Peripheral T-cell lymphoma mimicking marginal zone B-cell lymphoma. 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. 1991 Jul;86(7):801-8. Sun J, Zhang J, Ling Q, Luo Y, Wu S, Liang Z, Zhong D, Zeng X. 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. Before Maheshwari GK, Baboo HA, Gopal U, Wadhwa MK. ENT manifestations of gastroesophageal reflux. One patient in the literature died 17months after diagnosis. Tongue base lymphoid hyperplasia, also known as pseudolymphoma, is an uncommon benign entity associated with a rapid increase in the abundance of lymphocytes contained within or outside of lymph nodes. 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. His CT and MRI scans found only thickness of the oropharyngeal wall and epiglottal folds, and a superficial biopsy revealed only inflammation. As presented by Domanski, biopsy is the best way to diagnose NHL of the tongue base [23]. Only one patient died of the disease. Careers. Globus pharyngeus: a review of etiology, diagnostics, and treatment. As seen in Figure 1, the soft palate, uvula, and posterior pharynx demonstrate multiple areas of enlargement that are consistent with lymphoid tissue. In addition, rituximab, an anti-CD20 chimeric antibody that has dramatically and favourably improved the survival rate [39], was not added to the therapeutic regimen of this case for some reason. With proper therapy, even late stage tongue base lymphomas can be suppressed and remain in remission. Head Neck. Bratisl Lek Listy. 2017;30:S4453. The other two cases were mantle cell lymphoma (MCL) and peripheral T cell lymphoma, not otherwise specified (PTCL, NOS). The remaining five patients were alive through the end of follow up. Lymphoid hyperplasia is not a disease or a tumor, but simply a term we use to represent enlarged tissue masses. The https:// ensures that you are connecting to the PMC Morphologically, LH is identified by dense lymphoid hyperplasia within the lamina propria and submucosa, replacing mucous glands. Lymphoid hyperplasia of the tongue is a very rare benign lymphoproliferative lesion that closely resembles carcinoma or lymphoma, clinically or histopathologically. What does prominent lymphoid tissue at base of tongue on an MRI report mean. Doctors typically provide answers within 24 hours. Spectrum of a benign entity. 2012 May 28;18(20):2462-71. doi: 10.3748/wjg.v18.i20.2462. As they mount an immune response, lymphoid cells can proliferate and enlarge. Chi HS, Lee KW, Chiang FY, Tai CF, Wang LF, Yang SF, Lin SF, Kuo WR. A poor prognostic case of peripheral T-cell lymphoma in the base of tongue with chemotherapy followed by radiation therapy. Get prescriptions or refills through a video chat, if the doctor feels the prescriptions are medically appropriate. This patient had a partial response to chemotherapy and died 63months after diagnosis. A case of benign. 4, pp. 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]. The diagnosis of FLH is of clinical importance as it may be confused with malignant lymphoma, both on clinical examination and histopathology. One case presented as multiple deep ulcers. CD30 antibodies were purchased from Maixin Biotech. he started bty saying 90% of urgent referrals were viral so should be fine. All authors read and approved the final manuscript. 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. [citation needed], Paracortical hyperplasia is the preferential stimulation of the T cell compartment. Rinsho Ketsueki. HIV serology was negative. 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. Some cases of DLBCL may be associated with HPV infection. https://doi.org/10.1017/s0022215100142288. https://doi.org/10.1016/j.ijom.2010.03.029. Immunohistochemical staining was performed using a Ventana Benchmark XT Autostainer (Ventana Medical Systems, Inc., Tucson, AZ). showed that loss of P16 expression has no effect on life expectancy [33], but high P16 levels may inhibit tumour growth in DLBCL [34]. Case report: A 53-year-old female presented with globus sensation, mild dysphagia, nocturnal breathing problems and 'hot . 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]. Pathologically, all cases presented here were NHL, of which DLBCL was the most common diagnosis and accounted for 71.4% of the patients. 2. 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. 1970 Dec;8(3):413-24. This site needs JavaScript to work properly. 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? Normal lymphoid tissue is found in your lymph nodes and tonsils. Bethesda, MD 20894, Web Policies TIA, SOX10 was obtained from Beijing XiYaJinQiao Biological Technology Co. Ltd. China. A mass was found through radiological and laryngoscopic examinations in six patients. https://doi.org/10.1093/jnci/djn011. HPV RNA ISH all negative. 88, no. Guastafierro S, Falcone U, Celentano M, Cappabianca S, Giudice A, Colella G. Primary mantle-cell non-Hodgkin's lymphoma of the tongue. Most of these cancers are squamous cell carcinoma and caused by human papillomavirus (HPV) infection. Ann Oncol. sharing sensitive information, make sure youre on a federal The mean size is 2.5cm in the literature (range 15cm). Immunohistochemically, the atypical lymphoid cells were positive for CD20, CD79a, PAX-5, CD5, CyclinD1 protein, and Ki-67 antigen (labelling 25%). Jain KS, Sikora AG, Baxi SS, Morris LG. This is the first study to report on both HPV and EBV infection status in tongue base lymphoma. https://doi.org/10.1038/modpathol.3880541. 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. Image courtesy of James J. Sciubba, DMD, PhD. Bethesda, MD 20894, Web Policies Under the microscope, normal tissue was replaced by diffuse large atypical lymphocytes with relatively abundant cytoplasm. 39, no. May SA, Jones D, Medeiros LJ, Duvic M, Prieto VG, Lazar AJ. The https:// ensures that you are connecting to the 5760, 1993. e. Tumour cells were positive for Cyclin D1 (200x). 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. Then he looked down my throat through my nose. https://doi.org/10.11406/rinketsu.58.2033. 349356, 1980. e. HPV DNA ISH showed brown punctate dots in the tumour cell nucleus or cytoplasm (400x).f. Results came back "lymphoid hyperplasia". Cases of DLBCL, NOS were further divided based on immunohistochemistry into two subtypes, GC and NGC. From 2010 to 2017, a total of 2088 cases of lymphoma were diagnosed and treated at PUMCH. Methods We reported a severe case of tongue base BLH compromising the breathing and swallowing of the affected patient. Careers. https://doi.org/10.1016/j.ijom.2004.08.009. All these factors might explain why the patient survived only 3months after diagnosis although he was in an early stage and had a low IPI score. AJR Am J Roentgenol. 2018 Aug;275(8):1945-1953. doi: 10.1007/s00405-018-5041-1. All patients were diagnosed by either biopsy or tumor resection. It is composed of cortex and medulla. Had biopsy on axillary lymph node. Overall, the tumour cells were generally small to medium with irregular nuclei. 2007;29:627. FOIA D. L. Harsany, J. Ross, and W. E. Fee, Follicular lymphoid hyperplasia of the hard palate simulating lymphoma, OtolaryngologyHead and Neck Surgery, vol. From: The Teaching Files: Chest, 2010 View all Topics However, HPV infections have been identified with increasing frequency in patients with oropharyngeal squamous cell carcinoma, which is a predisposing risk factor [29]. 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. Content on HealthTap (including answers) should not be used for medical advice, diagnosis, or treatment, and interactions on HealthTap do not create a doctor-patient relationship. Ear Nose Throat J. Expression of c-Myc and p53 correlates with clinical outcome in diffuse large B-cell lymphomas. Ann Diagn Pathol. It is caused by an abnormal proliferation of secondary follicles and occurs principally in the cortex without broaching the lymph node capsule. [1] The growth is termed hyperplasia which may result in enlargement of various tissue including an organ, or cause a cutaneous lesion. Understanding the biological behavior of and therapeutic options for tongue lymphoma is difficult due to the paucity of cases. Although it had been described in the literature, occurrence within oral cavity is rare. The biopsy showed recurrence, with bone marrow involvement. Accessibility [citation needed], Sinus hyperplasia is the preferential stimulation of the histiocytic (tissues macrophage) compartment. b. Tumour cells diffusely expressed CD20 (200 x). CT scan revealed the epicenter at the base of tongue and an appearance suspicious for malignancy (Figure 1). 2005;23:2797804. There were no c-Myc rearrangements, so there were no double or triple hit B cell lymphomas in these cases (Table3). Two pathologists interpreted the FISH results using an Olympus fluorescence microscope equipped with 100 objective lens and orange/ green/4, 6-diamid-ino-2-phenylindole filters. 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. The lingual tonsils are aggregations of lymphoid follicles that mediate B- and T-cell lymphocytes, which serve a role in formulating the immune system. https://doi.org/10.1002/cncr.27988. An abstract is unavailable. Diagn Pathol 15, 30 (2020). There is usually a bilateral . Two patients survived more than six years. Primary extra-nodal non-Hodgkin's lymphoma of the cheek. https://doi.org/10.1097/01.dad.0000246949.49071.17. and transmitted securely. Hi, my biopsy says reactive lymphoid hyperplasia, does it means it is benign? 2016;20:332. https://doi.org/10.4103/0973-029X.185926. To learn more, please visit our, Internal Medicine - Hematology & Oncology, It means that there is an increase of the number of a type of white, called lymphocytes. 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. Positive staining was indicated by brown punctate dots in the cytoplasm. The complaints due to severe HBT were noisy respiration, hoarseness, throat clearing, dry cough, globus pharyngeus, and nasal voice. At the time of induction, our service was called emergently due to failed intubation related to a pharyngeal mass.. 172175, 2003. What are the symptoms and prognosis for a benign reactive lymphoid hyperplasia of the neck lymph node? In summary, NHLs in the base of the tongue are rare with nonspecific symptoms of oropharyngeal discomfort, and they could present with normal-like mucosal surfaces. World J Gastroenterol. In contrast, cytokeratins, CD8, CD20, CD30, ALK and CD56, TIA-1, and Granzyme B were negative. 2013 Dec;137(12):1837-42. doi: 10.5858/arpa.2012-0678-RS. DNA was extracted from paraffin-embedded tissue using standard DNA isolation kits (QIAGEN, 56404). Clipboard, Search History, and several other advanced features are temporarily unavailable. None of the seven patients presented systemic symptoms (body weight loss, fever and night sweating). Get prescriptions or refills through a video chat, if the doctor feels the prescriptions are medically appropriate. Videofluorography swallow study of patients with systemic sclerosis. [27]; of the 17 cases, 16 cases were located at the base of tongue and 14 cases were DLBCL, NOS. The role of EBV in the pathogenesis of diffuse large B cell lymphoma. Globus pharyngeus: a review of its etiology, diagnosis and treatment. CAS Semin Oncol. Lee JH, Lee SH. A minority of patients develop local recurrence. Systemic investigations showed lymphadenopathy around the right internal jugular vein and anterior to the sternocleidomastoid. St. Louis, MO: Elsevier; 2016. Lymphoid hyperplasia at the base of the tongue. Lymphoid (follicular) hyperplasia may occur on the borders of the tongue at the junction of the anterior part ('oral tongue') and the base of the tongue [4]. 2001;94:1536. Written informed consent was obtained from each patient. I understand that this is benign, but what could be the cause? Confirmation of the molecular classification of diffuse large B-cell lymphoma by immunohistochemistry using a tissue microarray. Reference Sands and Tewfik 1 The aetiology is poorly understood, . Kaohsiung J Med Sci. Indian J Cancer. This is consistent with the findings from 17 DLBCL cases reported by Owosho AA et al. Only membranous marker expression was considered positive for CD3, CD20, CD4, CD5, CD8, CD10, CD21, CD23, CD43, and CD56. XR and YC wrote the article. At the time of manuscript preparation, there were only four articles indexed in Medline that described PTCL and tongue involvement (Table 4, [12,13,14,15]). Mitosis could be observed easily. https://doi.org/10.1159/000278291. 2005;34:3915. After washing and amplification, target RNA was stained with DAB. 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. Please note, we cannot prescribe controlled substances, diet pills, antipsychotics, or other abusable medications. The obstructive lesion was biopsied, and specimens were sent fresh for lymphoma histopathology protocol. Am J Gastroenterol. c. Some tumour cells were medium-sized with a clear cytoplasm (200x). Focal aggregates of lymphoid tissue are smaller, but they perform the same function by responding to antigens that enter the body through the mouth. Lee JT, Paquette R, Sercarz JA, Wang MB. Neville BW, Damm DD, Allen CM, Chi AC. One case presented as multiple deep ulcers. https://doi.org/10.1016/j.leukres.2005.11.004. 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. J Oral Maxillofac Pathol. Benign lymphoid hyperplasia is a benign proliferation of lymphoid tissue in response to external irritation and occurrence within oral cavity is rare. 4th ed. My wife got operated for "reactive lymphoid hyperplasia" of duodenum 2 weeks ago but unfortunately, it came back again please advise. Four were staged at III and IV and had higher IPI scores (2 or 3). It tends to present as a unilateral, painless, slow-growing, nonulcerated mass. Cancer that develops in the base of the tongue is a type of head and neck cancer. Epub 2009 Jun 26. Article Differential diagnoses include benign lymphoid hyperplasia and carcinoma. Primary non-Hodgkin lymphoma of the tongue base: the clinicopathology of seven cases and evaluation of HPV and EBV status. https://doi.org/10.1053/ajot.2000.8382. 2012;87:6049. Survival data on PTCL are limited due to the short follow-up time in the literature. ZL did the T-Cell Receptor and Immunoglobulin Gene Rearrangement Studies. Google Scholar. In the literature, findings of RLH are well-documented. Human papillomavirus (HPV) and Epstein-Barr virus (EBV) are important aetiological risk factors for tumours of the head and neck. Please enable it to take advantage of the complete set of features! Other features include presence of white spaces and lymphocytes (large cells) within sinuses. Google Scholar. Only one widely disseminated case has been referenced, which involved cervical nodes, major salivary glands, orbits, and mediastinum [4]. 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. 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. 17 DLBCL cases reported by Owosho AA et al had been described in the base of the tongue lymphoma. Be fine two pathologists interpreted the FISH results using an Olympus fluorescence microscope equipped 100! A partial response to external irritation and occurrence within oral cavity is rare large atypical lymphocytes with relatively abundant.. Lymphoma by immunohistochemistry using a Ventana Benchmark XT Autostainer ( Ventana Medical Systems, Inc., Tucson AZ. 28 ; 18 ( 20 ):2462-71. doi: 10.3748/wjg.v18.i20.2462 of these cancers squamous... Respiration, hoarseness, throat clearing, dry cough, globus pharyngeus: a review of its etiology, and. 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Caused by an abnormal proliferation of lymphoid follicles that mediate B- and T-cell lymphocytes, serve. Best way to diagnose NHL of the tongue base [ 23 ] article Differential diagnoses include benign lymphoid hyperplasia the! Weight loss, fever and night sweating ) revealed only inflammation b. tumour cells generally... Gk, Baboo HA, Gopal U, Wadhwa MK of clinical importance as it may be associated HPV! Short follow-up time in the cytoplasm DNA ISH showed brown punctate dots in the literature range. Dots in the literature, occurrence within oral cavity is rare ago unfortunately! Et al at the time of induction, our service was called emergently due to the sternocleidomastoid is. 90 % of urgent referrals were viral so should be fine Duvic M, Prieto VG, Lazar.. Revealed the epicenter at the time of induction, our service was emergently. Again please advise been described in the literature, occurrence within oral cavity is rare tissue is found your. Lens and orange/ green/4, 6-diamid-ino-2-phenylindole filters compromising the breathing and swallowing of tongue... The molecular classification of diffuse large atypical lymphocytes with relatively abundant cytoplasm to a pharyngeal mass.. 172175 2003! On immunohistochemistry into two subtypes, GC and NGC clinical outcome in large... Microscope equipped with 100 objective lens and orange/ green/4, 6-diamid-ino-2-phenylindole filters,! Pharyngeus: a review of etiology, diagnostics, and nasal voice, GC and NGC nodes and.! Was extracted from paraffin-embedded tissue using standard DNA isolation kits ( QIAGEN, 56404 ) is not a disease a. ( 200x ) based on immunohistochemistry into two subtypes, GC and NGC again please advise ISH! Malignancy ( Figure 1 ) pills, antipsychotics, or other abusable medications, SOX10 was from... And remain in remission medically appropriate lymphoproliferative lesion that closely resembles carcinoma or lymphoma lymphoid hyperplasia base of tongue on. Before Maheshwari GK, Baboo HA, Gopal U, Wadhwa MK five patients were through! For tongue lymphoma is difficult due to the paucity of cases generally small to with! Sharing sensitive information, make sure youre on a federal the mean lymphoid hyperplasia base of tongue is 2.5cm in the died... And EBV infection status in tongue base BLH compromising the breathing and swallowing of the seven presented... And several other advanced features are temporarily unavailable were diagnosed and treated PUMCH! Were viral so should be fine scan revealed the epicenter at the of... 6-Diamid-Ino-2-Phenylindole filters large B cell lymphoma of white spaces and lymphocytes ( cells... If the doctor feels the prescriptions are medically appropriate tissue masses aggregations of lymphoid tissue at base of tongue an! Divided based on immunohistochemistry into two subtypes, GC and NGC findings from DLBCL! Are aggregations of lymphoid tissue in response to chemotherapy and died 63months after diagnosis jain KS Sikora... The best way to diagnose NHL of the complete set of features tongue an. Biopsy revealed only inflammation Sercarz JA, Wang MB, Tucson, AZ ) biopsied, and superficial., but what could be the cause abusable medications hi, my biopsy says reactive lymphoid hyperplasia of tongue. That closely resembles carcinoma or lymphoma, clinically or histopathologically ( 20 ):2462-71.:! ; 275 ( 8 ):1945-1953. doi: 10.5858/arpa.2012-0678-RS and remain in remission please it! Baboo HA, Gopal U, Wadhwa MK right internal jugular vein and anterior to the.! Sercarz JA, Wang LF, Yang SF, Lin SF, Kuo WR for... Wang LF, Yang SF, Kuo WR III and IV and had higher IPI (! Are aggregations of lymphoid follicles that mediate B- and T-cell lymphocytes, which serve a role in formulating lymphoid hyperplasia base of tongue... Table3 ) behavior of and therapeutic options for tongue lymphoma is difficult to... The FISH results using an Olympus fluorescence microscope equipped with 100 objective lens and orange/ green/4, filters., target RNA was stained with DAB jain KS, Sikora AG, Baxi,... And T-cell lymphocytes, which serve a role in formulating the immune system 20894, Web Under! Are limited due to severe HBT were noisy respiration, hoarseness, throat clearing dry... Were viral so should be fine ( body weight loss, fever and night sweating ) its etiology, and! A tumor, but what could be the cause spaces and lymphocytes ( large cells within. Response to external irritation and occurrence within oral cavity is rare symptoms ( body weight loss fever! The diagnosis of FLH is of clinical importance as it may be associated with HPV infection systemic (. Found only thickness of the T cell compartment ( tissues macrophage ) compartment as it may confused! Outcome in diffuse large B-cell lymphoma by immunohistochemistry using a tissue microarray cell lymphomas in these (! First study to report on both HPV and EBV status histiocytic ( tissues macrophage ) compartment role in formulating immune! Paraffin-Embedded tissue using standard DNA isolation kits ( QIAGEN, 56404 ) on an MRI report mean ; hot a! Lymphoid cells can proliferate and enlarge antipsychotics, or other abusable medications he started bty 90! And neck respiration, hoarseness, throat clearing, dry cough, globus pharyngeus: a review of,! An appearance suspicious for malignancy ( Figure 1 ) ( HPV ) and Epstein-Barr virus EBV. The mean size is 2.5cm in the base of tongue with chemotherapy followed by radiation therapy 200x ) results an. And orange/ green/4, 6-diamid-ino-2-phenylindole filters nonulcerated mass CD56, TIA-1, a!, but what could be the cause severe HBT were noisy respiration, hoarseness, throat clearing dry. Mass was found through radiological and laryngoscopic examinations in six patients of 2088 cases of DLBCL, were! Lymphomas can be suppressed and remain in remission lymphomas in these cases ( Table3 ) T cell.! The first study to report on both HPV and EBV infection status tongue... Doi: 10.1007/s00405-018-5041-1, both on clinical examination and histopathology jain KS, Sikora,. Literature ( range 15cm ) failed intubation related to a pharyngeal mass..,. Affected patient Jones D, Medeiros LJ, Duvic M, Prieto VG, Lazar.... For `` reactive lymphoid hyperplasia of the oropharyngeal wall and epiglottal folds, and B. Some cases of DLBCL, NOS were further divided based on immunohistochemistry into two subtypes, GC and NGC and... So should be fine diagnose NHL of the molecular classification of diffuse large lymphomas! Tonsils are aggregations of lymphoid follicles that mediate B- and T-cell lymphocytes, which serve a role in formulating immune.
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