All DLBCL cases were positive for CD20, Mum1,Bcl-2 and Bcl-6 and negative for CD5. J Oral Maxillofac Pathol. [1] The growth is termed hyperplasia which may result in enlargement of various tissue including an organ, or cause a cutaneous lesion. Video chat with a U.S. board-certified doctor 24/7 in less than one minute for common issues such as: colds and coughs, stomach symptoms, bladder infections, rashes, and more. 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. https://doi.org/10.11406/rinketsu.58.2033. Metastasis of the regional neck lymph nodes was noted in one case at the time of diagnoses. Generally, MCL patients have a median age of 60years and a striking male predominance [42] .Three of the four cases of MCL including our case, occurred at the base of the tongue. Primary extra-nodal non-Hodgkin's lymphoma of the cheek. Extranodal NHL is complicated; it consists of a group of tumours with different pathological, clinical and prognostic characteristics [6] .Existing series presenting extranodal NHL have mainly summarized the tumours that occur in the head and neck but are not specific to the base of the tongue. This may have been due to the expression of the cytotoxic marker TIA, Granzyme B, and a much higher Ki-67 index (80%), which may indicate a poor prognosis [41]. However, among our four DLBCL cases, two were in the late stage at diagnosis. Otolaryngol Head Neck Surg. She can be contacted at nburkhart@tamhsc.edu. CAS Before Int J Oral Maxillofac Surg. b. Tumour cells diffusely expressed CD20 (200 x). 2010;39:86972. Head Neck. MeSH A poor prognostic case of peripheral T-cell lymphoma in the base of tongue with chemotherapy followed by radiation therapy. Spectrum of a benign entity. Takahashi H, Fujita S, Okabe H, Tsuda N, Tezuka F. Immunophenotypic analysis of extranodal non-Hodgkin's lymphomas in the oral cavity. 2005;23:2797804. Uherova P, Ross CW, Finn WG, Singleton TP, Kansal R, Schnitzer B. Int J Cancer. Rinsho Ketsueki. Ren, X., Cheng, Y., Wu, S. et al. The tissue demonstrates a polarized mantle zone beneath a somewhat attenuated epithelium. The tumour cells were large and blastic, with a high mitotic rate, which was similar to diffuse large B lymphoma tumour cells. Some tumour cells were large cells similar to diffuse large B cells in H&E slides (200x). Improved survival of patients with human papillomavirus-positive head and neck squamous cell carcinoma in a prospective clinical trial. J Laryngol Otol. An official website of the United States government. DLBCL with high risk factors and MCL may have unfavourable outcomes. Tumour cell morphologies were different for each case, but all of the tumour cells expressed T cell markers, such as CD3, CD4, and CD8. Work-up of globus: assessing the benefits of neck ultrasound and videofluorography. 3). 2008;100:2619. PubMed Central Healy JA, Dave SS. CT scan revealed the epicenter at the base of tongue and an appearance suspicious for malignancy (Figure 1). CAS Disclaimer. By that time, and at one week after discharge, the pharynx appeared within normal limits. Ann Diagn Pathol. Vocal cord involvement can cause choking. 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]. AJR Am J Roentgenol. The airway was subsequently secured, and the procedure was undertaken. 2017 Feb;274(2):931-937. doi: 10.1007/s00405-016-4307-8. FISH detection found that one case had a single Bcl-2 rearrangement and one case had a single Bcl-6 rearrangement. Head and neck extranodal lymphoma in a single institute: a 17-year retrospective analysis. ZL, BW, XR and YC reviewed all the cases together. By using this website, you agree to our Hypermethylation of CpG islands in p16 as a prognostic factor for diffuse large B-cell lymphoma in a high-risk group. Cut-off values were set as previously described [9]. [3] Follicular hyperplasia must be distinguished from follicular lymphoma (bcl-2 protein is expressed in neoplastic follicles, but not reactive follicles). Accessibility https://doi.org/10.1093/annonc/mdl131. After washing and amplification, target RNA was stained with DAB. Mod Pathol. Dr. Burkhart was awarded an affiliate fellow status in the American Academy of Oral Medicine in 2016. Primary diffuse large B-cell lymphoma of the ovary is of a germinal Centre B-cell-like phenotype. TIA, SOX10 was obtained from Beijing XiYaJinQiao Biological Technology Co. Ltd. China. 2001;23:54758. [2] Lymph node anatomy [ edit] Benign lymphoid hyperplasia (BLH) is a benign proliferation of lymphoid tissue in response to external irritation. 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]. Six of the cases exhibited tongue base masses with smooth surface membranes. 2023 BioMed Central Ltd unless otherwise stated. J Clin Oncol. 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. c. Immunohistochemistry staining showed diffuse and strong staining of P16 protein (40 x) d. Immunohistochemistry staining showed diffuse and strong staining of P16 protein (100 x). The role of EBV in the pathogenesis of diffuse large B cell lymphoma. 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. [Diagnostics of laryngopharyngeal form of gastroesophageal reflux disease for adults (Lithuanian clinical practice guidelines)]. Mamede RC, Amaral Fd, Raimundo DG, Freitas LC, Ricz HM, Mello Filho FV. J Cancer Res Ther. This is consistent with the findings from 17 DLBCL cases reported by Owosho AA et al. DNA was extracted from paraffin-embedded tissue using standard DNA isolation kits (QIAGEN, 56404). Diagn Cytopathol. A mass was found through radiological and laryngoscopic examinations in six patients. HPV RNA ISH all negative. 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. HHS Vulnerability Disclosure, Help Effect of gastroesophageal reflux on hypertrophy of the base of the tongue. 349356, 1980. In the throat, at the base of the tongue, where tongue cancer may develop with few signs and symptoms (hypopharyngeal tongue cancer). c. Tumour cells diffusely expressed CD20 (200 x). e. Tumour cells were positive for CD4 (200x). 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. 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. Eur Arch Otorhinolaryngol. 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 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. D. L. Harsany, J. Ross, and W. E. Fee, Follicular lymphoid hyperplasia of the hard palate simulating lymphoma, OtolaryngologyHead and Neck Surgery, vol. Tumours in this site are predominantly DLBCL subtypes in histology. Russo S, Lo Re G, Galia M, Reginelli A, Lo Greco V, D'Agostino T, La Tona G, Coppolino F, Grassi R, Midiri M, Lagalla R. Radiol Med. At the time of induction, our service was called emergently due to failed intubation related to a pharyngeal mass.. Disclaimer. The biological behaviours that are exclusive to the tongue base are not clear. Some cases of DLBCL may be associated with HPV infection. This study describes the clinicopathological features of NHL in the tongue base and the status of HPV and EBV in these cases. PubMed Cytoplasmic staining was used for ALK, TIA, AE1/AE3. 4, pp. https://doi.org/10.4103/0019-509X.58873. Blood. Epub 2018 Jun 25. Imaging showed a well-bordered cystic mass (2cm in diameter) at the right base of the tongue that extended into the pharynx, and so a biopsy was performed. doi: 10.1148/radiology.144.4.7111732. Pseudotumours of the oropharynx due to muscular contraction. c. Some tumour cells were medium-sized with a clear cytoplasm (200x). Get prescriptions or refills through a video chat, if the doctor feels the prescriptions are medically appropriate. https://doi.org/10.1017/s0022215100142288. His IPI score was 2(low to intermediate risk group). CD30 antibodies were purchased from Maixin Biotech. J Postgrad Med. and transmitted securely. I am taking medicine nd it is reducing but its been 3 weeks now? Lymphoid hyperplasia of the tongue is a very rare benign lymphoproliferative lesion that closely resembles carcinoma or lymphoma, clinically or histopathologically. 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 . Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations. Expression and alteration of p16 in diffuse large B cell lymphoma. Acta Oncol. PET-CT/CT/MRI scans of the cancerous areas were reviewed to assess the extension of the lesions, including to the bone and thorax. a. CT showed an irregular soft tissue mass at the right posterior aspect of the tongue base. Under the microscope, normal tissue was replaced by diffuse large atypical lymphocytes with relatively abundant cytoplasm. In this paper we present a case of severe pharyngeal lymphoid hyperplasia causing airway obstruction and requiring tracheotomy and subsequent surgical debulking. Clipboard, Search History, and several other advanced features are temporarily unavailable. 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. Chang CC, Liu YC, Cleveland RP, Perkins SL. Please enable it to take advantage of the complete set of features! During the follow up period, the MCL patient and an elderly DLBCL patient died. Non-Hodgkin's lymphoma of the head and neck: a 30-year experience at the University of Florida. Although it had been described in the literature, occurrence within oral cavity is rare. f. Ki-67 staining of the tumour cells (200x). Synchronous cancers in patients with head and neck cancer: risks in the era of human papillomavirus-associated oropharyngeal cancer. When oral aggregates appear in clusters or have an unusual appearance or enlargement, clinicians may question whether abnormalities are present. 8600 Rockville Pike The other two cases were mantle cell lymphoma (MCL) and peripheral T cell lymphoma, not otherwise specified (PTCL, NOS). Mod Pathol. Positive nucleolus staining was used to identify Bcl-6, mum-1, CyclinD1, SOX11 and Ki-67. 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. B. C. Jham, N. O. Binmadi, M. A. Scheper et al., Follicular lymphoid hyperplasia of the palate: case report and literature review, Journal of Cranio-Maxillofacial Surgery, vol. These tissues act as your body's first line of defense against infections. The blastic variant of mantle cell lymphoma arising in Waldeyer's tonsillar ring. 2010;47:846. he started bty saying 90% of urgent referrals were viral so should be fine. 2017;118:6028. Jain KS, Sikora AG, Baxi SS, Morris LG. 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. Diagnostic Pathology None of the seven patients presented systemic symptoms (body weight loss, fever and night sweating). Part of What is the treatment for reactive lymphoid hyperplasia? showed that loss of P16 expression has no effect on life expectancy [33], but high P16 levels may inhibit tumour growth in DLBCL [34]. Narla S, Annapurneswari S, Parameswaran A, Nair S. Peripheral T-cell lymphoma of tongue: Report of a rare case and review of literature. 1, pp. Four were staged at III and IV and had higher IPI scores (2 or 3). Cancer that develops in the base of the tongue is a type of head and neck cancer. The .gov means its official. Paraffin sections were prepared according to the ThermoBrite Elite Automated FISH slide prep system manufacturers protocol. 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. 1997;36:41320. Among our cases, there were 1 GC and 3 NGC cases. https://doi.org/10.1186/s13000-020-00936-w, DOI: https://doi.org/10.1186/s13000-020-00936-w. To our knowledge, none of these have highlighted the presence of airway obstruction related to pharyngeal lymphoid hyperplasia. Postoperatively the patient was deemed unsafe for extubation and transferred to the intensive care unit while placed on high-dose intravenous dexamethasone. Radiology. 2. 88, no. Seven cases were identified from the Pathological Registry Database at Peking Union Medical College Hospital (PUMCH). https://doi.org/10.1182/blood-2003-05-1545. 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. 2). 37, no. Doctors typically provide answers within 24 hours. This study was supported by grants from CAMS Initiative for Innovative Medicine (CAMS-I2M) (2016-I2M-1-002). 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. He remains free of symptoms eight years after the initial presentation. Identifying lesions in areas where aggressive lesions may occur and offering patient-centered care can lead to better clinical outcomes. The presence of an excessively large tongue, which may be congenital or may develop as a result of a tumor or edema due to obstruction of lymphatic vessels, or it may occur in association with hyperpituitarism or acromegaly. 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. d. Tumour cells were positive for CD5 (200x). Oral Surg Oral Med Oral Pathol Oral Radiol. Non-Hodgkins lymphoma (NHL) primarily derived from the base of the tongue, is rare. Am J Dermatopathol. In the middle power view, there were plenty of moderate to large cells with distorted nuclear contours (Fig. 2012 May 28;18(20):2462-71. doi: 10.3748/wjg.v18.i20.2462. 2015;390:31537. 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Lymphoproliferative lesion that closely resembles carcinoma or lymphoma, clinically or histopathologically to diffuse large B-cell of... Unusual appearance lymphoid hyperplasia base of tongue enlargement, clinicians may question whether abnormalities are present ( 2016-I2M-1-002 ), S. al... Low to intermediate risk group ) offering patient-centered care can lead to better clinical outcomes Medicine. Areas were reviewed to assess the extension of the seven patients presented systemic symptoms body. Ss, Morris LG neck squamous cell carcinoma in a prospective clinical trial B lymphoid hyperplasia base of tongue. Been described in the literature, occurrence within oral cavity is rare factors and MCL may unfavourable! Of diagnoses defense against infections, clinically or histopathologically remains free of symptoms eight years after the initial presentation feels! Several other advanced features are temporarily unavailable or lymphoma, clinically or histopathologically identified from the Pathological Database! Published maps and institutional affiliations factors and MCL may have unfavourable outcomes obstruction and requiring tracheotomy subsequent... In areas where aggressive lesions lymphoid hyperplasia base of tongue occur and offering patient-centered care can lead better. Beneath a somewhat attenuated epithelium may be associated with HPV infection Automated fish slide prep system manufacturers protocol washing amplification... The complete set of features resembles carcinoma or lymphoma, clinically or histopathologically although it had been in. These cases WG, Singleton TP, Kansal R, Schnitzer b. Int J cancer in Waldeyer 's ring! May be associated with HPV infection chat, if the doctor feels the prescriptions medically! Mantle zone beneath a somewhat attenuated epithelium should be fine RP, SL. Referrals were viral so should be fine lymphoma, clinically or histopathologically Filho FV Int J.. Benign lymphoproliferative lesion that closely resembles carcinoma or lymphoma, clinically or histopathologically masses with smooth surface.! The late stage at diagnosis lymphoid hyperplasia base of tongue published maps and institutional affiliations 28 18... Dlbcl cases were identified from the base of tongue with chemotherapy followed radiation.
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