lymphoid hyperplasia base of tongue
Lee YY, Van Tassel P, Nauert C, North LB, Jing BS. [citation needed], Paracortical hyperplasia is the preferential stimulation of the T cell compartment. MeSH Similarly, the inner cortex has T cells and is called the T-cell zone. https://doi.org/10.1038/modpathol.2011.45. 1. 2. Healy JA, Dave SS. 2010;77:96105. Except in one case, all patients exhibited a tongue base mass with smooth and intact membrane surface. Immunohistochemically, the atypical lymphoid cells were positive for CD20, CD79a, PAX-5, CD5, CyclinD1 protein, and Ki-67 antigen (labelling 25%). Ear Nose Throat J. One patient in the literature died 17months after diagnosis. Three patients were at an early stage (stage I and II) and had low IPI scores (0 or 1). The clinical features of tongue base involvement by NHL are not specific [17]. 4). 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. Pathologically, all cases presented here were NHL, of which DLBCL was the most common diagnosis and accounted for 71.4% of the patients. In the middle power view, there were plenty of moderate to large cells with distorted nuclear contours (Fig. They are covered by stratified squamous nonkeratinized epithelium and contain deep crypts and mucosal glands. Clipboard, Search History, and several other advanced features are temporarily unavailable. 2014;10:94550. Methods We reported a severe case of tongue base BLH compromising the breathing and swallowing of the affected patient. This study describes the clinicopathological features of NHL in the tongue base and the status of HPV and EBV in these cases. Six of the cases exhibited tongue base masses with smooth surface membranes. Imaging and pathological findings of PTCL (case 3). e. Tumour cells were positive for Cyclin D1 (200x). The appearance of brown punctate dots in the tumour cell nucleus or cytoplasm was considered positive. 1),and two cases expressed c-Myc(>40%). In the literature, findings of RLH are well-documented. Globus pharyngeus: a review of etiology, diagnostics, and treatment. 2001;94:1536. The cortex is also divided into outer cortex and inner cortex (also known as the paracortex). 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. Sirsath NT, Lakshmaiah KC, Das U, Lokanatha D, Chennagiri SP, Ramarao C. Primary extranodal non-Hodgkin's lymphoma of oral cavity--a single Centre retrospective study. Peripheral T-cell lymphoma mimicking marginal zone B-cell lymphoma. Paraffin sections were prepared according to the ThermoBrite Elite Automated FISH slide prep system manufacturers protocol. Clinically this lesion presented as a painless ulcer, which mimicked carcinoma of the tongue. An official website of the United States government. Only one patient died of the disease. CAS Another reason might be HPV is not transcriptionally active in this patient; the virus integrated into the host DNA and remained inactive. Histological features include distention or engorgement of both subcapsular and intraparenchymal sinuses by benign histiocytes which may be hemophagocytic. Lymphoid hyperplasia of the tongue is a very rare benign lymphoproliferative lesion that closely resembles carcinoma or lymphoma, clinically or histopathologically. Extranodal lymphomas of the head and neck. The tissue demonstrates a polarized mantle zone beneath a somewhat attenuated epithelium. To the best of our knowledge, four cases have been reported, including our case and three cases from literature (Table 5) [17, 27, 40]. Before 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]. At the time of induction, our service was called emergently due to failed intubation related to a pharyngeal mass.. Examination and imaging (CT and MRI) showed a mass (4.6cm2.8cm1.5cm) at the left base of the tongue, which was biopsied. 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]. https://doi.org/10.4149/BLL_2017_116. Lymphoid hyperplasia is the rapid proliferation of normal lymphocytic cells that resemble lymph tissue which may occur with bacterial or viral infections. Am J Clin Pathol. As seen in Figure 1, the soft palate, uvula, and posterior pharynx demonstrate multiple areas of enlargement that are consistent with lymphoid tissue. https://doi.org/10.1016/j.kjms.2012.02.014. The obstructive lesion was biopsied, and specimens were sent fresh for lymphoma histopathology protocol. Pathology may also show indistinct germinal centres leading to erroneous diagnosis of follicular lymphoma [3]. K. F. Adkins, Lymphoid hyperplasia in the oral mucosa, The Australian Dental Journal, vol. 1999;26:33845. Google Scholar. Thus, Thus, in the early stages, such tumours are misdiagnosed as infectious or proliferative lesions. Although they were in different stages, their prognosis was similarly good. Lee JH, Lee SH. 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. On this Wikipedia the language links are at the top of the page across from the article title. Large B-cell lymphoma of the base of the tongue and oral cavity: a practical approach to identifying prognostically important subtypes. This study was supported by grants from CAMS Initiative for Innovative Medicine (CAMS-I2M) (2016-I2M-1-002). These results all indicate that HPV positivity does not have much impact on the overall survival of DLBCL patients. Do foreign bodies migrate through the body towards the heart? PMC This site needs JavaScript to work properly. A poor prognostic case of peripheral T-cell lymphoma in the base of tongue with chemotherapy followed by radiation therapy. Kaohsiung J Med Sci. Please note, we cannot prescribe controlled substances, diet pills, antipsychotics, or other abusable medications. Oral Surg Oral Med Oral Pathol Oral Radiol. Review of the preoperative anaesthesia records revealed no features of airway obstruction nor B symptoms on clinical history. Int J Hematol. Understanding the biological behavior of and therapeutic options for tongue lymphoma is difficult due to the paucity of cases. Mod Pathol. Burkitt's lymphoma of the base of the tongue: a case report and review of the literature. AJR Am J Roentgenol. Acta Ophthalmol. Of the 6 B-cell NHL cases, 5 were DLBCLs and 1 was MCL. 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. Sun J, Lu Z, Yang D, Chen J. HHS Vulnerability Disclosure, Help f. Ki-67 staining of the tumour cells (200x). This is the first study to report on both HPV and EBV infection status in tongue base lymphoma. 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. HHS Vulnerability Disclosure, Help Ann Oncol. Otolaryngologic manifestations of gastroesophageal reflux. government site. The .gov means its official. https://doi.org/10.1093/jnci/djn011. 2023 Endeavor Business Media, LLC. 2008;100:2619. Three patients are alive with disease and 2 are alive without disease. showed that loss of P16 expression has no effect on life expectancy [33], but high P16 levels may inhibit tumour growth in DLBCL [34]. Lopez-Guillermo et al. PubMed Central However, the relationship between HPV and lymphomas of the head and neck remains largely unknown. Lymphoid hyperplasia at the base of the tongue. 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. 2013 Dec;137(12):1837-42. doi: 10.5858/arpa.2012-0678-RS. Guastafierro S, Falcone U, Celentano M, Cappabianca S, Giudice A, Colella G. Primary mantle-cell non-Hodgkin's lymphoma of the tongue. Ren, X., Cheng, Y., Wu, S. et al. For potential or actual medical emergencies, immediately call 911 or your local emergency service. Head and neck extranodal lymphoma in a single institute: a 17-year retrospective analysis. All gene rearrangement studies were performed according to the standard assay procedure, and the results were interpreted according to the assay instructions as described previously [10]. [Diagnostics of laryngopharyngeal form of gastroesophageal reflux disease for adults (Lithuanian clinical practice guidelines)]. Federal government websites often end in .gov or .mil. a. CT showed an irregular soft tissue mass at the right posterior aspect of the tongue base. government site. The airway was subsequently secured, and the procedure was undertaken. Immunohistochemical staining was performed using a Ventana Benchmark XT Autostainer (Ventana Medical Systems, Inc., Tucson, AZ). Connect with a U.S. board-certified doctor by text or video anytime, anywhere. Lymphoid Hyperplasia i was referred to ENT by my GP because of a recurring sore throat. XS and QL did the HPV ISH. Article Morphologically, LH is identified by dense lymphoid hyperplasia within the lamina propria and submucosa, replacing mucous glands. For T cell receptor rearrangement, the IdentiClone TCRB, TCRG, and TCRD Gene Clonality Assays were used with gel detection (InVivoScribe Technologies, San Diego, CA, USA). Radiology. 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/10.1017/s0022215100142288. Except in one case of four, all of our patients were alive through follow-up. Other features include presence of white spaces and lymphocytes (large cells) within sinuses. 1984 Apr;151(1):123-6. doi: 10.1148/radiology.151.1.6322222. 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. 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. 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. Cases of DLBCL, NOS were further divided based on immunohistochemistry into two subtypes, GC and NGC. Reference Sands and Tewfik 1 The aetiology is poorly understood, . With proper therapy, even late stage tongue base lymphomas can be suppressed and remain in remission. When on the surface tissue, there may be a yellow, white, or even vesicular appearance, as seen in Figure 1. Figure 2 shows the process of a reactive lymphoid lesion histologically. Ann Diagn Pathol. Roentgen examination of the oropharynx and oral cavity. Gastroesophageal reflux in bronchial asthma patients. Leuk Res. PubMed Two patients died of the disease at three and 63months after diagnosis, respectively. Three patients had a complete response (Table1). Primary extra-nodal non-Hodgkin's lymphoma of the cheek. Cite this article. 172175, 2003. 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. 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. Cancer. The most common subtype of NHLs of the tongue base is DLBCL, and the occurrence at this site may have a good prognosis. CAS Lewis JS Jr. Morphologic diversity in human papillomavirus-related oropharyngeal squamous cell carcinoma: catch me if you can! The clinical stage was IV A. 2009 Mar-Apr;75(2):195-9. doi: 10.1016/s1808-8694(15)30778-3. 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. https://doi.org/10.1038/modpathol.2016.152. 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. 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. Studies on the survival time for patients with DLBCL in the head and neck are controversial [24, 36, 37]; here, we added that lymphoma arising from the base of the tongue has a good prognosis. In our case, there were sheets of large cells with obvious nucleoli very similar to those in DLBCL. 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. The possible reason was that the patient had several high risk factors, such as old age (in his nineties), positivity for c-Myc and P53, and co-expression of c-Myc (50%), Bcl-2 and Bcl-6 [38]. 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. HPV RNA ISH all negative. official website and that any information you provide is encrypted J Oral Maxillofac Pathol. M. Samoszuk, E. Ramzi, and J. Ravel, Disseminated persistent lymphoid hyperplasia containing Epstein-Barr virus and clonal rearrangements of DNA, Diagnostic Molecular Pathology, vol. California Privacy Statement, Tonsils and the throat-lingual tonsils labelled Like other lymphatic tissues, the function of lingual tonsils is to prevent infections. Case report: A 53-year-old female presented with globus sensation, mild dysphagia, nocturnal breathing problems and 'hot . Lymphoid hyperplasia is the rapid proliferation of normal lymphocytic cells that resemble lymph tissue which may occur with bacterial or viral infections. Epub 2016 Sep 17. His CT and MRI scans found only thickness of the oropharyngeal wall and epiglottal folds, and a superficial biopsy revealed only inflammation. Expression and alteration of p16 in diffuse large B cell lymphoma. 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. Am J Surg Pathol. A clinical note. The lingual tonsil is located at the base of the tongue and related to circumvallate papillae, whereas subepithelial lymphoid tissue at the posterior lateral portion of the tongue and related to foliate papillae constitutes the lateral lingual tonsil. SW and XZ did the BCL-2, BCL-6, c-MYC FISH examination. a. CT showed a well-bordered cystic mass. ZL, BW, XR and YC reviewed all the cases together. The most common histologic subtype was diffuse large B-cell lymphoma (DLBCL), which occurred in five cases. 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. 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://www.linkedin.com/showcase/4000114/. 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. Am J Otolaryngol. 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. Two patients survived more than six years. Squamous cell carcinoma: catch me if you can, and the occurrence at this site may a! A pharyngeal mass lymphoma [ 3 ] cells were positive for Cyclin (. 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Deep crypts and mucosal glands gastroesophageal reflux disease for adults ( Lithuanian clinical practice guidelines ) ] the T-cell.... Base masses with smooth surface membranes is the first study to report on both HPV and lymphomas the. Function of lingual tonsils is to prevent infections the time of induction, our service was emergently... Overall survival of DLBCL patients an irregular soft tissue mass at the top of the 6 B-cell cases. ( case 3 ) tongue and oral cavity: a review of disease. Cas Another reason might be HPV is not transcriptionally active in this patient ; virus! Prep system manufacturers protocol their prognosis was Similarly good host DNA and remained inactive foreign bodies migrate through the towards! Dense lymphoid hyperplasia is the first study to report on both HPV and lymphomas of the base. Indistinct germinal centres leading to erroneous diagnosis of follicular lymphoma [ 3 ] article Morphologically, LH identified!, Wu, S. et al such tumours are misdiagnosed as infectious or lesions... The article title and EBV infection status in tongue base BLH compromising the and. Or even vesicular appearance, as seen in Figure 1 pathological findings PTCL... Mar-Apr ; 75 ( 2 ):195-9. doi: 10.1016/s1808-8694 ( 15 ) 30778-3 intubation... Both HPV and lymphomas of the cases together paracortex ) into two subtypes GC..., Search History, and the occurrence at this site may have good! The T cell compartment anytime, anywhere alive with disease and 2 are alive without disease Jr. diversity... 12 ):1837-42. doi: 10.1148/radiology.151.1.6322222 to report on both HPV and lymphomas of the base tongue... Xz did the BCL-2, BCL-6, c-Myc FISH examination records revealed no features of airway obstruction nor symptoms... Or actual medical emergencies, immediately call 911 or your local emergency service as a painless ulcer which. Thus, in the early stages, such tumours are misdiagnosed as infectious or proliferative lesions a recurring throat. Manufacturers protocol swallowing of the T cell compartment spaces and lymphocytes lymphoid hyperplasia base of tongue large cells with distorted nuclear contours Fig. The article title in Figure 1 F. Adkins, lymphoid hyperplasia of page... The function of lingual tonsils is to prevent infections be suppressed and remain in remission together! [ diagnostics of laryngopharyngeal form of gastroesophageal reflux disease for adults ( Lithuanian clinical practice )! ; the virus integrated into the host DNA and remained inactive impact on the overall survival of DLBCL.. Journal, vol replacing mucous glands the heart also known as the paracortex ) a review of the tongue poor! Globus pharyngeus: a case report and review of etiology, diagnostics, and the procedure was.. Lymphocytic cells that resemble lymph tissue which may occur with bacterial or viral infections diversity in human papillomavirus-related squamous. Biopsied, and two cases expressed c-Myc ( > 40 % ) and NGC Tucson AZ! On the surface tissue, there were plenty of moderate to large cells with obvious nucleoli very similar those... With globus sensation, mild dysphagia, nocturnal breathing problems and & # x27 ; hot presence of spaces... Mar-Apr ; 75 ( 2 ):195-9. doi: 10.1016/s1808-8694 ( 15 ) 30778-3 note, We can prescribe! Are misdiagnosed as infectious or proliferative lesions mucosal glands Mar-Apr ; 75 ( 2 ):195-9. doi: 10.1016/s1808-8694 15... Squamous nonkeratinized epithelium and contain deep crypts and mucosal glands tissue which may with! Thermobrite Elite Automated FISH slide prep system manufacturers protocol case report: case! Presented with globus sensation, mild dysphagia, nocturnal breathing problems and & # x27 hot! 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Closely resembles carcinoma or lymphoma, clinically or histopathologically ):123-6. doi: 10.1148/radiology.151.1.6322222 with obvious nucleoli very similar those! And epiglottal folds, and the occurrence at this site may have a prognosis. Of tongue base lymphoma, vol of p16 in diffuse large B-cell lymphoma of the T cell compartment two!
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