Primary diffuse large B-cell lymphoma of the mandible

Siqueira, Juliana Mota; Fernandes, Patrícia Maria; Oliveira, Andrea Cruz Ferraz de; Vassallo, José; Alves, Fábio de Abreu; Jaguar, Graziella Chagas

doi:10.4322/acr.2019.109

Cited by 7 publications

(8 citation statements)

References 15 publications

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“…In the oral cavity, lymphomas can appear anywhere in the mouth but they predominate on the hard palate, gingiva, and tongue. The mandible is an infrequent localization of primary osseous NHL [9].…”

Section: Discussionmentioning

confidence: 99%

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Diffuse large B-cell lymphoma in the mandible mimicking post-extraction complication Presentation and a 5-year follow-up of a rare case report

Chaabani

Sioud

Kammoun

et al. 2022

Preprint

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Non-Hodgkin lymphomas (NHLs) are a heterogeneous group of malignancies originating from the lymphoid tissues, which can be differentiated by distinct epidemiology, etiology, and clinical characteristics. They can occur in the lymph nodes or as extranodal lesions. The vast majority of extranodal oral NHLs are classified as diffuse large B-cell lymphomas (DLBCL). They are usually found in the maxilla and they rarely occur in the mandible. The aim of this paper was to report a case of NHL with mandibular location by detailing its different clinical, radiological, and histopathological aspects. Herein, we report a case of NHL in the under chin region of the mandible in a 66-year-old male patient. The first diagnosis was post-extraction complication with delayed bone healing. The clinical and standard radiological examinations had no pathognomonic features. However, left labio-chin hypoesthesia and CT examination revealed a malignancy of the lesion without any precision. After performing further diagnostic examinations, including a subsequent biopsy, diagnosis of diffuse large B-cell lymphoma (DLBCL) was made. The patient was therefore treated with chemotherapy and he showed a satisfactory outcome for more than 5 years. Intraoral lymphomas may mimic odontogenic lesions; hence it is important for the dentist to be aware of the various manifestations of NHL to avoid delay and inappropriate treatment strategies.

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Section: Discussionmentioning

confidence: 99%

“…DLBCL is a heterogeneous entity having varied clinical features, morphology, immunohistochemistry, and prognosis. These differences should be carefully analyzed in order to ensure successful management [9].…”

Section: Discussionmentioning

confidence: 99%

Diffuse large B-cell lymphoma in the mandible mimicking post-extraction complication Presentation and a 5-year follow-up of a rare case report

Chaabani

Sioud

Kammoun

et al. 2022

Preprint

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“…DLBCL is the most common type of NHL, accounting for 40% of all cases. It is a type of cancer involving distinct clinical, morphological, immunohistochemical features and prognosis ( 7 ). Primary bone NHL involving the mandible is often characterized by swelling, pain, abnormal sensation, loose teeth, and pathological fracture.…”

Section: Discussionmentioning

confidence: 99%

“…NHL is primarily a disease of the lymph nodes, but it can also involve organs outside the lymphoid system such as the stomach, skin, lung, central nervous system, and oral cavity ( 6 ). Primary bone NHL involving the mandible, an uncommon oral cavity NHL, accounts for 0.6% of extranodal lymphomas ( 7 ). The clinical manifestations of Primary bone NHL involving the mandible are toothache, swelling, tooth loosening and pathological fracture.…”

Section: Introductionmentioning

confidence: 99%

“…The clinical manifestations of Primary bone NHL involving the mandible are toothache, swelling, tooth loosening and pathological fracture. In early stage, it is often misdiagnosed as dental pulp disease, causing a delay in the diagnosis and treatment ( 7 ). Most Primary bone NHL involving the mandible are diffuse large B-cell lymphoma (DLBCL), which develops rapidly and has poor prognosis ( 8 ).…”

Section: Introductionmentioning

confidence: 99%

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Diffuse Large B-Cell Lymphoma of the Mandible Diagnosed by Metagenomic Sequencing: A Case Report

et al. 2021

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Introduction: Non-Hodgkin lymphoma (NHL) has a much higher incidence rate than Hodgkin lymphoma. Approximately 40% NHL occurs in extranodal tissues or organs, and its clinical manifestations are often nonspecific. Primary bone NHL involving the mandible is an uncommon NHL that is characterized by fever, gum swelling and toothache. Therefore, it is often misdiagnosed as oral diseases.Case Presentation: A 52-year-old female had recurrent fever for more than 1 month, with numbness in her left jaw and toothache. PET/CT showed an uptake area in the left mandible, suggesting microbial infections. However, antibacterial, and antiviral treatment were ineffective. Furthermore, metagenomic sequencing of plasma reported no pathogens, but instead showed significant copy number variations of multiple chromosomes, which highly suggested the existence of tumor. Finally, diffuse large B-cell lymphoma (DLBCL) was diagnosed by mandibular biopsy, and the patient was transferred to Hematology department for chemotherapy.Conclusion: mNGS not only assists rapid etiological diagnosis, but also helps rule out infection and diagnose malignant neoplasm.

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Improved outcomes of localized diffuse large B‐cell lymphoma at the Waldeyer ring in comparison to the sinonasal area in the rituximab era

Ma,

Hong,

Lou

et al. 2023

Cancer Medicine

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BackgroundDiffuse large B‐cell lymphoma (DLBCL) of the head‐and‐neck area primarily involves the Waldeyer ring (WR) and sinonasal area (SN). However, the differential clinical outcomes between patients with WR‐DLBCL and those with SN‐DLBCL in the rituximab era remain unclear.MethodsTo avoid confounding factors contributed by advanced DLBCL with WR and SN involvement, we assessed the clinical outcomes of patients with stage I/II WR‐DLBCL and SN‐DLBCL and compared them with those having corresponding stages of DLBCL in the lymph nodes but without other extranodal involvement (LN‐DLBCL) in the same period. We compared the patients' clinical characteristics, treatment modalities, event‐free survival (EFS), and overall survival (OS) among the three subgroups.ResultsWe analyzed 67, 15, and 106 patients with WR‐DLBCL, SN‐DLBCL, and LN‐DLBCL, respectively, between January 2000 and December 2019. All patients received front‐line rituximab‐based regimens, and > 80% received rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisolone‐based regimens. More patients with SN‐DLBCL had revised International Prognostic Index (R‐IPI) score 3 (27%) when compared with those with WR‐DLBCL (7%) and those with LN‐DLBCL (10%, p = 0.181). Patients with WR‐DLBCL, LN‐DLBCL, and SN‐DLBCL had 5‐year EFS and OS rates of 80.7%, 59.5%, and 41.9% (p = 0.021) and 83.7%, 70.8%, and 55.8% (p = 0.032), respectively. Compared to patients with LN‐DLBCL, those with WR‐DLBCL also had a significantly favorable 5‐year EFS rate (p = 0.021) and 5‐year OS rate (p = 0.023). Three of the 15 patients with SN‐DLBCL experienced lymphoma recurrence in the brain after front‐line treatment. In multivariate analyses, R‐IPI scores of 1–2 and 3 served as significantly poor prognostic factors for patients with poor EFS and OS.ConclusionsCompared to patients with LN‐DLBCL, patients with WR‐DLBCL receiving front‐line rituximab‐based treatments had favorable clinical outcomes; however, patients with SN‐DLBCL had worse clinical outcomes. Further studies on molecular prognostic factors and treatment strategies for SN‐DLBCL are warranted.

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Primary diffuse large B-cell lymphoma of the mandible

Cited by 7 publications

References 15 publications

Diffuse large B-cell lymphoma in the mandible mimicking post-extraction complication Presentation and a 5-year follow-up of a rare case report

Diffuse large B-cell lymphoma in the mandible mimicking post-extraction complication Presentation and a 5-year follow-up of a rare case report

Diffuse Large B-Cell Lymphoma of the Mandible Diagnosed by Metagenomic Sequencing: A Case Report

Improved outcomes of localized diffuse large B‐cell lymphoma at the Waldeyer ring in comparison to the sinonasal area in the rituximab era

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