Primary oral mucosa-associated lymphoid tissue (MALT) lymphoma in patient with monoclonale gammopathy: a rare case report

Abstract

Background Monoclonal gammopathy is a biological reality encountered in approximately 1% of the general population. In the absence of clinical and biological signs, it is considered of undetermined significance; however, it can be a biological signature of a monoclonal lymphocytic or plasma-cell proliferation. Their localisation to the oral mucosa remains rare and difficult to diagnose, particularly in indolent forms that escape imaging techniques. Case presentation Here, we report the case of a 73-year-old woman with a history of IgM kappa gammopathy followed for 13 years. The patient did not have a chronic infection or an autoimmune disease, and all the biological investigations and radiological explorations were unremarkable during this period. The discovery of a submucosal nodule in the cheek led to the diagnosis of MALT lymphoma and regression of half of the IgM kappa level after resection. The review of the literature shows the dominance of clinical signs (i.e., a mass or swelling) in the diagnosis of primary MALT lymphomas of the oral cavity after surgical resection. Conclusions Our case illustrates the role of examination of the oral cavity in the context of a monoclonal gammopathy. The absence of clinical and radiological evidence in favor of lymphoplasmacytic proliferation, does not exclude a primary indolent MALT lymphoma of the oral mucosa.

Coexistence of primary mediastinal MALT lymphoma and multiple myeloma like POEMS syndrome: A case report and literature review

“…The cumulative probability of MGUS progression to MM or related disorders was 10% and 25% at 10 years and 20 years, respectively. [ 19 ] Another report showed that MGUS was present for 13 years at the time of diagnosis of MALT lymphoma, [ 20 ] despite MGUS did not transform into MM.…”

Follicular lymphoma manifests as multiple erosive and proliferative lesions of the oral mucosa: case report and brief literature review

“…According to a study by Barone S et al, the most commonly involved sites are in the soft tissues of oral cavity, with an incidence rate presenting as 38.4%, 19.2%, and 11.5% for buccal mucosa, tongue and gingiva [ 44 ]. As for the clinical appearance, lymphoma occurring in the gingiva, buccal mucosa, and palate usually manifests as ulceration (Table 2 ) [ 39 , 45 – 56 ], while that of FL has been discussed above, and masses or nodular lesions may be observed or palpated under the mucosa of the palate, buccal, and tongue [ 39 , 45 , 50 , 51 , 57 – 60 ]. Swelling of the lip, palate, gingiva, or buccal mucosa may serve as alternative oral signs of lymphoma [ 61 – 64 ].…”