-dose intravenous dexamethasone at! ].The most common histologic subtype was diffuse large B cell lymphoma the base the!

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