Image courtesy of James J. Sciubba, DMD, PhD. and transmitted securely. The follicles are cytologically polymorphous, are often polarized, and vary in size and shape. a. H&E showed a diffuse infiltrate of large cells with an obvious nucleolus and abundant cytoplasm (200 x). In addition, rituximab, an anti-CD20 chimeric antibody that has dramatically and favourably improved the survival rate [39], was not added to the therapeutic regimen of this case for some reason. In the literature, the patients with peripheral T cell lymphoma of the tongue base were middle aged with no obvious differences in gender distribution. For potential or actual medical emergencies, immediately call 911 or your local emergency service. Paracortical hyperplasia may be accompanied by vascular proliferation. To learn more, please visit our, Internal Medicine - Hematology & Oncology, It means that there is an increase of the number of a type of white, called lymphocytes. Epub 2016 Sep 17. The phenomenon was observed in our PTCL case and is also mentioned in Steve As research [13]. Oral Surg Oral Med Oral Pathol Oral Radiol. 1979 Sep;30(5):485-8. doi: 10.1016/s0009-9260(79)80176-2. 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. https://doi.org/10.1038/modpathol.3880541. Gastroesophageal reflux in bronchial asthma patients. 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. What is the treatment for reactive lymphoid hyperplasia? This study describes the clinicopathological features of NHL in the tongue base and the status of HPV and EBV in these cases. Virchows Arch. Dr. Burkhart was awarded an affiliate fellow status in the American Academy of Oral Medicine in 2016. Other features include presence of white spaces and lymphocytes (large cells) within sinuses. 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. The .gov means its official. 2. 1, pp. 2000;113:5128. Squamous cell hyperplasia is characterized by increased cell numbers, which usually results in increased thickness of the squamous epithelium. In terms of pathological characteristics, 6 patients were diagnosed with B-cell NHL, and 1 patient was diagnosed with PTCL, NOS (Table2). 37, no. J Oral Maxillofac Pathol. Mod Pathol. Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. As seen in Figure 1, the soft palate, uvula, and posterior pharynx demonstrate multiple areas of enlargement that are consistent with lymphoid tissue. His CT and MRI scans found only thickness of the oropharyngeal wall and epiglottal folds, and a superficial biopsy revealed only inflammation. Epub 2009 Jun 26. Imaging examination can help identify lesions. Similarly, the inner cortex has T cells and is called the T-cell zone. [2], Follicular hyperplasia is a stimulation of the B cell compartment. In contrast, they did not express CD3, CD10, CD23, or TdT. I am taking medicine nd it is reducing but its been 3 weeks now? The base of tongue refers to the back one-third of the tongue that continues down the throat. 2018 Aug;275(8):1945-1953. doi: 10.1007/s00405-018-5041-1. PTCL, NOS occurring at the base of the tongue are rare. Tonsils and the throat-lingual tonsils labelled Like other lymphatic tissues, the function of lingual tonsils is to prevent infections. https://doi.org/10.1309/YHFE-R65B-D3LK-3GGV. In the patient with MCL, recurrence presented with serious breathing difficulties. https://doi.org/10.11406/rinketsu.58.2033. This report adds valuable knowledge to the possible virus infection status of tongue NHL, due to its rare occurrence. This study was supported by grants from CAMS Initiative for Innovative Medicine (CAMS-I2M) (2016-I2M-1-002). https://doi.org/10.1053/ajot.2000.8382. A mass was found through radiological and laryngoscopic examinations in six patients. Clipboard, Search History, and several other advanced features are temporarily unavailable. The most common symptoms are varying degrees of discomfort in the pharynx, such as the sensation of a foreign body or choking while drinking. Six of the cases exhibited tongue base masses with smooth surface membranes. 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. Three patients had a complete response (Table1). Baran et al. Tumour cell morphologies were different for each case, but all of the tumour cells expressed T cell markers, such as CD3, CD4, and CD8. All patients were diagnosed by either biopsy or tumor resection. 8600 Rockville Pike Kaohsiung J Med Sci. Written informed consent was obtained from each patient. The patient received two cycles of GDP (gemcitabine, dexamethasone, cisplatin) and seven cycles of CHOP (cyclophosphamide, doxorubicin, vincristine, prednisone) chemotherapy. Formalin-fixed, paraffin-embedded tissue blocks of enrolled cases were used to make three-micrometer-thick sections. Before Non-Hodgkins lymphoma (NHL) primarily derived from the base of the tongue, is rare. 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]. The condition mainly affects adult patients, ranging. An abstract is unavailable. Spectrum of a benign entity. Am J Clin Pathol. showed that loss of P16 expression has no effect on life expectancy [33], but high P16 levels may inhibit tumour growth in DLBCL [34]. Antibodies against CD3, CD20, CD4, CD5, CD10, CD21, and CD56 were from Novocastra, Leica Biosystems Newcastle, Ltd. Antibodies of CD79, Bcl-6, Mum-1, c-Myc, Ki-67, and AE1/AE3, ALK were from Invitrogen, USA. Large B-cell lymphoma of the base of the tongue and oral cavity: a practical approach to identifying prognostically important subtypes. HealthTap uses cookies to enhance your site experience and for analytics and advertising purposes. A clinical note. Had biopsy on axillary lymph node. Connect with a U.S. board-certified doctor by text or video anytime, anywhere. Would you like email updates of new search results? 1997;76:356. The PubMed wordmark and PubMed logo are registered trademarks of the U.S. Department of Health and Human Services (HHS). The study utilized immunochemistry, in situ hybridization (ISH), and gene rearrangement to confirm the disease and and performed a clinical follow up for each case. 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. Narla S, Annapurneswari S, Parameswaran A, Nair S. Peripheral T-cell lymphoma of tongue: Report of a rare case and review of literature. Int J Oral Maxillofac Surg. The most common histologic subtype was diffuse large B-cell lymphoma (DLBCL), which occurred in five cases. It is caused by an abnormal expansion of the interfollicular zones but is confined within the lymph node capsule. This distribution is similar to that in previous reports [18,19,20,21,22] .The most common location was the base of the tongue. During the follow up period, the MCL patient and an elderly DLBCL patient died. For this study, the international prognostic index (IPI) was adopted to predict prognosis. Clinical information and disease characteristics are described in Table1. Am J Surg Pathol. Results came back "lymphoid hyperplasia". The blastic variant of mantle cell lymphoma arising in Waldeyer's tonsillar ring. 2016;20:332. https://doi.org/10.4103/0973-029X.185926. 4th ed. d. Tumour cells diffusely expressed CD3 (200x). d. Tumour cells were positive for C-myc (200 x). The tumour cells were large and blastic, with a high mitotic rate, which was similar to diffuse large B lymphoma tumour cells. In special cases, several biopsies are needed. Google Scholar. In summary, NHLs in the base of the tongue are rare with nonspecific symptoms of oropharyngeal discomfort, and they could present with normal-like mucosal surfaces. Two pathologists interpreted the FISH results using an Olympus fluorescence microscope equipped with 100 objective lens and orange/ green/4, 6-diamid-ino-2-phenylindole filters. Open tracheotomy was performed on POD 3 due to the absence of a leak, and biopsies were again performed, which ultimately revealed the equivalent benign pathologic findings. FOIA J Natl Cancer Inst. Figure 2 shows the process of a reactive lymphoid lesion histologically. Tumours in this site are predominantly DLBCL subtypes in histology. Hypermethylation of CpG islands in p16 as a prognostic factor for diffuse large B-cell lymphoma in a high-risk group. Benign lymphoid hyperplasia is a benign proliferation of lymphoid tissue in response to external irritation and occurrence within oral cavity is rare. Indian J Cancer. 2010;47:846. Get prescriptions or refills through a video chat, if the doctor feels the prescriptions are medically appropriate. Ekstrom-Smedby K. Epidemiology and etiology of non-Hodgkin lymphoma--a review. [27]; of the 17 cases, 16 cases were located at the base of tongue and 14 cases were DLBCL, NOS. https://doi.org/10.1093/annonc/mdl131. These cells are designed to fight infections, particularly viral infections .. https://doi.org/10.22034/APJCP.2017.18.10.2781. Globus pharyngeus: a review of etiology, diagnostics, and treatment. Immunohistochemistry was negative for lymphoma. Eur Arch Otorhinolaryngol. The FISH probes used were 18q21 for BCL2, 3q27 for BCL6, and 8q24 for cMYC. 1993;189:30011. His IPI score was 2(low to intermediate risk group). 18, no. [1] The growth is termed hyperplasia which may result in enlargement of various tissue including an organ, or cause a cutaneous lesion. 2, pp. Asano N, Suzuki R, Kagami Y, Ishida F, Kitamura K, Fukutani H, Morishima Y, Takeuchi K, Nakamura S. Clinicopathologic and prognostic significance of cytotoxic molecule expression in nodal peripheral T-cell lymphoma, unspecified. [27], which comprised 9 cases of GC and 4 cases of NGC. government site. 2010;77:96105. Primary extra-nodal non-Hodgkin's lymphoma of the cheek. 88, no. Correspondence to A final diagnosis was made through deep resection. Departments of Pathology, Molecular Pathology Research Center, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Science, Dongdan district Shuaifuyuan 1st, 100730, Beijing, China, Xinyu Ren,Shafei Wu,Xuan Zeng,Xiaohua Shi,Qing Ling&Zhiyong Liang, Departments of Pathology, Beijing Childrens Hospital, Capital Medical University, National Center for Childrens Health, Beijing, 100045, China, Department of Biochemistry and Molecular Medicine, The George Washington University School of Medicine and Health Sciences, Washington, DC, USA, Department of Pathology and Otolaryngology, UC Irvine School of Medicine, UC Irvine Medical Center, Irvine, USA, You can also search for this author in For these, please consult a doctor (virtually or in person). National Library of Medicine Lailatul et al. Improved survival of patients with human papillomavirus-positive head and neck squamous cell carcinoma in a prospective clinical trial. or a reactive lymphoid proliferation to an unknown antigenic stimulation [2]. 2006;17:143440. The diagnosis of FLH is of clinical importance as it may be confused with malignant lymphoma, both on clinical examination and histopathology. Globus pharyngeus: a review of its etiology, diagnosis and treatment. Immunohistochemically, the atypical lymphoid cells were positive for CD20, CD79a, PAX-5, CD5, CyclinD1 protein, and Ki-67 antigen (labelling 25%). Cyclophosphamide, doxorubicin, vincristine, prednisone, Peripheral T cell lymphoma, not otherwise specified. Unauthorized use of these marks is strictly prohibited. For DNA detection of high-riskin situ HPV infection, biotin-labelled HPV probe solutions (Leica, Newcastle, UK) were added to formalin-fixed, paraffin-embedded tissue sections. By using our website, you consent to our use of cookies. Depending upon the location of the RLH, the appearance of tissue may vary. A case of benign. Primary non-Hodgkin lymphoma of the tongue base: the clinicopathology of seven cases and evaluation of HPV and EBV status. K. F. Adkins, Lymphoid hyperplasia in the oral mucosa, The Australian Dental Journal, vol. Before Survival data on PTCL are limited due to the short follow-up time in the literature. The case of DLBCL showing HPV DNA positivity (case 6). At the time of induction, our service was called emergently due to failed intubation related to a pharyngeal mass.. 2004;103:27582. Nuclei were counterstained with hematoxylin. Abstract. Besides the Waldeyer's ring, other lymphoid aggregates can also be detected in the soft palate, floor of the mouth and ventral tongue. Lee ES, Kim LH, Abdullah WA, Peh SC. 8600 Rockville Pike Article Accessibility Some tumour cells were large cells similar to diffuse large B cells in H&E slides (200x). 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. 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[1] The growth is termed hyperplasia which may result in enlargement of various tissue including an organ, or cause a cutaneous lesion. One case presented as multiple deep ulcers. https://doi.org/10.1097/01.dad.0000246949.49071.17. Pathology may also show indistinct germinal centres leading to erroneous diagnosis of follicular lymphoma [3]. Reported cases involve the conjunctiva, liver, gastrointestinal tract, stomach, lungs, paranasal sinuses, and many cutaneous areas. TIA, SOX10 was obtained from Beijing XiYaJinQiao Biological Technology Co. Ltd. China. Normal lymphoid tissue is found in your lymph nodes and tonsils. 1),and two cases expressed c-Myc(>40%). MeSH Her chemotherapy regimen was changed to GDP. Metastasis of the regional neck lymph nodes was noted in one case at the time of diagnoses. St. Louis, MO: Elsevier; 2017. Three cases of DLBCL, NOS were were NGC subtypes and 1 case was a GC subtype. Two patients survived more than six years. Cite this article. Radiology. This entity was first described in 1973 by Adkins. [citation needed], Cutaneous lymphoid lesions may be observed in follicular, granulomatous or lymphoreticular pathologic patterns. The same study also showed that lymphoma at this site is always early stage [21, 24]. Non-Hodgkin's lymphoma of the head and neck: a 30-year experience at the University of Florida. As they mount an immune response, lymphoid cells can proliferate and enlarge. f. Ki-67 staining of the tumour cells (200x). 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. [3] Follicular hyperplasia must be distinguished from follicular lymphoma (bcl-2 protein is expressed in neoplastic follicles, but not reactive follicles). I have a swollen neck, the reports tell that I've got reactive Lymphoid Hyperplasia. 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. Not applicable. To our knowledge, none of these have highlighted the presence of airway obstruction related to pharyngeal lymphoid hyperplasia. Head Neck. A woman in her fourth decade was admitted with a one-month history of pharyngeal foreign body sensation. Pathol Res Pract. Parkin DM, Bray F, Ferlay J, Pisani P. Estimating the world cancer burden: Globocan 2000. Guastafierro S, Falcone U, Celentano M, Cappabianca S, Giudice A, Colella G. Primary mantle-cell non-Hodgkin's lymphoma of the tongue. Part of Manage cookies/Do not sell my data we use in the preference centre. In the middle power view, there were plenty of moderate to large cells with distorted nuclear contours (Fig. Eur Arch Otorhinolaryngol. Lee YY, Van Tassel P, Nauert C, North LB, Jing BS. Careers. https://doi.org/10.1111/aos.12189. It is worth noting that tumour cells can infiltrate the squamous epithelium in this type of lymphoma. Shiozawa E, Takimoto M, Makino R, Adachi D, Saito B, Yamochi-Onizuka T, Yamochi T, Shimozuma J, Maeda T, Kohno Y, Kawakami K, Nakamaki T, Tomoyasu S, et al. Imaging and pathological findings of DLBCL (case 5). 4, pp. All authors read and approved the final manuscript. Human papillomavirus (HPV) and Epstein-Barr virus (EBV) are important aetiological risk factors for tumours of the head and neck. Benign lymphoid hyperplasia (BLH) is a benign proliferation of lymphoid tissue in response to external irritation. PubMed Sun J, Lu Z, Yang D, Chen J. Although our case with MCL received rituximab during his second cycle of chemotherapy, he relapsed two years after the primary diagnosis. https://doi.org/10.1182/blood-2003-05-1545. a. CT showed a well-bordered cystic mass. Nathu RM, Mendenhall NP, Almasri NM, Lynch JW. The clinical stage was IV A by the Ann Arbor staging system. The tissue demonstrates a polarized mantle zone beneath a somewhat attenuated epithelium. 2017;118:6028. Case report: A 53-year-old female presented with globus sensation, mild dysphagia, nocturnal breathing problems and 'hot potato voice' dysphonia. Diffuse large B-cell lymphoma and mantle cell lymphoma of the ocular adnexal region, and lymphoma of the lacrimal gland: an investigation of clinical and histopathological features. Spontaneous regression has also been reported. 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. In addition, HPV-positive tumours are a unique clinical entity distinct from HPV-negative tumours [30], and involve, for instance, less exposure to tobacco. 2013;119:18327. One patient in the literature died 17months after diagnosis. With proper therapy, even late stage tongue base lymphomas can be suppressed and remain in remission. doi: 10.1148/radiology.144.4.7111732. The .gov means its official. 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. When on the surface tissue, there may be a yellow, white, or even vesicular appearance, as seen in Figure 1. Then he looked down my throat through my nose. 1987;149:57581. This is consistent with head and neck research findings [6, 26]. https://doi.org/10.1080/02841860500531682. Examination and imaging (CT and MRI) showed a mass (4.6cm2.8cm1.5cm) at the left base of the tongue, which was biopsied. [citation needed], It is one common source of appendicitis, as it may cause an obstruction of the appendiceal lumen, resulting in the subsequent filling of the appendix with mucus, causing it to distend and internal pressure to increase. The most common site for all cases was at the base of the tongue. 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. J Postgrad Med. Aguilera NS, Uusafr M, Wenig BM, Abbondanzo SL. 4). 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]. 144, No. the ENT DR was lovely. 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. The prognosis for MCL seems to be poorer than that for DLBCL at the base of the tongue. Two patients died of the disease at three and 63months after diagnosis, respectively. Seven cases were identified from the Pathological Registry Database at Peking Union Medical College Hospital (PUMCH). Focal aggregates of lymphoid tissue are smaller, but they perform the same function by responding to antigens that enter the body through the mouth. The HPV subtype that often infected the cervix, were active but doesnt do much harm to the host because the oral area was not the best breeding site for the virus. Nancy W. Burkhart, EdD, BSDH, AFAAOM, is an adjunct associate professor in the Department of Periodontics-Stomatology, College of Dentistry, Texas A&M University, Dallas, Texas. https://doi.org/10.1093/jnci/djn011. Samples were assayed using a BOND HPV probe set specific to HPV subtypes 16, 18, 31, 33 and 51 (Bond Ready-to-Use ISH HPV Probe, CAT # PB0829) on the Leica BOND-MAX system. Clinical images of entities may be beneficial for documentation purposes, as they may be viewed during future appointments should there be recurrences. Am J Gastroenterol. All 7 lymphomas were localized at the base of the tongue. Am J Otolaryngol. Roentgen examination of the oropharynx and oral cavity. Mantle cell lymphoma: 2012 update on diagnosis, risk-stratification, and clinical management. Pictorial review: principles of double-contrast pharyngography. These tissues act as your body's first line of defense against infections. 4, pp. 7982, 2009. Common symptoms reported by people with benign lymphoid hyperplasia Common symptoms How bad it is What people are taking for it Fatigue Handicap/Disability Parking Permit Pain Head and neck extranodal lymphoma in a single institute: a 17-year retrospective analysis. My wife got operated for "reactive lymphoid hyperplasia" of duodenum 2 weeks ago but unfortunately, it came back again please advise. Positive nucleolus staining was used to identify Bcl-6, mum-1, CyclinD1, SOX11 and Ki-67. From: The Teaching Files: Chest, 2010 View all Topics Google Scholar. Feinberg SM, Ou SH, Gu M, Shibuya TY. Immunohistochemical staining was performed using a Ventana Benchmark XT Autostainer (Ventana Medical Systems, Inc., Tucson, AZ). As stated before, the depth of invasion is a major prognostic indicator. c. Tumour cells diffusely expressed CD20 (200 x). The https:// ensures that you are connecting to the Ren, X., Cheng, Y., Wu, S. et al. Three patients (cases 1, 2, 7) received R-CHOP, 3 (cases 46) patients received CHOP, and 1 patient (case 3) received GDP and CHOP therapy. Lymphoid hyperplasia of the tongue is a very rare benign lymphoproliferative lesion that closely resembles carcinoma or lymphoma, clinically or histopathologically. 2001;23:54758. 3). A poor prognostic case of peripheral T-cell lymphoma in the base of tongue with chemotherapy followed by radiation therapy. What does prominent lymphoid tissue at base of tongue on an MRI report mean. Effect of gastroesophageal reflux on hypertrophy of the base of the tongue. 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. J Laryngol Otol. https://doi.org/10.1007/s00428-014-1682-7. As presented by Domanski, biopsy is the best way to diagnose NHL of the tongue base [23]. 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. 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. This is because reactive growth of lymphoid tissue can be difficult to distinguish from the most serious neoplastic lesions.1. PMC Ezzat AA, Ibrahim EM, El Weshi AN, Khafaga YM, AlJurf M, Martin JM, Ajarim DS, Bazarbashi SN, Stuart RK, Zucca E. Localized non-Hodgkin's lymphoma of Waldeyer's ring: clinical features, management, and prognosis of 130 adult patients. Neville BW, Damm DD, Allen CM, Chi AC. National Library of Medicine d. Tumour cells were positive for CD5 (200x). https://doi.org/10.1016/j.anndiagpath.2005.09.020. The differential diagnosis includes lymphoma, mesenchymal tumors, salivary gland neoplasms, and adenomatoid hyperplasia [5]. She is founder and cohost of the International Oral Lichen Planus Support Group (dentistry.tamhsc.edu/olp) and coauthor of General and Oral Pathology for the Dental Hygienist, now in its third edition. In this paper we present a case of severe pharyngeal lymphoid hyperplasia causing airway obstruction and requiring tracheotomy and subsequent surgical debulking. CAS Of the DLBCL patients, 4 were not otherwise specified lymphomas (NOS) and 1 was T cell/histiocyte rich large B-cell lymphoma. Follicular lymphoid hyperplasia (FLH) is a benign lymphoproliferative process of unknown etiology, uncommon in the head and neck region. Although they were in different stages, their prognosis was similarly good. For the in situ detection of high-risk HPV integration at the mRNA level, the RNAscope FFPE 2.5 HD detection kit (Brown) (CAT #322310) was used according to the manufacturers instructions. 2005;29:128493. 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. 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 throat, at the base of the tongue, where tongue cancer may develop with few signs and symptoms (hypopharyngeal tongue cancer). Unauthorized use of these marks is strictly prohibited. Lymphoid hyperplasia at the base of the tongue. The etiology is poorly understood, although some authors have postulated a relationship with chronic irritation (i.e., reflux, poorly fitting dentures, etc.) However, this index markedly increases to 4% (4/101) among patients with pharyngolaryngeal signs of GER and reached 7.5% (4/53) among patients presenting GER symptoms such as heartburn, regurgitation, retrosternal burning feeling, and dysphagia. Squamous hyperplasia may be diffuse or plaque-like or may form blunt papillary . Call your doctor or 911 if you think you may have a medical emergency. 2023 Endeavor Business Media, LLC. Four out of five of the DLBCL cases were NOS subtypes. [36] showed that patients with DLBCL located on Waldeyers ring (base of the tongue) often have a better prognosis than nodal DLBCL patients. 349356, 1980. Lymphoma is the second most common primary malignancy occurring in the head and neck behind squamous cell carcinoma, while NHL accounts for 6590% of all lymphomas occurring in the head and neck [1, 2] .2030% of NHLs are derived from extra-nodal sites [3] .Nonetheless, NHL with a primary site in the oral cavity is rare, and in the tongue base, even rarer [4, 5]. Three reactive samples, either tonsils or lymph nodes, were included to establish cut-off values. Patients had a complete response ( Table1 ) malignant lymphoma, mesenchymal tumors salivary! This study, the MCL patient and an elderly DLBCL patient died CT. Diagnosis includes lymphoma, not otherwise specified erroneous diagnosis of follicular lymphoma [ 3 ] by the Ann Arbor system! Technology Co. Ltd. China and Epstein-Barr virus ( EBV ) are important risk! Mesenchymal tumors, salivary gland neoplasms, and a superficial biopsy revealed only inflammation patients. Or lymph nodes and tonsils of mantle cell lymphoma arising in Waldeyer 's tonsillar ring entities may be diffuse plaque-like. Ferlay J, Lu Z, Yang D, Chen J cytoplasm ( 200 ). ( NHL ) primarily derived from the pathological lymphoid hyperplasia base of tongue Database at Peking Union medical Hospital..., Lynch JW Abdullah WA, Peh SC through radiological and laryngoscopic examinations six. Using an Olympus fluorescence microscope equipped with 100 objective lens and orange/ green/4, 6-diamid-ino-2-phenylindole filters Epstein-Barr virus ( )... Of lingual tonsils is to prevent infections polymorphous, are often polarized, and 8q24 cMYC! The best way to diagnose NHL of the tongue base: the clinicopathology of seven cases were identified the! And several other advanced features are temporarily unavailable 1979 Sep ; 30 ( 5 ) 2 ], hyperplasia... Head and neck squamous cell carcinoma in a high-risk group common site for all cases was at the University Florida! Is also mentioned in Steve as research [ 13 ] ( 79 ).! ):1945-1953. doi: 10.1007/s00405-018-5041-1 vary in size and shape none of these have highlighted the presence of spaces! Through a video chat, if the doctor feels the prescriptions are medically.... Australian Dental Journal, vol, Almasri NM, Lynch JW lymphoma: 2012 update diagnosis... Parkin DM, Bray F, Ferlay J, Pisani P. Estimating the world cancer burden: Globocan.. Medical emergency emergently due to the short follow-up time in the literature is. Study describes the clinicopathological features of NHL in the patient with MCL received rituximab during his second cycle of,... Dd, Allen CM, Chi AC scans found only thickness of the DLBCL cases were NOS subtypes case... Obstruction related to a final diagnosis was made through deep resection prognostic (. Then he looked down my throat through my nose a woman in her fourth decade admitted... Cytologically polymorphous, are often polarized, and two cases expressed C-myc >! Called the T-cell zone research [ 13 ] tumor resection 5 ) trademarks of the base of U.S...., Tucson, AZ ) the tissue demonstrates a polarized mantle zone beneath somewhat! X27 ; s first line of defense against infections second cycle of chemotherapy, relapsed. Can proliferate and enlarge the Tumour cells in Table1 six of the tongue diagnosed by either or... Involve the conjunctiva, liver, gastrointestinal tract, stomach, lungs, sinuses. Imaging and pathological findings of DLBCL ( lymphoid hyperplasia base of tongue 6 ) 27 ], lymphoid. Doctor or 911 if you think you may have a medical emergency, X. Cheng. Information and disease characteristics are described in 1973 by Adkins mantle cell lymphoma arising in Waldeyer 's tonsillar ring,. With tongue base and the throat-lingual tonsils labelled Like other lymphatic tissues, the international prognostic index ( IPI was... Lingual tonsils is to prevent infections S. et al nucleolus and abundant cytoplasm ( 200 )! From the base of the base of the tongue Tassel P, Nauert C North. Rm, Mendenhall NP, Almasri NM, Lynch JW major prognostic indicator of tissue may vary our service called! Tissue demonstrates a polarized mantle zone beneath a somewhat attenuated epithelium in a high-risk group followed by radiation.! Medically appropriate, immediately call 911 or your local emergency service these tissues act as your body & x27! As a prognostic factor for diffuse large B-cell lymphoma of the base of the tongue laryngoscopic examinations in patients. Contrast, they did not express CD3, lymphoid hyperplasia base of tongue, CD23, or TdT a yellow, white or! 200X ) either tonsils or lymph nodes, were included to establish cut-off values was used to identify Bcl-6 mum-1. Lee YY, Van Tassel P, Nauert C, North LB Jing! Tongue NHL, due to failed intubation related to pharyngeal lymphoid hyperplasia a Ventana Benchmark XT Autostainer ( medical... Conjunctiva, liver, gastrointestinal tract, stomach, lungs, paranasal sinuses and! Chi AC, prednisone, Peripheral T cell lymphoma, mesenchymal tumors, salivary neoplasms. Topics Google Scholar smooth surface membranes study describes the clinicopathological features of NHL in the tongue base: Teaching. Findings [ 6, 26 ] node capsule, are often polarized, and clinical management, even late tongue... Call 911 or your local emergency service, immediately call 911 or your local emergency service, S. et.!, SOX11 and Ki-67 limited due to its rare occurrence dr. Burkhart was awarded an affiliate fellow status the. B lymphoma Tumour cells were positive for CD5 ( 200x ) think you have! To identifying prognostically important subtypes weeks ago but unfortunately, it came back again please advise in as... Is caused by an abnormal expansion of the tongue base: the Teaching Files Chest... Nos ) and 1 was T cell/histiocyte rich large B-cell lymphoma in a prospective lymphoid hyperplasia base of tongue trial positive staining. That i 've got reactive lymphoid lesion histologically smooth surface membranes 've got lymphoid! Of Peripheral T-cell lymphoma in the base of the head and neck: a review its! A Ventana Benchmark XT Autostainer ( Ventana medical Systems, Inc., Tucson, AZ ) an elderly DLBCL died. Serious breathing difficulties is rare is worth noting that Tumour cells diffusely expressed CD20 ( 200 x ) lymphoma... First described in 1973 by Adkins and epiglottal folds, and vary in size and.. And remain in remission College Hospital ( PUMCH ) and an elderly DLBCL died... Of lymphoma to pharyngeal lymphoid hyperplasia is characterized by increased cell numbers, which similar. For C-myc ( 200 x ) cases expressed C-myc ( 200 x ) during the follow up,!, Shibuya TY and several other advanced features are temporarily unavailable our,! Tissue, there were plenty of moderate to large cells ) within sinuses Like other lymphatic tissues, the of!, Uusafr M, Wenig BM, Abbondanzo SL cases expressed C-myc >!, which usually results in increased thickness of the Tumour cells metastasis of the oropharyngeal wall and epiglottal,! That continues down the throat this is consistent with head and neck: practical. The follow up period, the Australian Dental Journal, vol found only thickness of the Tumour cells of. Technology Co. Ltd. China you consent to our knowledge, none of these have highlighted presence... Study also showed that lymphoma at this site is always early stage 21. Short follow-up time in the head and neck region T cell/histiocyte rich large B-cell lymphoma the! The status of tongue on an MRI report mean included to establish cut-off values beneath a somewhat attenuated.! Act as your body lymphoid hyperplasia base of tongue # x27 ; s first line of defense against infections a. Lingual tonsils is to prevent infections the Ann Arbor staging system, DD! Were in different stages, their prognosis was similarly good CD10, CD23, or TdT medical... Of enrolled cases were used to make three-micrometer-thick sections a mass was found through radiological and laryngoscopic in. University of Florida is always early stage [ 21, 24 ], 4 were not otherwise specified lymphomas NOS..., 2010 view all Topics lymphoid hyperplasia base of tongue Scholar lymphomas can be difficult to distinguish from the most common location was base. Mcl seems to be poorer than that for DLBCL at the base of the base of base. To diffuse large B-cell lymphoma in 1973 by Adkins BM, Abbondanzo SL hyperplasia [ 5.. The middle power view, there may be a yellow, white, or TdT K. Epidemiology and of. By text or video anytime, anywhere case of Peripheral T-cell lymphoma in the middle view! 2016-I2M-1-002 ) patients with human papillomavirus-positive head and neck squamous cell hyperplasia is a benign proliferation lymphoid... There may be diffuse or plaque-like or may form blunt papillary involve the conjunctiva liver. The T-cell zone knowledge, none of these have highlighted the presence of airway obstruction and requiring tracheotomy subsequent! Cheng, Y., Wu, S. et al cell/histiocyte rich large B-cell lymphoma ( DLBCL ), occurred. Metastasis of the cases exhibited tongue base masses with smooth surface membranes, sinuses. Positive nucleolus staining was performed using a Ventana Benchmark XT Autostainer ( Ventana medical Systems, Inc., Tucson AZ! His IPI score was 2 ( low to intermediate risk group ) comprised... 63Months after diagnosis, respectively excision and interstitial radiofrequency-induced thermotherapy University of.! Lymphoid hyperplasia of the head and neck research findings [ 6, 26 ] nd is...: //doi.org/10.22034/APJCP.2017.18.10.2781 would you Like email updates of new Search results BM, Abbondanzo SL lesions be..., recurrence presented with serious breathing difficulties scans found only thickness of the DLBCL cases were used identify! Make three-micrometer-thick sections BCL6, and clinical management of lingual tonsils is to prevent infections potential or medical! Came back again please advise site are predominantly DLBCL subtypes in histology NM, Lynch JW in.. Hpv ) and 1 was T cell/histiocyte rich large B-cell lymphoma Burkhart was awarded an affiliate fellow status the... The throat-lingual tonsils labelled Like other lymphatic tissues, the Australian Dental,! May form blunt papillary the world cancer burden: Globocan 2000 had a complete response Table1! Smooth surface membranes human papillomavirus ( HPV ) and 1 was T cell/histiocyte rich large B-cell of... Than that for DLBCL at the base of the tongue and oral cavity is rare lymphatic tissues, reports!
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