Oral manifestations of lymphoma: a systematic review

Silva, Taísa Domingues Bernardes; Ferreira, Camila Belo Tavares; Leite, Gustavo Boehmer; Pontes, José Roberto de Menezes; Antunes, Héliton Spíndola

doi:10.3332/ecancer.2016.665

Cited by 95 publications

(120 citation statements)

References 84 publications

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“…A good medical history, detailed clinical and imaging evaluations, and attention to the patient's signs and symptoms are crucial for the correct diagnosis and appropriate treatment. [2] In the present case, a diagnosis of B-cell lymphoma was suspected when a sudden increase in the facial swellings was noticed which indicated the possibility of emergence of a pathology other than the initial benign lymphoepithelial lesion. It is difficult to give a definitive diagnosis pre-operatively based on fine needle aspiration biopsy (FNAB) [17] , therefore surgical excision is preferable in such cases.…”

Section: Section: Dentistry Discussionmentioning

confidence: 63%

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Diffuse Swelling of Salivary and Lacrimal Glands as a First and only Manifestation of Non-Hodgkin B-Cell Lymphoma: A Case Report

Eltayeb¹,

Alfadul²,

Agaimy³

et al. 2016

AIMDR

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Lymphoma is the third most common cancer worldwide. Oral cavity Lymphoma forms 3% of all lymphomas in the general population. This is a case report of non Hodgkin B-cell lymphoma in 60 -year-old black male who was diagnosed earlier as having benign lympho-epithelial lesions of salivary and lacrimal glands. The patient was complaining of painless symmetrical facial swelling of the parotid, submandibular and lacrimal glands. Serological findings were negative for antinuclear antibody (ANA), anti-SS-A and anti-SS-B antibodies. Bilateral surgical excision of disfiguring buccal swollen salivary gland revealed a B-cell lymphoma. Chemotherapy started and dramatic response was noticed with total disappearance of all lacrimal and salivary gland swelling.

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Section: Section: Dentistry Discussionmentioning

confidence: 63%

“…Lymphoma has two forms: Hodgkin's lymphoma (HL) and non-Hodgkin's lymphoma (NHL). Head and neck lymphomas are mainly non-Hodgkin's lymphoma with an incidence of 11-33% [2,3] The most common sites of growth are salivary glands, eyes, nasopharynx, maxillary sinuses and rarely the floor of the mouth and lips [4] .…”

Section: Introductionmentioning

confidence: 99%

Diffuse Swelling of Salivary and Lacrimal Glands as a First and only Manifestation of Non-Hodgkin B-Cell Lymphoma: A Case Report

Eltayeb¹,

Alfadul²,

Agaimy³

et al. 2016

AIMDR

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“…It resulted in delayed proper treatment, therefore allowing the progression Montaner et al J Hematol. 2018;7(1):23-28 of the lymphoma [4]. In our first case, the palatal hyperplasia overlying the removable prosthesis could also have been misdiagnosed as a fibro-epithelial polyp or a reactive hyperplasia.…”

Section: Discussionmentioning

confidence: 80%

“…Lymphomas are not so rare in the oral cavity and we must not forget that local lesions can be caused by general pathology. A delayed diagnosis is detrimental for the patient when it reaches several months, while follicular lymphoma prognosis is very good with early diagnosis and appropriate therapy [2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18].…”

Section: Discussionmentioning

confidence: 99%

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Follicular Lymphomas of Oral Region Treated by Rituximab Monotherapy: About Two Cases

Montaner¹,

Weingertner²,

Ledoux³

et al. 2018

J Hematol

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Lymphomas represent the second most common malignant lesions of the head and neck. Among them, follicular lymphomas (FLs) are the second most frequent B-cell non-Hodgkin's lymphomas. However, their incidence is rare in the oral cavity. We describe here two cases of FL with initial intra-oral presentation. The first patient was 81 years old and presented a palatal hyperplasia, covering the posterior edge of her dental removable prosthesis. After surgical excision of the lesion, the pathological diagnosis was an extra-nodal low-grade follicular lymphoma. Medical imaging assessment found a widespread but non-bulky involvement. The second patient was 38 years old and referred for asymptomatic swelling of the lower vestibule evolving for 4 months. Surgical exploration revealed a cheek lymphadenopathy infiltrated by a grade 3 FL; this patient did not have any other localization. Both patients were treated by a rituximab monotherapy with excellent response after 2 years of follow-up. Most of the time, FL affecting the oral cavity presenting as unspecific swelling, can mimic other frequent and benign oral lesions. In the absence of biopsy, both diagnosis and proper onco-hematological management may be delayed. The introduction of monoclonal antibody rituximab represents a major advance in the management of FL: it can be used as monotherapy or may be combined with chemo-immunotherapy according to histological grading, initial staging (extent, tumor mass or bulk), age and co-morbidities. These two observations show the importance of an early diagnosis regarding a chronic lesion in the oral cavity. Painless lymphadenopathy, asymptomatic swelling, aspecific mucosal lesions, or subprosthetic lesions should draw attention of any oral specialist.

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Cancer in Patients With Incidental Asymmetric Oropharynx Positron Emission Tomography Uptake

Armstrong,

Burkett,

O’Byrne

et al. 2024

JAMA Otolaryngol Head Neck Surg

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ImportanceAsymmetric oropharynx uptake on positron emission tomography (PET)/computed tomography (CT) is a common incidental finding and often prompts otolaryngology referral to rule out malignancy; however, the true risk of malignancy based on this finding is unknown.ObjectiveTo identify the incidence of oropharynx cancer in patients with incidental asymmetric oropharynx PET uptake.Design, Setting, and ParticipantsIn this retrospective cohort study, patients 18 years and older undergoing PET/CT scans at Mayo Clinic between January 2001 and December 2018 were included. Patients with a history or pretest suspicion of oropharynx cancer were excluded. Data were analyzed from March 2021 to December 2023.ExposureBlinded radiologic review of imaging studies, including measurement of maximum standardized uptake values (SUVmax) of the ipsilateral side of concern and contralateral side. Retrospective medical record review for associated clinical data.Main Outcomes and MeasuresThe primary study outcome was the incidence of oropharynx cancer diagnosis in patients with asymmetric oropharynx PET uptake. The primary outcome was formulated before data collection.ResultsOf the 1854 patients identified with asymmetric oropharynx PET uptake, 327 (17.6%) met inclusion criteria. Of these, 173 (52.9%) were male, and the median (range) age was 65.0 (24.8-90.7) years. The mean (SD) follow-up interval was 52.1 (43.4) months. A total of 18 of 327 patients (5.5%) were newly diagnosed with oropharynx cancer. The most common diagnosis was squamous cell carcinoma (n = 9), followed by lymphoma (n = 8), and sarcoma (n = 1). Patients with an incidental diagnosis of oropharynx cancer had higher mean (SD) ipsilateral SUVmax (8.7 [3.7] vs 5.3 [1.9]) and SUVmax ratio (3.0 [1.6] vs 1.6 [0.6]) compared with patients with normal examination findings. SUVmax ratio and difference were found to be good discriminators of oropharynx cancer, with areas under the receiver operating characteristic curve of 86.3% (95% CI, 76.4-94.6) and 85.8% (95% CI, 74.8-94.6), respectively. Patients with a new diagnosis of oropharynx cancer were more likely to have a corresponding CT abnormality than those with normal examination findings (6 of 18 [33%] vs 24 of 295 [8.1%]). Patients with concerning lesions on oropharynx palpation by an otolaryngology health care professional were significantly more likely to be diagnosed with oropharynx cancer compared with patients with normal examination findings (odds ratio, 28.4; 95% CI, 6.6-145.8).Conclusions and RelevanceIn this cohort study, while incidental asymmetric oropharynx PET uptake was common, a new diagnosis of oropharynx cancer was not and potentially results in a large volume of unnecessary referrals and work-up. Using SUVmax ratio, SUVmax difference, and CT correlation may increase the benefit of referral. Patients with a palpable oropharynx lesion and asymmetric oropharynx PET uptake should undergo confirmatory biopsy.

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Oral manifestations of lymphoma: a systematic review

Cited by 95 publications

References 84 publications

Diffuse Swelling of Salivary and Lacrimal Glands as a First and only Manifestation of Non-Hodgkin B-Cell Lymphoma: A Case Report

Diffuse Swelling of Salivary and Lacrimal Glands as a First and only Manifestation of Non-Hodgkin B-Cell Lymphoma: A Case Report

Follicular Lymphomas of Oral Region Treated by Rituximab Monotherapy: About Two Cases

Cancer in Patients With Incidental Asymmetric Oropharynx Positron Emission Tomography Uptake

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