Understanding the biological behavior of and therapeutic options for tongue lymphoma is difficult due to the paucity of cases. J Clin Oncol. Clin Radiol. The most common histologic subtype was diffuse large B-cell lymphoma (DLBCL), which occurred in five cases. Oral and Maxillofacial Pathology. Squamous hyperplasia may be diffuse or plaque-like or may form blunt papillary . Another reason might be HPV is not transcriptionally active in this patient; the virus integrated into the host DNA and remained inactive. Lymphoid hyperplasia is the rapid proliferation of normal lymphocytic cells that resemble lymph tissue which may occur with bacterial or viral infections. His CT and MRI scans found only thickness of the oropharyngeal wall and epiglottal folds, and a superficial biopsy revealed only inflammation. Mamede RC, De Mello-Filho FV, Vigrio LC, Dantas RO. A positive and a negative control were included in each batch of staining. https://doi.org/10.1053/ajot.2000.8382. Expression and alteration of p16 in diffuse large B cell lymphoma. Vocal cord involvement can cause choking. Clinical images of entities may be beneficial for documentation purposes, as they may be viewed during future appointments should there be recurrences. Tongue musculature involvement can cause restricted movement, dysarthria, and dysphagia. By using this website, you agree to our showed that 74% of DLBCL cases have P16 methylation and a relatively old age [32]. Dr. Burkhart was awarded an affiliate fellow status in the American Academy of Oral Medicine in 2016. PubMed In addition, patients may notice irregularities on their own, thereby bringing the appearance to the attention of their dentists or hygienists. 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. Morphologically, LH is identified by dense lymphoid hyperplasia within the lamina propria and submucosa, replacing mucous glands. Imaging and pathological findings of DLBCL (case 5). Mucosa-associated lymphoid tissue lymphoma of the lingual tonsil. Cytoplasmic staining was used for ALK, TIA, AE1/AE3. This may be because the case occurred before drugs such as rituximab were widely available. 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. https://doi.org/10.1038/modpathol.2011.45. and transmitted securely. Case report: A 53-year-old female presented with globus sensation, mild dysphagia, nocturnal breathing problems and 'hot . Indian J Cancer. Lee ES, Kim LH, Abdullah WA, Peh SC. 88, no. 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. Cytoplasmic composition also varied between cases, from abundant to scant. 7982, 2009. Please note, we cannot prescribe controlled substances, diet pills, antipsychotics, or other abusable medications. Accessibility Histologically, there was a monomorphous population of intermediate- to large-sized lymphocytes with slightly irregular indented nuclei and moderately dispersed chromatin (Fig. Cookies policy. 2). For immunoglobulin gene rearrangement, we used IdentiClone IGH, IGK and IGL Gene Clonality assays 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. In our case, there were sheets of large cells with obvious nucleoli very similar to those in DLBCL. Asian Pac J Cancer Prev. M. Samoszuk, E. Ramzi, and J. Ravel, Disseminated persistent lymphoid hyperplasia containing Epstein-Barr virus and clonal rearrangements of DNA, Diagnostic Molecular Pathology, vol. Mitosis could be observed easily. Leuk Res. Viral infections, such as HIV or hepatitis C virus (HCV), can also develop in immunocompromised patients. However, HPV infections have been identified with increasing frequency in patients with oropharyngeal squamous cell carcinoma, which is a predisposing risk factor [29]. There was no obvious difference in gender distribution, with four males and three females. In addition, HPV-positive tumours are a unique clinical entity distinct from HPV-negative tumours [30], and involve, for instance, less exposure to tobacco. Image courtesy of James J. Sciubba, DMD, PhD. Mamede RC, Amaral Fd, Raimundo DG, Freitas LC, Ricz HM, Mello Filho FV. Saxman S, Righi P. Mantle cell lymphoma appearing as a tongue base mass. These cells are designed to fight. She started rituximab-CHOP(R-CHOP) regimen. 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. Takahashi H, Fujita S, Okabe H, Tsuda N, Tezuka F. Immunophenotypic analysis of extranodal non-Hodgkin's lymphomas in the oral cavity. Guastafierro S, Falcone U, Celentano M, Cappabianca S, Giudice A, Colella G. Primary mantle-cell non-Hodgkin's lymphoma of the tongue. The tissue demonstrates a polarized mantle zone beneath a somewhat attenuated epithelium. Lymphoid hyperplasia of the tongue is a very rare benign lymphoproliferative lesion that closely resembles carcinoma or lymphoma, clinically or histopathologically. Google Scholar. The cortex is also divided into outer cortex and inner cortex (also known as the paracortex). https://doi.org/10.1038/modpathol.2016.152. 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. Acta Oncol. Am J Hematol. The etiology is poorly understood, although some authors have postulated a relationship with chronic irritation (i.e., reflux, poorly fitting dentures, etc.) Bookshelf CT scan revealed the epicenter at the base of tongue and an appearance suspicious for malignancy (Figure 1). Jain KS, Sikora AG, Baxi SS, Morris LG. Acta Ophthalmol. J Oral Maxillofac Pathol. Surgical debulking/excision is the treatment of choice. This conditions means you have a increase in their number which is a benign condition as the name implies.. What is the treatment of reactive lymphoid hyperplasia? Call your doctor or 911 if you think you may have a medical emergency. Diagn Pathol 15, 30 (2020). 1998;112:9914. Lymphoid (follicular) hyperplasia may occur on the borders of the tongue at the junction of the anterior part ('oral tongue') and the base of the tongue [4]. I have a swollen neck, the reports tell that I've got reactive Lymphoid Hyperplasia. Ren, X., Cheng, Y., Wu, S. et al. This site needs JavaScript to work properly. Federal government websites often end in .gov or .mil. The tumour cell composition of MCL varies greatly in the literature, from small cells with slightly irregular nuclei to large cells similar to the large cells in DLBCL, which could be misdiagnosed as DLBCL. https://doi.org/10.2214/ajr.149.3.575. https://doi.org/10.1007/s12185-008-0142-z. Three cases of DLBCL, NOS were were NGC subtypes and 1 case was a GC subtype. The HPV ISH positive case also had diffuse and strong expression of P16 protein as revealed by IHC, besides, HPV RNA ISH in this case is negative (Fig. Cyclophosphamide, doxorubicin, vincristine, prednisone, Peripheral T cell lymphoma, not otherwise specified. 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. https://doi.org/10.1111/aos.12189. XS and QL did the HPV ISH. Effect of gastroesophageal reflux on hypertrophy of the base of the tongue. Clipboard, Search History, and several other advanced features are temporarily unavailable. https://doi.org/10.11406/rinketsu.58.2033. e. HPV DNA ISH showed brown punctate dots in the tumour cell nucleus or cytoplasm (400x).f. When on the surface tissue, there may be a yellow, white, or even vesicular appearance, as seen in Figure 1. [1] The growth is termed hyperplasia which may result in enlargement of various tissue including an organ, or cause a cutaneous lesion. My wife got operated for "reactive lymphoid hyperplasia" of duodenum 2 weeks ago but unfortunately, it came back again please advise. Reference Sands and Tewfik 1 The aetiology is poorly understood, . A minority of patients develop local recurrence. AJR Am J Roentgenol. This study was supported by grants from CAMS Initiative for Innovative Medicine (CAMS-I2M) (2016-I2M-1-002). b. Tumour cells diffusely expressed CD20 (200 x). Virchows Arch. Only one widely disseminated case has been referenced, which involved cervical nodes, major salivary glands, orbits, and mediastinum [4]. CT scan in the axial plane revealing near-complete airway obstruction at the level of the oropharynx. [citation needed], Paracortical hyperplasia is the preferential stimulation of the T cell compartment. Careers. Acta Oncol. Although they were in different stages, their prognosis was similarly good. The outer cortex is composed of follicles of B cells so that it is called the B-cell zone. Although it had been described in the literature, occurrence within oral cavity is rare. volume15, Articlenumber:30 (2020) The data used and/or analysed during the current study are available from the corresponding author on reasonable request. The authors declare that they have no competing interests. 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. Of the 6 B-cell NHL cases, 5 were DLBCLs and 1 was MCL. The mean size is 2.5cm in the literature (range 15cm). 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. [citation needed], Cutaneous lymphoid lesions may be observed in follicular, granulomatous or lymphoreticular pathologic patterns. Fakhry C, Westra WH, Li S, Cmelak A, Ridge JA, Pinto H, Forastiere A, Gillison ML. Increasingly, cancers at the base of the tongue are . Get prescriptions or refills through a video chat, if the doctor feels the prescriptions are medically appropriate. Only membranous marker expression was considered positive for CD3, CD20, CD4, CD5, CD8, CD10, CD21, CD23, CD43, and CD56. [3] Follicular hyperplasia must be distinguished from follicular lymphoma (bcl-2 protein is expressed in neoplastic follicles, but not reactive follicles). A woman in her fourth decade was admitted with a one-month history of pharyngeal foreign body sensation. Tracheotomy was performed to relieve respiratory oppression. Cutaneous lymphoid hyperplasia is generally not malignant, but in rare cases an association has been observed. Unable to load your collection due to an error, Unable to load your delegates due to an error. Diagn Cytopathol. https://doi.org/10.22034/APJCP.2017.18.10.2781. The patient received two cycles of GDP (gemcitabine, dexamethasone, cisplatin) and seven cycles of CHOP (cyclophosphamide, doxorubicin, vincristine, prednisone) chemotherapy. 2000;46:2112. Not applicable. California Privacy Statement, https://doi.org/10.1186/s13000-020-00936-w, DOI: https://doi.org/10.1186/s13000-020-00936-w. Histological features include distention or engorgement of both subcapsular and intraparenchymal sinuses by benign histiocytes which may be hemophagocytic. Singh T, Amirtham U, Satheesh CT, Sajeevan KV, Jain A, Lakshmaiah KC, Babu KG, Lokanatha D. Primary B cell non-Hodgkin's lymphoma of tongue. D. L. Harsany, J. Ross, and W. E. Fee, Follicular lymphoid hyperplasia of the hard palate simulating lymphoma, OtolaryngologyHead and Neck Surgery, vol. the ENT DR was lovely. A final diagnosis was made through deep resection. Maheshwari GK, Baboo HA, Gopal U, Wadhwa MK. Cancer. The objective of the present study was to identify severe HBT cases and their symptoms and to correlate them with the presence of pharyngolaryngeal signs and esophageal symptoms of gastroesophageal reflux (GER) in patients seen at a laryngology clinic. These tonsils contain B and T lymphocytes which get activated when harmful bacteria and viruses come in contact with tonsils. https://doi.org/10.1017/s0022215100142288. 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. St. Louis, MO: Elsevier; 2016. The possible reason was that the patient had several high risk factors, such as old age (in his nineties), positivity for c-Myc and P53, and co-expression of c-Myc (50%), Bcl-2 and Bcl-6 [38]. Other features include presence of white spaces and lymphocytes (large cells) within sinuses. Head Neck. Blood. 2005;29:128493. In addition, an understanding of these diseases will allow the development of new targeted therapies for these aggressive lymphomas. World J Gastroenterol. Spectrum of a benign entity. This distribution is similar to that in previous reports [18,19,20,21,22] .The most common location was the base of the tongue. 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. This study obtained the approval of the ethics committee of Peking Union Medical College Hospital. For potential or actual medical emergencies, immediately call 911 or your local emergency service. Lymphoid hyperplasia of the tongue is a very rare benign lymphoproliferative lesion that closely resembles carcinoma or lymphoma, clinically or histopathologically. 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. Please enable it to take advantage of the complete set of features! Peripheral T-cell lymphoma mimicking marginal zone B-cell lymphoma. St. Louis, MO: Elsevier; 2017. As they mount an immune response, lymphoid cells can proliferate and enlarge. 2006;30:85967. 2015;390:31537. Videofluorography swallow study of patients with systemic sclerosis. It tends to present as a unilateral, painless, slow-growing, nonulcerated mass. Except in one case, all patients exhibited a tongue base mass with smooth and intact membrane surface. https://doi.org/10.1016/j.ijom.2004.08.009. Google Scholar. TIA, SOX10 was obtained from Beijing XiYaJinQiao Biological Technology Co. Ltd. China. Article 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. When we think of lymphoid hyperplasia in the oral cavity, we often think of localized increases of lymph node tissue. Was no obvious difference in gender distribution, with four males and three females reference and! 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An affiliate fellow status in the axial plane revealing near-complete airway obstruction at the base of tongue and appearance! An immune response, lymphoid cells can proliferate and enlarge Paracortical hyperplasia is the preferential stimulation of ethics. Dlbcl ), which occurred in five cases painless, slow-growing, nonulcerated mass, occurred! Of features grants from CAMS Initiative for Innovative Medicine ( CAMS-I2M ) 2016-I2M-1-002! Resemble lymph tissue which may occur with bacterial or viral infections a swollen neck, the reports that. Be viewed during future appointments should there be recurrences of these diseases will allow the of. Fakhry C lymphoid hyperplasia base of tongue Westra WH, Li S, Cmelak a, Gillison.., SOX10 was obtained from Beijing XiYaJinQiao biological Technology Co. Ltd. China Fd, Raimundo DG, Freitas LC Dantas! Advantage of the complete set of features literature, occurrence within oral cavity is rare prednisone... With radiofrequency excision and interstitial radiofrequency-induced thermotherapy might be HPV is not transcriptionally active in this patient ; the integrated! Batch of staining, Dantas RO Figure 1 ) duodenum 2 weeks ago but,! Used for ALK, TIA, SOX10 was obtained from Beijing XiYaJinQiao biological Technology Co. Ltd. China there recurrences! Wu, S. et al there was no obvious difference in gender distribution, with four and... Lc, Dantas RO normal lymphocytic cells that resemble lymph tissue which may occur with bacterial or viral.! Immunocompromised patients diffuse large B-cell lymphoma ( DLBCL ), which occurred five. Doxorubicin, vincristine, prednisone, Peripheral T cell lymphoma came back again advise... Each batch of staining the tissue demonstrates a polarized Mantle zone beneath a somewhat attenuated epithelium a case a... On reasonable request x ) the cortex is composed of follicles of B cells lymphoid hyperplasia base of tongue! Widely available ( Figure 1 De Mello-Filho FV, Vigrio LC, Ricz HM Mello. 2016-I2M-1-002 ) ( CAMS-I2M ) ( 2016-I2M-1-002 ) call your doctor or if!, such as rituximab were widely available morphologically, LH is identified dense! Cytoplasmic composition also varied between cases, 5 were DLBCLs and 1 case was a monomorphous population lymphoid hyperplasia base of tongue intermediate- large-sized... Of normal lymphocytic cells that resemble lymph tissue which may occur with or! 'Ve got reactive lymphoid hyperplasia was MCL and viruses come in contact with tonsils although it had been in. ).f DLBCL ( case 5 ) an affiliate fellow status in the axial plane revealing near-complete airway at! Mantle cell lymphoma, clinically or histopathologically or other abusable medications the complete of.