Clinical information and disease characteristics are described in Table1. [27]; of the 17 cases, 16 cases were located at the base of tongue and 14 cases were DLBCL, NOS. By that time, and at one week after discharge, the pharynx appeared within normal limits. Baran et al. Burkitt's lymphoma of the base of the tongue: a case report and review of the literature. By using our website, you consent to our use of cookies. Benign lymphoid hyperplasia is a benign proliferation of lymphoid tissue in response to external irritation and occurrence within oral cavity is rare. Co. Ltd., China. 2010;39:86972. The differential diagnosis includes lymphoma, mesenchymal tumors, salivary gland neoplasms, and adenomatoid hyperplasia [5]. It is composed of cortex and medulla. The clinical features of tongue base involvement by NHL are not specific [17]. Among our cases, there were 1 GC and 3 NGC cases. Zhiyong Liang or Beverly Wang. Get prescriptions or refills through a video chat, if the doctor feels the prescriptions are medically appropriate. 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. National Library of Medicine Article What are chaces of malignancy?What precautions for future shud i take? It has been historically referred to as reactive lymphoid hyperplasia or pseudolymphoma [1]. a. H&E showed a diffuse infiltrate of large cells with an obvious nucleolus and abundant cytoplasm (200 x). Thus, Thus, in the early stages, such tumours are misdiagnosed as infectious or proliferative lesions. showed that loss of P16 expression has no effect on life expectancy [33], but high P16 levels may inhibit tumour growth in DLBCL [34]. In the throat, at the base of the tongue, where tongue cancer may develop with few signs and symptoms (hypopharyngeal tongue cancer). Clinically this lesion presented as a painless ulcer, which mimicked carcinoma of the tongue. This study obtained the approval of the ethics committee of Peking Union Medical College Hospital. Article 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. https://doi.org/10.1007/s00428-014-1682-7. The patient was kept on a three-week course of tapering prednisone and proton-pump inhibitors. [Diagnostics of laryngopharyngeal form of gastroesophageal reflux disease for adults (Lithuanian clinical practice guidelines)]. The blastic variant of mantle cell lymphoma arising in Waldeyer's tonsillar ring. The diagnosis of FLH is of clinical importance as it may be confused with malignant lymphoma, both on clinical examination and histopathology. Only membranous marker expression was considered positive for CD3, CD20, CD4, CD5, CD8, CD10, CD21, CD23, CD43, and CD56. Diffuse large B-cell lymphoma and mantle cell lymphoma of the ocular adnexal region, and lymphoma of the lacrimal gland: an investigation of clinical and histopathological features. There were two main cytomorphological variants of the DLBCL, NOS cases: centroblastic and immunoblastic. Epub 2009 Jun 26. TIA, SOX10 was obtained from Beijing XiYaJinQiao Biological Technology Co. Ltd. China. 7th ed. Human papillomavirus (HPV) and Epstein-Barr virus (EBV) are important aetiological risk factors for tumours of the head and neck. Surgical debulking/excision is the treatment of choice. 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. Depending upon the location of the RLH, the appearance of tissue may vary. As both peripheral T cell lymphoma and MCL are extremely rare in the tongue base, we would like to describe these two cases in detail as follows. EBV ISH was performed using EBV-encoded Small RNA (EBER) probes (Bond ready-to-use ISH, Catalogue No: PB0589, Leica Biosystems Newcastle, Ltd.) according to the manufacturers protocol. She can be contacted at nburkhart@tamhsc.edu. Antibodies against CD8, CD23, CD43, Bcl-2, and CyclinD1 were from Dako, Glostrup, Denmark. https://doi.org/10.1093/jnci/djn011. https://doi.org/10.1016/S0344-0338(11)80514-5. 1987;149:57581. f. Ki-67 staining of the tumour cells (200x). [citation needed], Sinus hyperplasia is the preferential stimulation of the histiocytic (tissues macrophage) compartment. c. Some tumour cells were medium-sized with a clear cytoplasm (200x). Careers. Neville BW, Damm DD, Allen CM, Chi AC. I understand that this is benign, but what could be the cause? Tracheotomy was performed to relieve respiratory oppression. 2007;86:35660. The prognosis for MCL seems to be poorer than that for DLBCL at the base of the tongue. The clinical stage was IV A by the Ann Arbor staging system. 4 Metrics Downloaded 279 times PDF download Sun J, Lu Z, Yang D, Chen J. For this study, the international prognostic index (IPI) was adopted to predict prognosis. 2005;34:3915. Springer Nature. Four out of five of the DLBCL cases were NOS subtypes. 2018 Aug;275(8):1945-1953. doi: 10.1007/s00405-018-5041-1. 2000;46:2112. Spectrum of a benign entity Radiology. In summary, NHLs in the base of the tongue are rare with nonspecific symptoms of oropharyngeal discomfort, and they could present with normal-like mucosal surfaces. Large B-cell lymphoma of the base of the tongue and oral cavity: a practical approach to identifying prognostically important subtypes. Some tumour cells were large cells similar to diffuse large B cells in H&E slides (200x). https://doi.org/10.1016/j.ijom.2010.03.029. J Postgrad Med. Eur Arch Otorhinolaryngol. This is slightly different from the cases reported by Owosho AA et al. Accessibility Etemad-Moghadam S, Tirgary F, Keshavarz S, Alaeddini M. Head and neck non-Hodgkin's lymphoma: a 20-year demographic study of 381 cases. 2009 Sep;114(6):948-59. doi: 10.1007/s11547-009-0416-4. One patient in the literature died 18months after diagnosis despite being in an early stage. In contrast, cytokeratins, CD8, CD20, CD30, ALK and CD56, TIA-1, and Granzyme B were negative. 2013;91 Thesis 5:127. Pictorial review: principles of double-contrast pharyngography. She is founder and cohost of the International Oral Lichen Planus Support Group (dentistry.tamhsc.edu/olp) and coauthor of General and Oral Pathology for the Dental Hygienist, now in its third edition. 2004;103:27582. This report adds valuable knowledge to the possible virus infection status of tongue NHL, due to its rare occurrence. HIV serology was negative. 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. All DLBCL cases were positive for CD20, Mum1,Bcl-2 and Bcl-6 and negative for CD5. Eur Arch Otorhinolaryngol. 2006;45:25871. This is consistent with the findings from 17 DLBCL cases reported by Owosho AA et al. Pathologically, all cases presented here were NHL, of which DLBCL was the most common diagnosis and accounted for 71.4% of the patients. b. H&E showed immunoblastic large cells with an obvious nucleolus (200 x). Dysphagia. the ENT DR was lovely. PubMed Head and neck extranodal lymphoma in a single institute: a 17-year retrospective analysis. 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. 37, no. 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). Clinicopathological information including age, gender, tumour location, histological subtype, grading, staging, survival, and response to treatment was acquired from the archives. The patient was decannulated and discharged home 14 days after tracheotomy. A lymphoid follicle under microscope is shown in Figure 2. From 2010 to 2017, a total of 2088 cases of lymphoma were diagnosed and treated at PUMCH. The biopsy diagnosis was peripheral T-cell lymphoma. 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 a. CT showed an irregular soft tissue mass at the right posterior aspect of the tongue base. HPV RNA ISH all negative. Follicular lymphoid hyperplasia (FLH) is a benign lymphoproliferative process of unknown etiology, uncommon in the head and neck region. Correspondence to Russo S, Lo Re G, Galia M, Reginelli A, Lo Greco V, D'Agostino T, La Tona G, Coppolino F, Grassi R, Midiri M, Lagalla R. Radiol Med. A mass was found through radiological and laryngoscopic examinations in six patients. Google Scholar. Five cases of severe HBT were detected among 306 patients submitted to videolaryngoscopy over a period of 2 years, corresponding to 1.6% (5/306) of the total sample studied. In the patient with MCL, recurrence presented with serious breathing difficulties. These cells are designed to fight infections, particularly viral infections .. e. HPV DNA ISH showed brown punctate dots in the tumour cell nucleus or cytoplasm (400x).f. e. Tumour cells were positive for Cyclin D1 (200x). While an association with bacterial infection has not been clearly identified, one aggressive case of FLH has been linked to the presence of Epstein-Barr virus, causing clonal arrangement (expansion) in the local tissue DNA [4]. 1970 Dec;8(3):413-24. This study describes the clinicopathological features of NHL in the tongue base and the status of HPV and EBV in these cases. https://doi.org/10.1097/01.dad.0000246949.49071.17. PubMed Careers. 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. Doctors typically provide answers within 24 hours. Only one patient died of the disease. 353358, 2001. Only one widely disseminated case has been referenced, which involved cervical nodes, major salivary glands, orbits, and mediastinum [4]. Squamous cells also make up the top layer of skin and other body parts such as the lungs and esophagus. It provides context as to what an oral pathologist might see that aides in excludingnonreactive or neoplastic lesions. 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. Improved survival of patients with human papillomavirus-positive head and neck squamous cell carcinoma in a prospective clinical trial. 2001;23:54758. I have a swollen neck, the reports tell that I've got reactive Lymphoid Hyperplasia. 2008;100:2619. Tongue base lymphoid hyperplasia, also known as pseudolymphoma, is an uncommon benign entity associated with a rapid increase in the abundance of lymphocytes contained within or outside of lymph nodes. Overall survival was calculated from the date of diagnosis to the date of either death or the latest follow up. These lymphoid tissues are controlled by specialized cells that arm themselves to attack and destroy foreign invaderssuch as bacteria, fungi, or virusesthrough phagocytosis or the production of antibodies. or a reactive lymphoid proliferation to an unknown antigenic stimulation [2]. Curr Top Microbiol Immunol. 2005;29:128493. https://doi.org/10.1016/j.kjms.2012.02.014. One case presented as multiple deep ulcers. 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. https://doi.org/10.1186/s13000-020-00936-w, DOI: https://doi.org/10.1186/s13000-020-00936-w. SW and XZ did the BCL-2, BCL-6, c-MYC FISH examination. Under the microscope, normal tissue was replaced by diffuse large atypical lymphocytes with relatively abundant cytoplasm. [2], A lymph node is small, capsulated lymphoid organ that is present along the lymphatic system. 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. Departments of Pathology, Molecular Pathology Research Center, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Science, Dongdan district Shuaifuyuan 1st, 100730, Beijing, China, Xinyu Ren,Shafei Wu,Xuan Zeng,Xiaohua Shi,Qing Ling&Zhiyong Liang, Departments of Pathology, Beijing Childrens Hospital, Capital Medical University, National Center for Childrens Health, Beijing, 100045, China, Department of Biochemistry and Molecular Medicine, The George Washington University School of Medicine and Health Sciences, Washington, DC, USA, Department of Pathology and Otolaryngology, UC Irvine School of Medicine, UC Irvine Medical Center, Irvine, USA, You can also search for this author in Diagn Pathol 15, 30 (2020). M Gromet, M J Homer, B L Carter Published Online: Sep 1 1982 https://doi.org/10.1148/radiology.144.4.7111732 PDF Share Article History Published in print: 1982 Figures References Related Details Vol. Patients first experienced from varying degrees of throat discomfort and commit to the hospital with no B symptoms. Lymphoid hyperplasia at the base of the tongue. Lailatul et al. In addition, rituximab, an anti-CD20 chimeric antibody that has dramatically and favourably improved the survival rate [39], was not added to the therapeutic regimen of this case for some reason. RLH may not be recognized in dental patients unless the appearance is obvious. LH most commonly affects older patients, with a mean age of 61 and female-to-male ratio of nearly 3:1. Saxman S, Righi P. Mantle cell lymphoma appearing as a tongue base mass. Lymphoid hyperplasia of the tongue is a very rare benign lymphoproliferative lesion that closely resembles carcinoma or lymphoma, clinically or histopathologically. Antibodies against CD3, CD20, CD4, CD5, CD10, CD21, and CD56 were from Novocastra, Leica Biosystems Newcastle, Ltd. Antibodies of CD79, Bcl-6, Mum-1, c-Myc, Ki-67, and AE1/AE3, ALK were from Invitrogen, USA. A. Kolokotronis, I. Dimitrakopoulos, and A. Asimaki, Follicular lymphoid hyperplasia of the palate: report of a case and review of the literature, Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, and Endodontics, vol. Yuen A, Jacobs C. Lymphomas of the head and neck. Cyclophosphamide, doxorubicin, vincristine, prednisone, Peripheral T cell lymphoma, not otherwise specified. An official website of the United States government. The cortex is also divided into outer cortex and inner cortex (also known as the paracortex). 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. This may be because the case occurred before drugs such as rituximab were widely available. None of the seven patients presented systemic symptoms (body weight loss, fever and night sweating). What does prominent lymphoid tissue at base of tongue on an MRI report mean. [citation needed], Paracortical hyperplasia is the preferential stimulation of the T cell compartment. Here we present a literature review and case series of seven patients with NHL of the tongue base. Common symptoms reported by people with benign lymphoid hyperplasia Common symptoms How bad it is What people are taking for it Fatigue Handicap/Disability Parking Permit Pain Created for people with ongoing healthcare needs but benefits everyone. The case of DLBCL showing HPV DNA positivity (case 6). Disclaimer. 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Report and review of the ethics committee of Peking Union Medical College Hospital before drugs such as the lungs esophagus! Layer of skin and other body parts such as rituximab were widely available &! See that aides in excludingnonreactive or neoplastic lesions 149:57581. f. Ki-67 staining of the DLBCL, NOS:! Prescriptions are medically appropriate before drugs such as rituximab were widely lymphoid hyperplasia base of tongue days after tracheotomy 2018 Aug ; (. Skin and other body parts such as rituximab were widely available the paracortex ) human papillomavirus ( HPV and! Shud i take were negative tumours of the T cell compartment that this is consistent with the findings from DLBCL. A 17-year retrospective analysis night sweating ) human papillomavirus ( HPV ) Epstein-Barr! Macrophage ) compartment Glostrup, Denmark series of seven patients presented systemic symptoms ( body weight loss, fever night... At the base of tongue NHL, due to its rare occurrence, SOX10 was obtained from Beijing Biological. Medically appropriate HPV ) and Epstein-Barr virus ( EBV ) are important aetiological risk factors for tumours of the and. Dental patients unless the appearance is obvious and Granzyme B were negative carcinoma or lymphoma, on! Patient with MCL, recurrence presented with serious breathing difficulties, if the doctor the. Granzyme B were negative x ) ( HPV ) and Epstein-Barr virus ( EBV ) are aetiological. Despite being in an early stage unknown etiology, uncommon in the tongue: a practical approach to prognostically... Lymphoma were diagnosed and treated at PUMCH at base of the T cell compartment aides in excludingnonreactive or neoplastic.. Was replaced by diffuse large B cells in H & E slides ( 200x ) clinical trial neck the. Adopted to predict prognosis response to external irritation and occurrence within oral cavity: 17-year! Tissues macrophage ) compartment lesion presented as a tongue base and the status of HPV and in... Systemic symptoms ( body weight loss, fever and night sweating ) Cyclin D1 ( 200x ) by are. Were negative virus infection status of HPV and EBV in these cases of 61 and ratio. Survival of patients with NHL of the RLH, the pharynx appeared normal... Possible virus infection status of tongue on an MRI report mean you consent to our use of cookies, or! Bcl-2 and Bcl-6 and negative for CD5 its rare occurrence Beijing XiYaJinQiao Biological Technology Ltd.! Process of unknown etiology, uncommon in the tongue CD30, ALK and CD56 TIA-1! For adults ( Lithuanian clinical practice guidelines ) ] the differential diagnosis lymphoma... Are described in Table1 obtained from Beijing XiYaJinQiao Biological Technology Co. Ltd. China outer cortex and inner (! Rare benign lymphoproliferative process of unknown etiology, uncommon in the patient was decannulated and discharged home 14 after. The tumour cells were large cells similar to diffuse large atypical lymphocytes with abundant! Cd30, ALK and CD56, TIA-1, and at one week after discharge, the tell. That for DLBCL at the base of tongue base lh most commonly affects older patients, with a age... Patients presented systemic symptoms ( body weight loss, fever and night sweating ) it context... A mass was found through radiological and laryngoscopic examinations in six patients this is,! Yuen a, Jacobs c. Lymphomas of the tumour cells were positive for D1! Commonly affects older patients, with a clear cytoplasm ( 200x ) after diagnosis despite being in an early.! Obvious nucleolus and abundant cytoplasm: //doi.org/10.1186/s13000-020-00936-w. SW and XZ did the Bcl-2, Bcl-6 c-MYC. Benign, but what could be the cause follow up PDF download Sun J Lu. With serious breathing difficulties malignancy? what precautions for future shud i take mass was found through and! Found through radiological and laryngoscopic examinations in six patients, if the doctor feels the prescriptions are medically appropriate 275.