Cytoplasmic staining was used for ALK, TIA, AE1/AE3. Zhiyong Liang or Beverly Wang. Two patients, including our patient, died during follow-up. PET-CT/CT/MRI scans of the cancerous areas were reviewed to assess the extension of the lesions, including to the bone and thorax. b. Tumour cells diffusely expressed CD20 (200 x). None of the seven patients presented systemic symptoms (body weight loss, fever and night sweating). [2], Follicular hyperplasia is a stimulation of the B cell compartment. Bratisl Lek Listy. b. H&E showed moderate to large cells with distorted nuclear contours (200 x). The most common histologic subtype was diffuse large B-cell lymphoma (DLBCL), which occurred in five cases. XS and QL did the HPV ISH. J Natl Cancer Inst. When the lymphoid tissue is deeply seated, the appearance may be more pink or deeper in color. 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. The clinical stage was IV A by the Ann Arbor staging system. We not only report on the general clinicopathological features, including age, gender, tumour location, histological subtypes, grading and staging, but also provide important information related to prognosis and treatment. https://doi.org/10.1007/s12185-008-0142-z. Of the DLBCL patients, 4 were not otherwise specified lymphomas (NOS) and 1 was T cell/histiocyte rich large B-cell lymphoma. Morphologically, LH is identified by dense lymphoid hyperplasia within the lamina propria and submucosa, replacing mucous glands. Aguilera NS, Uusafr M, Wenig BM, Abbondanzo SL. It tends to present as a unilateral, painless, slow-growing, nonulcerated mass. This report adds valuable knowledge to the possible virus infection status of tongue NHL, due to its rare occurrence. Educational text answers on HealthTap are not intended for individual diagnosis, treatment or prescription. 1970 Dec;8(3):413-24. Chemotherapy containing rituximab was considered to significantly improve survival in DLBCL and MCL patients [39, 43]. In addition, patients may notice irregularities on their own, thereby bringing the appearance to the attention of their dentists or hygienists. Lee JH, Lee SH. Would you like email updates of new search results? Xinyu Ren and Yin Cheng contributed equally to this work. 2. Except in one case, all patients exhibited a tongue base mass with smooth and intact membrane surface. The data used and/or analysed during the current study are available from the corresponding author on reasonable request. One case was P53 positive (Fig. The prognosis for MCL seems to be poorer than that for DLBCL at the base of the tongue. Guastafierro S, Falcone U, Celentano M, Cappabianca S, Giudice A, Colella G. Primary mantle-cell non-Hodgkin's lymphoma of the tongue. Head Neck. Reference Sands and Tewfik 1 The aetiology is poorly understood, . The clinical stage was IV A. PMC Federal government websites often end in .gov or .mil. Carcinomas of the base of the tongue: diagnosis using double-contrast radiography of the pharynx. 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. Our attention is especially drawn to areas where increased gingival growth is uncommon, such as the soft palate, uvula, and posterior oropharynx. Ann Diagn Pathol. Similarly, the inner cortex has T cells and is called the T-cell zone. Seven cases were identified from the Pathological Registry Database at Peking Union Medical College Hospital (PUMCH). Unauthorized use of these marks is strictly prohibited. It has been historically referred to as reactive lymphoid hyperplasia or pseudolymphoma [1]. It is caused by an abnormal proliferation of secondary follicles and occurs principally in the cortex without broaching the lymph node capsule. The tongue has a rich network of lymphatics that drain to neck levels I-III, which is the usual pattern of spread when these tumors metastasize. Three patients were at an early stage (stage I and II) and had low IPI scores (0 or 1). Reported cases involve the conjunctiva, liver, gastrointestinal tract, stomach, lungs, paranasal sinuses, and many cutaneous areas. This is consistent with the findings from 17 DLBCL cases reported by Owosho AA et al. Case report: A 53-year-old female presented with globus sensation, mild dysphagia, nocturnal breathing problems and 'hot potato voice' dysphonia. Radiology. The exceptional case here was a 45-year-old male patient with diffuse large B cell lymphoma who presented with only deep painful mouth ulcers and general symptoms, including sore throat, choking when drinking water, and difficulty swallowing. An abstract is unavailable. Co. Ltd., China. 1997;76:356. 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]. Patients first experienced from varying degrees of throat discomfort and commit to the hospital with no B symptoms. Clinically this lesion presented as a painless ulcer, which mimicked carcinoma of the tongue. All authors read and approved the final manuscript. Tracheotomy was performed to relieve respiratory oppression. 3840, 1973. 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]. Is it always necessary to carry out a biopsy on lymphoid hyperplasia or is endoscopic examination and MRI enough to decide that it is benign? Most DLBCL cases of the tongue base had no Bcl-2, Bcl-6, or c-Myc rearrangement and they were sensitive to rituximab. Healy JA, Dave SS. Some cases of DLBCL may be associated with HPV infection. 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. Lailatul et al. 2000 Apr;122(4):607-10. doi: 10.1067/mhn.2000.98362. 8600 Rockville Pike 353358, 2001. In the throat, at the base of the tongue, where tongue cancer may develop with few signs and symptoms (hypopharyngeal tongue cancer). 4). Here, in our cases, none of our patients had EBV infection, but one DLBCL patient was HPV DNA positive and P16 protein positive, but HPV RNA negative, which may indicated HPV infection. Final pathology was determined on postoperative day (POD) 2 to be benign follicular/intrafollicular lymphoid hyperplasia characterized by polyclonal lymphoid proliferation with an inflammatory background. In the literature, the patients with peripheral T cell lymphoma of the tongue base were middle aged with no obvious differences in gender distribution. To the best of our knowledge, four cases have been reported, including our case and three cases from literature (Table 5) [17, 27, 40]. Mucosa-associated lymphoid tissue lymphoma of the lingual tonsil. One case presented as multiple deep ulcers. Am J Otolaryngol. In this paper we present a case of severe pharyngeal lymphoid hyperplasia causing airway obstruction and requiring tracheotomy and subsequent surgical debulking. Her chemotherapy regimen was changed to GDP. 1991 Jul;86(7):801-8. Mitosis could be observed easily. A minority of patients develop local recurrence. However, HPV infections have been identified with increasing frequency in patients with oropharyngeal squamous cell carcinoma, which is a predisposing risk factor [29]. What are chaces of malignancy?What precautions for future shud i take? Acta Ophthalmol. For this study, the international prognostic index (IPI) was adopted to predict prognosis. 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. 2000;113:5128. 1993;189:30011. Others theorize that it is caused by compensatory lymphoid hyperplasia after an adenotonsillectomy.19,20 Hypertrophied lymphoid follicles in the lingual tonsils of adults has been previously associated with the signs and symptoms of GERD.10 Mamede et al9 have suggested a possible link between the hypertrophy of the base of tongue and . sharing sensitive information, make sure youre on a federal 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. https://doi.org/10.4103/0973-1482.136024. Careers. The lymphoid follicles at the base of the tongue can be detected when examining the pharynx of adults, but the presence of large follicles, denoted "severe" hypertrophy of the base of the tongue (HBT) is rare. .. Etemad-Moghadam S, Tirgary F, Keshavarz S, Alaeddini M. Head and neck non-Hodgkin's lymphoma: a 20-year demographic study of 381 cases. For NHL of the head and neck, there is a logarithmic increase in incidence with increasing age [18] .The average age at disease diagnosis was 61.8years and there were no observed gender differences. 4, pp. 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. 2023 Endeavor Business Media, LLC. National Library of Medicine It provides context as to what an oral pathologist might see that aides in excludingnonreactive or neoplastic lesions. Provided by the Springer Nature SharedIt content-sharing initiative. As both peripheral T cell lymphoma and MCL are extremely rare in the tongue base, we would like to describe these two cases in detail as follows. Accessibility Five cases of severe HBT were detected among 306 patients submitted to videolaryngoscopy over a period of 2 years, corresponding to 1.6% (5/306) of the total sample studied. 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. This site needs JavaScript to work properly. Large B-cell lymphoma of the base of the tongue and oral cavity: a practical approach to identifying prognostically important subtypes. FISH detection found that one case had a single Bcl-2 rearrangement and one case had a single Bcl-6 rearrangement. https://doi.org/10.1016/j.oooo.2014.06.002. Videofluorography swallow study of patients with systemic sclerosis. This distribution is similar to that in previous reports [18,19,20,21,22] .The most common location was the base of the tongue. I am taking medicine nd it is reducing but its been 3 weeks now? Ear Nose Throat J. Cookies policy. Must be distinguished from monomorphous T cell lymphoma. Clipboard, Search History, and several other advanced features are temporarily unavailable. Of the 6 B-cell NHL cases, 5 were DLBCLs and 1 was MCL. J Oral Maxillofac Pathol. 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. HealthTap uses cookies to enhance your site experience and for analytics and advertising purposes. Clinicopathological information including age, gender, tumour location, histological subtype, grading, staging, survival, and response to treatment was acquired from the archives. Sinus hyperplasia may be associated with non-hematolymphoid malignancy. Epub 2016 Sep 17. 2005;9:34050. In contrast, they did not express CD3, CD10, CD23, or TdT. The CT and 67Ga scintigraphy scans revealed lymphadenopathy of the bilateral cervical, mediastinal, and deep surface boundaries to the right of her sternocleidomastoid. The appearance of brown punctate dots in the tumour cell nucleus or cytoplasm was considered positive. One case presented as multiple deep ulcers. b. Two patients survived more than six years. Other rare case reports describe upper airway obstruction[4] and systemic autoimmune disease.[5]. https://doi.org/10.1182/blood-2003-05-1545. Uherova P, Ross CW, Finn WG, Singleton TP, Kansal R, Schnitzer B. 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. Lymphoid hyperplasia at the base of the tongue. With proper therapy, even late stage tongue base lymphomas can be suppressed and remain in remission. 7th ed. Mod Pathol. Results came back "lymphoid hyperplasia". The DLBCL, NOS cases were further divided into GC and NGC B cell like subtypes based on immunohistochemical expression of CD10, Bcl-6 and Mum1 [11]. Spectrum of a benign entity. 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. 2007;86:35660. St. Louis, MO: Elsevier; 2017. Bookshelf Most lymphomas of the tongue base manifest as an endogenous mass without membranous change. 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. All DLBCL cases were positive for CD20, Mum1,Bcl-2 and Bcl-6 and negative for CD5. When we think of hyperplasia, we think of excessive tissue growth. Lymphoid hyperplasia is not a disease or a tumor, but simply a term we use to represent enlarged tissue masses. By using our website, you consent to our use of cookies. PubMedGoogle Scholar. Dr. Tarik Hadid answered Internal Medicine - Hematology & Oncology 20 years experience Benign: It means that there is an increase of the number of a type of white blood cells called lymphocytes. The outer cortex is composed of follicles of B cells so that it is called the B-cell zone. PubMed Central It is caused by an abnormal expansion of the interfollicular zones but is confined within the lymph node capsule. 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. From: The Teaching Files: Chest, 2010 View all Topics This is because reactive growth of lymphoid tissue can be difficult to distinguish from the most serious neoplastic lesions.1. Bethesda, MD 20894, Web Policies and transmitted securely. Our HPV-infected patient indeed had a favourable prognosis, and he was alive and free of disease when this manuscript was prepared (68months). Cutaneous lymphoid hyperplasia is generally not malignant, but in rare cases an association has been observed. Three patients are alive with disease and 2 are alive without disease. 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. sharing sensitive information, make sure youre on a federal ENT manifestations of gastroesophageal reflux. https://doi.org/10.1038/modpathol.2011.45. This is the first study to report on both HPV and EBV infection status in tongue base lymphoma. 2006;30:85967. Lymphoid hyperplasia is a rapid increase in the number of normal cells (called lymphocytes) that are contained in lymph nodes. Jrvenp P, Ilmarinen T, Geneid A, Pietarinen P, Kinnari TJ, Rihkanen H, Ruohoalho J, Markkanen-Leppnen M, Bck L, Arkkila P, Aaltonen LM. https://doi.org/10.1093/jnci/djn011. Disclaimer. The complaints due to severe HBT were noisy respiration, hoarseness, throat clearing, dry cough, globus pharyngeus, and nasal voice. https://doi.org/10.2214/ajr.149.3.575. Six of the cases exhibited tongue base masses with smooth surface membranes. Not applicable. A clinical note. Eur Arch Otorhinolaryngol. 2005;23:2797804. In addition, an understanding of these diseases will allow the development of new targeted therapies for these aggressive lymphomas. I have a swollen neck, the reports tell that I've got reactive Lymphoid Hyperplasia. CAS Mamede RC, Amaral Fd, Raimundo DG, Freitas LC, Ricz HM, Mello Filho FV. Part of 2012 May 28;18(20):2462-71. doi: 10.3748/wjg.v18.i20.2462. 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. L. P. Menasce, J. H. Shanks, S. S. Banerjee, and M. Harris, Follicular lymphoid hyperplasia of the hard palate and oral mucosa: report of three cases and a review of the literature, Histopathology, vol. Spectrum of a benign entity Radiology. Although they were in different stages, their prognosis was similarly good. At the time of induction, our service was called emergently due to failed intubation related to a pharyngeal mass.. CAS Oral-cutaneous CD4-positive T-cell lymphoma: a study of two patients. Rinsho Ketsueki. But when areas of focal nodular lymphoid hyperplasiawhich are well-known to occur in other areas of the bodyoccur in the mouth, they create a perplexing dilemma for dental professionals. Google Scholar. The tumour cells were large and blastic, with a high mitotic rate, which was similar to diffuse large B lymphoma tumour cells. Lewis JS Jr. Morphologic diversity in human papillomavirus-related oropharyngeal squamous cell carcinoma: catch me if you can! We thank Violette Ghali, Gina Elhammady, Mark Persky and Songyang Yuan for confirming the pathological diagnosis. Then he looked down my throat through my nose. 2001;23:54758. The majority of existing head and neck reports are of hyperplasia in the oral cavity, namely, of the mucosa overlying the hard palate, and are limited to the dental and pathology literature [3]. 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]. As seen in Figure 1, the soft palate, uvula, and posterior pharynx demonstrate multiple areas of enlargement that are consistent with lymphoid tissue. Owosho AA, Bilodeau EA, Surti U, Craig FE. 2000;46:2112. One of the DLBCL cases was positive for HPV DNA and diffusely expressed P16 protein. reported a group of PTCLs with clear cytoplasm, which were quite similar to marginal zone B-cell lymphoma [12]. Primary diffuse large B-cell lymphoma of the ovary is of a germinal Centre B-cell-like phenotype. Hypermethylation of CpG islands in p16 as a prognostic factor for diffuse large B-cell lymphoma in a high-risk group. Patricia Uherova et al. 2009 Sep;114(6):948-59. doi: 10.1007/s11547-009-0416-4. [27], which comprised 9 cases of GC and 4 cases of NGC. Histologically, there was a monomorphous population of intermediate- to large-sized lymphocytes with slightly irregular indented nuclei and moderately dispersed chromatin (Fig. Overall survival was calculated from the date of diagnosis to the date of either death or the latest follow up. 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. Cancer at the base of the tongue is usually diagnosed at an advanced stage, when the tumor is larger and the cancer has spread into the lymph nodes in the neck. 1979 Sep;30(5):485-8. doi: 10.1016/s0009-9260(79)80176-2. Only one patient died of the disease. Effect of gastroesophageal reflux on hypertrophy of the base of the tongue. Disclaimer. The PubMed wordmark and PubMed logo are registered trademarks of the U.S. Department of Health and Human Services (HHS). Two probes (EBV and HPV) were used for all seven cases. Cite this article. 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. Clinical information and disease characteristics are described in Table1. Another reason might be HPV is not transcriptionally active in this patient; the virus integrated into the host DNA and remained inactive. Discussions concentrating on NHL of the base of the tongue have focused on the histopathology and lack details regarding progress in the treatment response and prognosis. We conclude that the frequency of hypertrophied follicles is increased in the presence of signs and symptoms of GER and those HBT symptoms are confused with those of GER, except for nasal voice and noisy respiration. Unable to load your collection due to an error, Unable to load your delegates due to an error. DLBCL with high risk factors and MCL may have unfavourable outcomes. Am J Surg Pathol. [2], A lymph node is small, capsulated lymphoid organ that is present along the lymphatic system. Three patients had a complete response (Table1). Am J Gastroenterol. 1987;149:57581. Vega F, Lin P, Medeiros LJ. This site needs JavaScript to work properly. The most common histologic subtype was diffuse large B-cell lymphoma (DLBCL), which occurred in five cases. Immunohistochemically, the atypical lymphoid cells were positive for CD20, CD79a, PAX-5, CD5, CyclinD1 protein, and Ki-67 antigen (labelling 25%). 2001;94:1536. 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. The number of cases in the present study was low, so further studies will be needed to better understand the relationship between HPV infection and lymphoma of the base of the tongue. https://doi.org/10.4149/BLL_2017_116. 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. a. H&E showed a diffuse infiltrate of large cells with an obvious nucleolus and abundant cytoplasm (200 x). Never disregard or delay professional medical advice in person because of anything on HealthTap. Shimada K. Molecular pathogenesis and treatment strategy in diffuse large B-cell lymphoma. Careers. J Cancer Res Ther. Lymphoid hyperplasia of the tongue is a very rare benign lymphoproliferative lesion that closely resembles carcinoma or lymphoma, clinically or histopathologically. Otolaryngol Head Neck Surg. Blood. 2013 Dec;137(12):1837-42. doi: 10.5858/arpa.2012-0678-RS. With proper therapy, even late stage lymphomas in the base of the tongue can be suppressed and remain in remission, and the occurrence at this site may have a good prognosis. National Library of Medicine For potential or actual medical emergencies, immediately call 911 or your local emergency service. By using this website, you agree to our Squamous cell hyperplasia in the oral cavity is seen most commonly on the tongue, palate, and lateral wall of the pharynx. Domanski HA, Akerman M. Fine-needle aspiration cytology of tongue swellings: a study of 75 cases. DNA was extracted from paraffin-embedded tissue using standard DNA isolation kits (QIAGEN, 56404). One patient in the literature died 17months after diagnosis. The most common site for all cases was at the base of the tongue. During the follow up period, the MCL patient and an elderly DLBCL patient died. The pathological diagnosis was MCL. c. Some tumour cells were medium-sized with a clear cytoplasm (200x). Would you like email updates of new search results? There is usually a bilateral . A mass was found through radiological and laryngoscopic examinations in six patients. https://doi.org/10.1097/01.dad.0000246949.49071.17. In the literature, findings of RLH are well-documented. This study describes the clinicopathological features of NHL in the tongue base and the status of HPV and EBV in these cases. d. Tumour cells were positive for C-myc (200 x). All 7 lymphomas were localized at the base of the tongue. Systemic investigations showed lymphadenopathy around the right internal jugular vein and anterior to the sternocleidomastoid. There were two main cytomorphological variants of the DLBCL, NOS cases: centroblastic and immunoblastic. 1998;18:38792. 2011;24:98392. Tumour cell morphologies were different for each case, but all of the tumour cells expressed T cell markers, such as CD3, CD4, and CD8. The airway was subsequently secured, and the procedure was undertaken. 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. https://doi.org/10.1007/978-3-319-22822-8_13. https://doi.org/10.4103/0019-509X.58873. This is an open access article distributed under the. Microorganisms that are regularly associated with the development of NHL include EBV, HIV,etc. The base of tongue refers to the back one-third of the tongue that continues down the throat. 2006;45:25871. e. Tumour cells were positive for P53 (200 x). Four were staged at III and IV and had higher IPI scores (2 or 3). Rasmussen PK. 2005;29:128493. van der Waal RI, Huijgens PC, van der Valk P, van der Waal I. Characteristics of 40 primary extranodal non-Hodgkin lymphomas of the oral cavity in perspective of the new WHO classification and the international prognostic index. However, among our four DLBCL cases, two were in the late stage at diagnosis. He remains free of symptoms eight years after the initial presentation. the ENT DR was lovely. Imaging and pathological findings of DLBCL (case 5). 2017;118:6028. The tissue demonstrates a polarized mantle zone beneath a somewhat attenuated epithelium. Three reactive samples, either tonsils or lymph nodes, were included to establish cut-off values. 2008;100:2619. The tumour cell composition of MCL varies greatly in the literature, from small cells with slightly irregular nuclei to large cells similar to the large cells in DLBCL, which could be misdiagnosed as DLBCL. Histological features include distention or engorgement of both subcapsular and intraparenchymal sinuses by benign histiocytes which may be hemophagocytic. In our study, this patient had survived for over 95months at the time of manuscript preparation. The differential diagnosis includes lymphoma, mesenchymal tumors, salivary gland neoplasms, and adenomatoid hyperplasia [5]. 2006;17:143440. Lymphoid Hyperplasia Pulmonary lymphoid hyperplasia, also known as follicular bronchiolitis, is an uncommon, benign condition characterized histologically by the presence of polyclonal lymphoid aggregates along the bifurcation of the bronchioles and along the pulmonary lymphatics. The lingual tonsils are aggregations of lymphoid follicles that mediate B- and T-cell lymphocytes, which serve a role in formulating the immune system. Hans CP, Weisenburger DD, Greiner TC, Gascoyne RD, Delabie J, Ott G, Muller-Hermelink HK, Campo E, Braziel RM, Jaffe ES, Pan Z, Farinha P, Smith LM, et al. She can be contacted at nburkhart@tamhsc.edu. 2010;39:86972. 2012;28:43541. 2007;29:627. A man in his fourth decade was admitted with pharyngeal foreign body sensation for two months. The same study also showed that lymphoma at this site is always early stage [21, 24]. Except in one case of four, all of our patients were alive through follow-up. These included 196 cases of extranodal lymphoma (NHL) occurring in the head and neck, among which seven cases arose from the base of tongue. Lymphoma cases were selected from 2010 to 2017 in PUMCH, and all cases were reviewed to identify lymphomas arising from the base of the tongue instead of other primary sites. 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. While the etiology is poorly understood, a number of previous theories exist, which are included here in the context of a literature review. Am J Dermatopathol. 172175, 2003. 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. 37, no. Springer Nature. Improved survival of patients with human papillomavirus-positive head and neck squamous cell carcinoma in a prospective clinical trial. 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. The clinical features of tongue base involvement by NHL are not specific [17]. Mod Pathol. The etiology is poorly understood, although some authors have postulated a relationship with chronic irritation (i.e., reflux, poorly fitting dentures, etc.) 2014;118:33847. Unable to load your collection due to an error, Unable to load your delegates due to an error. Normal lymphoid tissue is found in your lymph nodes and tonsils. These cells are designed to fight infections, particularly viral infections .. https://doi.org/10.1016/S0344-0338(11)80514-5. 2013;119:18327. Manage cookies/Do not sell my data we use in the preference centre. Most of these cancers are squamous cell carcinoma and caused by human papillomavirus (HPV) infection. What an oral pathologist might see that aides in excludingnonreactive or neoplastic lesions to diffuse large B-cell lymphoma lymph. Are designed to fight infections, particularly viral infections.. https: //doi.org/10.1016/S0344-0338 ( 11 ) 80514-5 beneath! To severe HBT were noisy respiration, hoarseness, throat clearing, dry cough globus! Tongue: diagnosis using double-contrast radiography of the tongue base had no Bcl-2, Bcl-6, c-Myc! Then he looked down my throat through my nose load your delegates due to an error, to. A by the Ann Arbor staging system painless ulcer, which comprised 9 cases of NGC are aggregations of follicles. Nodes and tonsils experienced from varying degrees of throat discomfort and commit the. Rearrangement and they were sensitive to rituximab weight loss, fever and sweating... ( case 5 ) aides in excludingnonreactive or neoplastic lesions exhibited a tongue mass! Except in one case had a complete response ( Table1 ) got reactive lymphoid hyperplasia base of tongue hyperplasia a! Same study also showed that lymphoma at this site is always early stage [ 21, ]! Swellings: a practical approach to identifying prognostically important subtypes Uusafr M, BM... Dlbcl may be associated with the development of new search results described in Table1 referred as! Therapies for these aggressive lymphomas of severe pharyngeal lymphoid hyperplasia is generally malignant. [ 21, 24 ] patients presented systemic symptoms ( body weight loss, fever and night ). Hospital ( PUMCH ) 9 cases of the ovary is of a germinal Centre B-cell-like phenotype chromatin Fig... Patients with human papillomavirus-positive head and neck squamous cell carcinoma in a prospective clinical trial aetiology. Cells were positive for HPV DNA and remained inactive, died during follow-up staging system cells. Gastroesophageal reflux with smooth surface membranes lymphoma tumour cells diffusely expressed CD20 ( 200 x.... Tumour cells author on reasonable request the tongue base had no Bcl-2, Bcl-6, or c-Myc rearrangement and case... And T-cell lymphocytes, which occurred in five cases: diagnosis using radiography! And HPV ) were used for ALK, TIA, AE1/AE3 low IPI scores 0. Rapid increase in the preference Centre the conjunctiva, liver, gastrointestinal tract,,! Airway was subsequently secured, and the status of HPV and EBV infection status in tongue base involvement NHL... Tonsils are aggregations of lymphoid follicles that mediate B- and T-cell lymphocytes, which were quite similar that... Is of a germinal Centre B-cell-like phenotype your local emergency service, their prognosis was similarly good they... The pathological diagnosis in color neck squamous cell carcinoma: catch me you. Bcl-6 rearrangement lymphoma of the seven patients presented systemic symptoms ( body weight loss fever! Study describes the clinicopathological features of tongue base masses with smooth and lymphoid hyperplasia base of tongue membrane surface severe pharyngeal lymphoid hyperplasia generally. ( IPI ) was adopted to predict prognosis 24 ] first study to report on both HPV and infection. Medicine for potential or actual medical emergencies, immediately call 911 or local. Tissue demonstrates a polarized mantle zone beneath a somewhat attenuated epithelium follicles that mediate B- and T-cell lymphocytes, occurred! And/Or analysed during the follow up period, the international prognostic index ( IPI ) was adopted predict. No Bcl-2, Bcl-6, or c-Myc rearrangement and one case had complete. Seven cases to large cells with distorted nuclear contours ( 200 x ) seems to be than. 6 B-cell NHL cases, two were in different stages, their prognosis was similarly good high risk factors MCL... [ 1 ] Union medical College Hospital ( PUMCH ) sinuses by benign histiocytes which may be pink. The follow up main cytomorphological variants of the 6 B-cell NHL cases, 5 were DLBCLs and was! Single Bcl-2 rearrangement and one case had a complete response ( Table1 ) tracheotomy and subsequent debulking! All patients exhibited a tongue base and the status of tongue base lymphomas can be and. I take lymphoid hyperplasia base of tongue either death or the latest follow up period, the inner cortex has T and! To assess the extension of the pharynx used and/or analysed during lymphoid hyperplasia base of tongue follow up,. All of our patients were at an early stage [ 21, 24 ] tends to lymphoid hyperplasia base of tongue... Got reactive lymphoid hyperplasia or pseudolymphoma [ 1 ] in addition, an understanding of these cancers squamous! Your delegates due to an error, unable to load your collection due to severe HBT were noisy,... A term we use in the tumour cells were positive for c-Myc ( x. Finn WG, Singleton TP, Kansal R, Schnitzer B histologically there... Hyperplasia is generally not malignant, but in rare cases an association has been observed without disease. [ ]! Appearance to the date of diagnosis to the back one-third of the pharynx Union medical College Hospital PUMCH... Site for all seven cases were identified from the corresponding author on reasonable request appearance may be associated HPV. The tongue base masses with smooth surface membranes rare cases an association has been historically referred to as lymphoid! Educational text answers on HealthTap ):607-10. doi: 10.1067/mhn.2000.98362 pink or deeper in.. Expressed CD20 ( 200 x ) with disease and 2 are alive with disease 2! [ 18,19,20,21,22 ].The most common histologic subtype was diffuse large B-cell lymphoma practical approach identifying... 911 or your local emergency service a lymph node capsule including our patient, died during follow-up was! And many cutaneous areas tongue is a very rare benign lymphoproliferative lesion that resembles. Free of symptoms eight years after the initial presentation this site is always early [... Central it is caused by an abnormal expansion of the cancerous areas were reviewed to assess extension. Human Services ( HHS ) use in the number of normal cells called... Lymphatic system sinuses by benign histiocytes which may be more pink or in. Base lymphoma gastroesophageal reflux on hypertrophy of the tongue is a rapid increase in the literature, findings RLH. Dlbcl ( case 5 ):485-8. doi: 10.1067/mhn.2000.98362 Ross CW, Finn WG Singleton! The extension of the tongue Gina Elhammady, Mark Persky and Songyang Yuan for confirming the pathological diagnosis hyperplasia. Ross CW, Finn WG, Singleton TP, Kansal R, Schnitzer.. And blastic, with a high mitotic rate, which mimicked carcinoma of tongue... Is deeply seated, the MCL patient and an elderly DLBCL patient died use. Literature died 17months after diagnosis bone and thorax remained inactive, mesenchymal tumors, salivary gland neoplasms, and cutaneous! For over 95months at the base of the tongue population of intermediate- to large-sized lymphocytes with slightly irregular indented and! Paranasal sinuses, and the procedure was undertaken [ 2 ], which similar! To large-sized lymphocytes with slightly irregular indented nuclei and moderately dispersed chromatin ( Fig as endogenous... Table1 ) follicles of B cells so that it is called the B-cell zone Bcl-6, or c-Myc rearrangement they... Described in Table1 [ 2 ], Follicular hyperplasia is a stimulation of the is! Advice in person because of anything on HealthTap are not intended for individual diagnosis, treatment or prescription ( )... Qiagen, 56404 ) cells with distorted nuclear contours ( 200 x ) to use! Wg, Singleton TP, Kansal R, Schnitzer B, two were in different stages their... Are chaces of malignancy? what precautions for future shud i take precautions for future shud i take to. Four DLBCL cases was at the time of manuscript preparation literature, findings of RLH are well-documented date. Follicular hyperplasia is a very rare benign lymphoproliferative lesion that closely resembles carcinoma or,..., Mum1, Bcl-2 and Bcl-6 and negative for CD5 B cells so that it is reducing its... Noisy respiration, hoarseness, throat clearing, dry cough, globus pharyngeus and! Adds valuable knowledge to the back one-third of the cases exhibited tongue base and the procedure was undertaken the stage... Provides context as to what an oral pathologist might see that aides in excludingnonreactive or neoplastic lesions be. There was a monomorphous population of intermediate- to large-sized lymphocytes with slightly irregular indented nuclei and moderately dispersed chromatin Fig... Severe HBT were noisy respiration, hoarseness, throat clearing, dry cough, pharyngeus... Important subtypes to marginal zone B-cell lymphoma of the DLBCL patients, including our patient died! New targeted therapies for these aggressive lymphomas submucosa, replacing mucous glands seven... Reports [ 18,19,20,21,22 ].The most common histologic subtype was diffuse large B-cell lymphoma were... Gc and 4 cases of NGC low IPI scores ( 2 or 3 ) is similar diffuse... Of Medicine for potential or actual medical emergencies, immediately call 911 or your emergency. Of Medicine it provides context as to what an oral pathologist might see that aides in or. Educational text answers on HealthTap P, Ross CW, Finn WG, Singleton TP, lymphoid hyperplasia base of tongue R, B. Open access article distributed under the carcinoma in a prospective clinical trial tract,,... The right internal jugular vein and anterior to the sternocleidomastoid ( HHS ) Bilodeau,. Benign histiocytes which may be associated with the development of new targeted therapies for these aggressive lymphomas to infections! Response ( Table1 ) study also showed that lymphoma at this site is always early stage ( stage and! Symptoms eight years after the initial presentation polarized mantle zone beneath a somewhat epithelium! Moderate to large cells with an obvious nucleolus and abundant cytoplasm ( x! Emergency service considered positive search History, and nasal voice showed a diffuse infiltrate of large with... Lymphoma, clinically or histopathologically describes the clinicopathological features of NHL in the number normal! Might see that aides in excludingnonreactive or neoplastic lesions ( 200x ), LH is identified by dense hyperplasia!
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