An official website of the United States government. Clipboard, Search History, and several other advanced features are temporarily unavailable. 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. Globus pharyngeus: a review of etiology, diagnostics, and treatment. Mod Pathol. This is slightly different from the cases reported by Owosho AA et al. The surface of the tongue in this area is made up primarily of lymphoid tissue known as the lingual tonsil. Sun J, Lu Z, Yang D, Chen J. CT scan in the axial plane revealing near-complete airway obstruction at the level of the oropharynx. Follicular lymphoid hyperplasia (FLH) is an uncommon benign entity related to a rapid increase in the abundance of lymphocytes contained within or outside of lymph nodes. All 7 lymphomas were localized at the base of the tongue. Oral Pathology: Clinical Pathologic Correlations. Blood. Epub 2009 Jun 26. This study obtained the approval of the ethics committee of Peking Union Medical College Hospital. Gastroesophageal reflux in bronchial asthma patients. Ekstrom-Smedby K. Epidemiology and etiology of non-Hodgkin lymphoma--a review. The data used and/or analysed during the current study are available from the corresponding author on reasonable request. Ear Nose Throat J. It has been historically referred to as reactive lymphoid hyperplasia or pseudolymphoma [1]. 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. Like all lymphoid tissue in the body, oral lymphoid tissue is highly reactive and can enlarge from time to time as it reacts to foreign entities. What is the treatment for reactive lymphoid hyperplasia? 353358, 2001. 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. Mamede RC, De Mello-Filho FV, Vigrio LC, Dantas RO. Guastafierro S, Falcone U, Celentano M, Cappabianca S, Giudice A, Colella G. Primary mantle-cell non-Hodgkin's lymphoma of the tongue. Lymphomas of the head and neck: CT findings at initial presentation. Otolaryngologic manifestations of gastroesophageal reflux. b. Aggregates of lymphoid tissue are all over the oral mucosa, but they are often prominent in the soft palate, uvula, and pharynx. Saxman S, Righi P. Mantle cell lymphoma appearing as a tongue base mass. 1998;18:38792. RLH may not be recognized in dental patients unless the appearance is obvious. On this Wikipedia the language links are at the top of the page across from the article title. 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. 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. The follow-up period started from the date of diagnosis until August 30, 2019, and ranged from 3 to 90months. They are covered by stratified squamous nonkeratinized epithelium and contain deep crypts and mucosal glands. The most common histologic subtype was diffuse large B-cell lymphoma (DLBCL), which occurred in five cases. Our HPV-infected patient indeed had a favourable prognosis, and he was alive and free of disease when this manuscript was prepared (68months). Epub 2018 Jun 25. https://doi.org/10.1111/aos.12189. This procedure was carried out under general anesthetic in the form of a modified adenotonsillectomy, using a Boyle Davis gag for exposure and a combination of monopolar cautery for the palatine tonsils and suction cautery for subtotal ablation of the lingual tonsils. Human papillomavirus (HPV) and Epstein-Barr virus (EBV) are important aetiological risk factors for tumours of the head and neck. [2], A lymph node is small, capsulated lymphoid organ that is present along the lymphatic system. Semin Oncol. Four out of five of the DLBCL cases were NOS subtypes. DLBCL with high risk factors and MCL may have unfavourable outcomes. Am J Hematol. 2013 Dec;137(12):1837-42. doi: 10.5858/arpa.2012-0678-RS. All DLBCL cases were positive for CD20, Mum1,Bcl-2 and Bcl-6 and negative for CD5. By using our website, you consent to our use of cookies. In terms of pathological characteristics, 6 patients were diagnosed with B-cell NHL, and 1 patient was diagnosed with PTCL, NOS (Table2). A mass was identified in the right base of the tongue that caused breathing difficulties. https://doi.org/10.1007/s12185-008-0142-z. 88, no. Am J Clin Pathol. 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. Pathologically, all cases presented here were NHL, of which DLBCL was the most common diagnosis and accounted for 71.4% of the patients. Nathu RM, Mendenhall NP, Almasri NM, Lynch JW. 172175, 2003. https://doi.org/10.1016/j.anndiagpath.2005.09.020. Video chat with a U.S. board-certified doctor 24/7 in less than one minute for common issues such as: colds and coughs, stomach symptoms, bladder infections, rashes, and more. For this study, the international prognostic index (IPI) was adopted to predict prognosis. 2. PMC 1),and two cases expressed c-Myc(>40%). External beam radiation has been successful in a single case [6]. Only membranous marker expression was considered positive for CD3, CD20, CD4, CD5, CD8, CD10, CD21, CD23, CD43, and CD56. Systemic investigations showed lymphadenopathy around the right internal jugular vein and anterior to the sternocleidomastoid. FISH detection found that one case had a single Bcl-2 rearrangement and one case had a single Bcl-6 rearrangement. Pribuisiene R, Uloza V, Siupsinskiene N, Butkus E, Kupcinskas L. Al-Asoom L, Al-Rubaish AM, El-Munshid HA, Al-Nafaie AN, Bukharie HA, Abdulrahman IS. Pathology may also show indistinct germinal centres leading to erroneous diagnosis of follicular lymphoma [3]. The site is secure. 2023 Endeavor Business Media, LLC. c. Tumour cells diffusely expressed CD20 (200 x). PubMed Central All 7 lymphomas were localized at the base of the tongue. World J Gastroenterol. Other rare case reports describe upper airway obstruction[4] and systemic autoimmune disease.[5]. 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. 2016;20:332. https://doi.org/10.4103/0973-029X.185926. 2007;29:627. Immunohistochemistry was negative for lymphoma. Benign Lymphoid Hyperplasia of the Tongue Base Causing Upper Airway Obstruction 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. A mass was found through radiological and laryngoscopic examinations in six patients. 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. In contrast, they did not express CD3, CD10, CD23, or TdT. Ann Oncol. 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). 2, pp. Provided by the Springer Nature SharedIt content-sharing initiative. 4 Metrics Downloaded 279 times PDF download Mohd Ridah LJ, A Talib N, Muhammad N, Hussain FA, Zainuddin N. p16 Tumor Suppressor Gene Methylation in Diffuse Large B Cell Lymphoma: A Study of 88 Cases at Two Hospitals in the East Coast of Malaysia. 2013;119:18327. Benign lymphoid hyperplasia is a benign proliferation of lymphoid tissue in response to external irritation and occurrence within oral cavity is rare. Created for people with ongoing healthcare needs but benefits everyone. It is caused by an abnormal expansion of the interfollicular zones but is confined within the lymph node capsule. 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]. 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. Cytoplasmic staining was used for ALK, TIA, AE1/AE3. Owosho AA, Bilodeau EA, Surti U, Craig FE. There was no cervical adenopathy, and CT of the thorax and abdomen was negative. Only one widely disseminated case has been referenced, which involved cervical nodes, major salivary glands, orbits, and mediastinum [4]. One case presented as multiple deep ulcers. Spectrum of a benign entity Radiology. Polyclonal lymphoid proliferation with immunohistochemistry stains for kappa or lambda light chains are diagnostic. 1991;6(3):170-8. doi: 10.1007/BF02493520. Diagn Cytopathol. HHS Vulnerability Disclosure, Help All patients were diagnosed by either biopsy or tumor resection. The PubMed wordmark and PubMed logo are registered trademarks of the U.S. Department of Health and Human Services (HHS). Clinically this lesion presented as a painless ulcer, which mimicked carcinoma of the tongue. The condition mainly affects adult patients, ranging. 2012;87:6049. Copyright 2011 Noah B. Sands and Marc Tewfik. From: The Teaching Files: Chest, 2010 View all Topics Roentgen examination of the oropharynx and oral cavity. Radiology. Dysphagia. PMC e. Tumour cells were positive for Cyclin D1 (200x). Imaging examination can help identify lesions. 1, pp. Paracortical hyperplasia may be accompanied by vascular proliferation. Curr Top Microbiol Immunol. Three patients are alive with disease and 2 are alive without disease. Bethesda, MD 20894, Web Policies Am J Surg Pathol. 1970 Dec;8(3):413-24. Please note, we cannot prescribe controlled substances, diet pills, antipsychotics, or other abusable medications. Extranodal NHL is complicated; it consists of a group of tumours with different pathological, clinical and prognostic characteristics [6] .Existing series presenting extranodal NHL have mainly summarized the tumours that occur in the head and neck but are not specific to the base of the tongue. 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. official website and that any information you provide is encrypted Google Scholar. National Library of Medicine While the etiology is poorly understood, a number of previous theories exist, which are included here in the context of a literature review. Leuk Res. Seven cases were identified from the Pathological Registry Database at Peking Union Medical College Hospital (PUMCH). Except in one case, all patients exhibited a tongue base mass with smooth and intact membrane surface. 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). The base of tongue refers to the back one-third of the tongue that continues down the throat. Oral LCs are often detected in the floor of mouth and lateral margin of tongue, as nodules of normal-yellow to white color, microscopically presenting a central cavity lined by stratified squamous epithelium and cystic capsule containing lymphoid tissue in a follicular pattern [16]. The blastic variant of mantle cell lymphoma arising in Waldeyer's tonsillar ring. Our attention is especially drawn to areas where increased gingival growth is uncommon, such as the soft palate, uvula, and posterior oropharynx. c. Tumour cell infiltrated squamous epithelium (400x). 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. Two patients died of the disease at three and 63months after diagnosis, respectively. Patricia Uherova et al. 2002;15:4205. P16 stains the nucleolus and cytoplasm. XS and QL did the HPV ISH. In the middle power view, there were plenty of moderate to large cells with distorted nuclear contours (Fig. https://doi.org/10.1002/ajh.23176. Immunohistochemically, the atypical lymphoid cells were positive for CD20, CD79a, PAX-5, CD5, CyclinD1 protein, and Ki-67 antigen (labelling 25%). At the time of induction, our service was called emergently due to failed intubation related to a pharyngeal mass.. Unable to load your collection due to an error, Unable to load your delegates due to an error. Cases of PTCL and MCL are described in detail in the Results section. PubMedGoogle Scholar. Chemotherapy containing rituximab was considered to significantly improve survival in DLBCL and MCL patients [39, 43]. Lymphoid hyperplasia of the tongue is a very rare benign lymphoproliferative lesion that closely resembles carcinoma or lymphoma, clinically or histopathologically. I have a swollen neck, the reports tell that I've got reactive Lymphoid Hyperplasia. Dental professionals should pay close attention to these areas of the mouth due to the possibility of oral cancer, which is being increasingly seen at the base of the tongue and in the oropharynx. 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]. These cells are designed to fight. Maheshwari GK, Baboo HA, Gopal U, Wadhwa MK. 2, no. 2000;21:2716. Here we present a literature review and case series of seven patients with NHL of the tongue base. Article Abstract. Globus pharyngeus: a review of its etiology, diagnosis and treatment. 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. A finding indicating enlargement of the tongue. Reported cases involve the conjunctiva, liver, gastrointestinal tract, stomach, lungs, paranasal sinuses, and many cutaneous areas. A lymphoid follicle under microscope is shown in Figure 2. 1999;26:33845. Positive nucleolus staining was used to identify Bcl-6, mum-1, CyclinD1, SOX11 and Ki-67. a. CT showed a well-bordered cystic mass. FOIA and has since been primarily reported in the skin, breasts, gastrointestinal tract, lungs, and nasopharynx [2]. https://doi.org/10.1002/cncr.27988. By Owosho AA, Bilodeau EA, Surti U, Wadhwa MK the. Owosho AA, Bilodeau EA, Surti U, Wadhwa MK obstruction 4. Mcl may have unfavourable outcomes Mantle cell lymphoma arising in Waldeyer 's tonsillar ring 30,,... Figure 2 Web Policies Am J Surg Pathol benign proliferation of lymphoid tissue known the! And abdomen was negative mucosal glands to 90months oral cavity ekstrom-smedby K. Epidemiology and etiology of lymphoma! Leading to erroneous diagnosis of follicular lymphoma [ 3 ] involve the conjunctiva, liver, gastrointestinal,! Most common histologic subtype was diffuse large B-cell lymphoma ( DLBCL ) and. 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