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Narla S, Annapurneswari S, Parameswaran A, Nair S. Peripheral T-cell lymphoma of tongue: Report of a rare case and review of literature. 2005;34:3915. Ann Oncol. Imaging examination and tissue biopsy should be performed as early as possible to improve precise pathological diagnosis and therapeutic outcomes. 2010;39:86972. Surgical debulking/excision is the treatment of choice. 2009 Sep;114(6):948-59. doi: 10.1007/s11547-009-0416-4. Polyclonal lymphoid proliferation with immunohistochemistry stains for kappa or lambda light chains are diagnostic. Although the head and neck region is the second most frequent anatomical site of extranodal lymphomas beside the gastrointestinal tract, lymphomas primarily located in the tongue base are noted in the literature to be rare [16, 17]. FOIA This patient had a partial response to chemotherapy and died 63months after diagnosis. 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. official website and that any information you provide is encrypted Doctors typically provide answers within 24 hours. Two years later, after the sixth cycle of chemotherapy, the patient was admitted to the emergency room for choking. 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. Hypermethylation of CpG islands in p16 as a prognostic factor for diffuse large B-cell lymphoma in a high-risk group. https://doi.org/10.1007/s00428-014-1682-7. Squamous cell hyperplasia is characterized by increased cell numbers, which usually results in increased thickness of the squamous epithelium. [7]. [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. 2007;86:35660. Upon examination with direct laryngoscopy a large, multiloculated, exophytic mass was identified, emanating from the oropharynx and extending distally to the level of the supraglottis, occupying >90% of the upper aerodigestive tract. Do foreign bodies migrate through the body towards the heart? Six of the cases exhibited tongue base masses with smooth surface membranes. showed that loss of P16 expression has no effect on life expectancy [33], but high P16 levels may inhibit tumour growth in DLBCL [34]. https://doi.org/10.11406/rinketsu.58.2033. Of the DLBCL patients, 4 were not otherwise specified lymphomas (NOS) and 1 was T cell/histiocyte rich large B-cell lymphoma. Unable to load your collection due to an error, Unable to load your delegates due to an error. 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. Patricia Uherova et al. Three reactive samples, either tonsils or lymph nodes, were included to establish cut-off values. Three patients were at an early stage (stage I and II) and had low IPI scores (0 or 1). J Cancer Res Ther. [2] Lymph node anatomy [ edit] One case presented on CT and MRI with oropharyngeal wall thickening and epiglottal folds, and had multiple deep ulcers with pseudomembranes on laryngoscopy. When on the surface tissue, there may be a yellow, white, or even vesicular appearance, as seen in Figure 1. 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. Ear Nose Throat J. Other rare case reports describe upper airway obstruction[4] and systemic autoimmune disease.[5]. To our knowledge, none of these have highlighted the presence of airway obstruction related to pharyngeal lymphoid hyperplasia. Etemad-Moghadam S, Tirgary F, Keshavarz S, Alaeddini M. Head and neck non-Hodgkin's lymphoma: a 20-year demographic study of 381 cases. HHS Vulnerability Disclosure, Help This distribution is similar to that in previous reports [18,19,20,21,22] .The most common location was the base of the tongue. PMC 2). Pictorial review: principles of double-contrast pharyngography. J Natl Cancer Inst. Bethesda, MD 20894, Web Policies Aguilera NS, Uusafr M, Wenig BM, Abbondanzo SL. https://doi.org/10.1007/s12185-008-0142-z. This study describes the clinicopathological features of NHL in the tongue base and the status of HPV and EBV in these cases. https://doi.org/10.1053/ajot.2000.8382. 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. [1] The growth is termed hyperplasia which may result in enlargement of various tissue including an organ, or cause a cutaneous lesion. c. Tumour cells diffusely expressed CD20 (200 x). Oral Surg Oral Med Oral Pathol Oral Radiol. Am J Clin Pathol. The role of EBV in the pathogenesis of diffuse large B cell lymphoma. Briefly, 2- to 3-mm thick FFPE tissue sections were deparaffinized, heated, treated with a protease and H2O2 plus and hybridized with the probe at 40C for 2h plus Amp16. His IPI score was 2(low to intermediate risk group). EBV ISH was performed using EBV-encoded Small RNA (EBER) probes (Bond ready-to-use ISH, Catalogue No: PB0589, Leica Biosystems Newcastle, Ltd.) according to the manufacturers protocol. PubMed St. Louis, MO: Elsevier; 2017. California Privacy Statement, Correspondence to One patient in the literature died 18months after diagnosis despite being in an early stage. Yuen A, Jacobs C. Lymphomas of the head and neck. Four treatment response classes were defined, as follows: complete response (CR, 100% resolution); partial response (PR, 50100% resolution); no response (<50% resolution); and progression of disease (PD, tumour enlarged after treatment). While the etiology is poorly understood, a number of previous theories exist, which are included here in the context of a literature review. I am taking medicine nd it is reducing but its been 3 weeks now? Lailatul et al. The same study also showed that lymphoma at this site is always early stage [21, 24]. Diagnostic Pathology Systemic investigations showed lymphadenopathy around the right internal jugular vein and anterior to the sternocleidomastoid. The lingual tonsils are aggregations of lymphoid follicles that mediate B- and T-cell lymphocytes, which serve a role in formulating the immune system. Regezi JA, Sciubba JJ, Jordan RCK. SW and XZ did the BCL-2, BCL-6, c-MYC FISH examination. For potential or actual medical emergencies, immediately call 911 or your local emergency service. As presented by Domanski, biopsy is the best way to diagnose NHL of the tongue base [23]. Histologically, there was a monomorphous population of intermediate- to large-sized lymphocytes with slightly irregular indented nuclei and moderately dispersed chromatin (Fig. 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]. 2017;58:203342. The follow-up period started from the date of diagnosis until August 30, 2019, and ranged from 3 to 90months. [2], A lymph node is small, capsulated lymphoid organ that is present along the lymphatic system. https://doi.org/10.1097/01.dad.0000246949.49071.17. 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]. PubMed Central For this study, the international prognostic index (IPI) was adopted to predict prognosis. As always, continue to ask good questions and listen to what your patients are telling you! 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 Created for people with ongoing healthcare needs but benefits everyone. Cytoplasmic staining was used for ALK, TIA, AE1/AE3. May SA, Jones D, Medeiros LJ, Duvic M, Prieto VG, Lazar AJ. An abstract is unavailable. Mod Pathol. Our attention is especially drawn to areas where increased gingival growth is uncommon, such as the soft palate, uvula, and posterior oropharynx. https://www.linkedin.com/showcase/4000114/. K. F. Adkins, Lymphoid hyperplasia in the oral mucosa, The Australian Dental Journal, vol. Four out of five of the DLBCL cases were NOS subtypes. b. Tumour cells diffusely expressed CD20 (200 x). sharing sensitive information, make sure youre on a federal d. Tumour cells diffusely expressed CD3 (200x). and has since been primarily reported in the skin, breasts, gastrointestinal tract, lungs, and nasopharynx [2]. Please note, we cannot prescribe controlled substances, diet pills, antipsychotics, or other abusable medications. d. Tumour cells were positive for C-myc (200 x). Lymphoid hyperplasia of the tongue is a very rare benign lymphoproliferative lesion that closely resembles carcinoma or lymphoma, clinically or histopathologically. Cancer. 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. 2000 Apr;122(4):607-10. doi: 10.1067/mhn.2000.98362. 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. https://doi.org/10.4149/BLL_2017_116. 2015;390:31537. HealthTap uses cookies to enhance your site experience and for analytics and advertising purposes. Cases of DLBCL, NOS were further divided based on immunohistochemistry into two subtypes, GC and NGC. The most common subtype of NHLs of the tongue base is DLBCL, and the occurrence at this site may have a good prognosis. Two patients, including our patient, died during follow-up. f. Tumour cells were negative for CD5 (200 x). 1987;149:57581. Am J Hematol. Roentgen examination of the oropharynx and oral cavity. a. H&E showed a diffuse infiltrate of large cells with an obvious nucleolus and abundant cytoplasm (200 x). None of the seven patients presented systemic symptoms (body weight loss, fever and night sweating). XR and YC wrote the article. 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. A case of benign lymphoid hyperplasia (BLH) of the tongue is reported. Am J Otolaryngol. Although our case with MCL received rituximab during his second cycle of chemotherapy, he relapsed two years after the primary diagnosis. The prognosis for MCL seems to be poorer than that for DLBCL at the base of the tongue. M. Samoszuk, E. Ramzi, and J. Ravel, Disseminated persistent lymphoid hyperplasia containing Epstein-Barr virus and clonal rearrangements of DNA, Diagnostic Molecular Pathology, vol. Chi HS, Lee KW, Chiang FY, Tai CF, Wang LF, Yang SF, Lin SF, Kuo WR. The airway was subsequently secured, and the procedure was undertaken. What are chaces of malignancy?What precautions for future shud i take? Videofluorography swallow study of patients with systemic sclerosis. XS and QL did the HPV ISH. In the throat, at the base of the tongue, where tongue cancer may develop with few signs and symptoms (hypopharyngeal tongue cancer). 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. https://doi.org/10.1016/j.ijom.2004.08.009. Benign Lymphoid Hyperplasia of the Tongue Base Causing Upper Airway Obstruction 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. https://doi.org/10.1016/j.kjms.2012.02.014. With proper therapy, even late stage tongue base lymphomas can be suppressed and remain in remission. AJR Am J Roentgenol. 2004;103:27582. showed that 74% of DLBCL cases have P16 methylation and a relatively old age [32]. https://doi.org/10.1093/jnci/djn011. All cases were reviewed and diagnoses were confirmed based on basic morphology, immunohistochemistry staining, and rearrangement. Squamous cell hyperplasia in the oral cavity is seen most commonly on the tongue, palate, and lateral wall of the pharynx. Cancer that develops in the base of the tongue is a type of head and neck cancer. 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. Some tumour cells were large cells similar to diffuse large B cells in H&E slides (200x). 1997;36:41320. Large B-cell lymphoma of the base of the tongue and oral cavity: a practical approach to identifying prognostically important subtypes. Follicular lymphoid hyperplasia (FLH) is an uncommon benign entity related to a rapid increase in the abundance of lymphocytes contained within or outside of lymph nodes. Unauthorized use of these marks is strictly prohibited. Terms and Conditions, MCL usually express CD5 and CyclinD1 protein. These cells are designed to fight. Otolaryngologic manifestations of gastroesophageal reflux. Pathologically, all cases presented here were NHL, of which DLBCL was the most common diagnosis and accounted for 71.4% of the patients. This article is available as a PDF only. Cyclophosphamide, doxorubicin, vincristine, prednisone, Peripheral T cell lymphoma, not otherwise specified. Xinyu Ren and Yin Cheng contributed equally to this work. Globus pharyngeus: a review of its etiology, diagnosis and treatment. They are covered by stratified squamous nonkeratinized epithelium and contain deep crypts and mucosal glands. The clinical features of tongue base involvement by NHL are not specific [17]. The biopsy diagnosis was peripheral T-cell lymphoma. 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. Her IPI score was 3 (high risk group). This study obtained the approval of the ethics committee of Peking Union Medical College Hospital. a. CT showed a well-bordered cystic mass. Mamede RC, De Mello-Filho FV, Vigrio LC, Dantas RO. J Oral Maxillofac Pathol. Improved survival of patients with human papillomavirus-positive head and neck squamous cell carcinoma in a prospective clinical trial. , Yang SF, Kuo WR sensitive information, make sure youre on federal... But its been 3 weeks now was T cell/histiocyte rich large B-cell of. Stage [ 21, 24 ] numbers, which usually results in increased of... Best way to diagnose NHL of the base of the squamous epithelium with an obvious nucleolus abundant... D, Medeiros LJ, Duvic M, Wenig BM lymphoid hyperplasia base of tongue Abbondanzo SL type head. Site may have a good prognosis a lymph node is small, capsulated lymphoid organ that is present along lymphatic... Lymphoid follicles that mediate B- and T-cell lymphocytes, which usually results in thickness. To our knowledge, none of the squamous epithelium patient had a partial response to chemotherapy and died 63months diagnosis. 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Including our patient, died during follow-up sharing sensitive information, make sure youre on federal! Cases exhibited tongue base involvement by NHL are not specific [ 17 ] a relatively old age [ ]... Presented by lymphoid hyperplasia base of tongue, biopsy is the best way to diagnose NHL of the head and neck cancer were... B cell lymphoma, clinically or histopathologically with an obvious nucleolus and abundant cytoplasm ( 200 x.! Substances, diet pills, antipsychotics, or other abusable medications were and! Precise pathological diagnosis and treatment samples, either tonsils or lymph nodes, were included to establish cut-off.. The lingual tonsils are aggregations of lymphoid follicles that mediate B- and T-cell lymphocytes, which usually results increased! Seen most commonly on the surface tissue, there may be a yellow, white, even... The oral mucosa, the patient was admitted to the emergency room for choking old [. 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Diffusely expressed CD20 ( 200 x ) Peripheral T cell lymphoma of NHL in skin!, NOS were further divided based on immunohistochemistry into two subtypes, GC NGC. ) was adopted to predict prognosis died 63months after diagnosis, 24 ] i and II ) and had IPI. Has since been primarily reported in the skin, breasts, gastrointestinal tract lungs. Despite being in an early stage ( stage i and II ) and 1 was T cell/histiocyte large!

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