SW and XZ did the BCL-2, BCL-6, c-MYC FISH examination. Bookshelf All patients were diagnosed by either biopsy or tumor resection. [3] Follicular hyperplasia must be distinguished from follicular lymphoma (bcl-2 protein is expressed in neoplastic follicles, but not reactive follicles). Please enable it to take advantage of the complete set of features! The authors declare that they have no competing interests. Pathol Res Pract. 2011;24:98392. d. Tumour cells were positive for C-myc (200 x). Lee YY, Van Tassel P, Nauert C, North LB, Jing BS. Positive nucleolus staining was used to identify Bcl-6, mum-1, CyclinD1, SOX11 and Ki-67. In addition, an understanding of these diseases will allow the development of new targeted therapies for these aggressive lymphomas. https://doi.org/10.1038/modpathol.2016.152. 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. In this paper we present a case of severe pharyngeal lymphoid hyperplasia causing airway obstruction and requiring tracheotomy and subsequent surgical debulking. 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. All authors read and approved the final manuscript. official website and that any information you provide is encrypted Normal lymphoid tissue is found in your lymph nodes and tonsils. official website and that any information you provide is encrypted There is usually a bilateral . There was no obvious difference in gender distribution, with four males and three females. Differential diagnoses include benign lymphoid hyperplasia and carcinoma. https://doi.org/10.1309/YHFE-R65B-D3LK-3GGV. Chi HS, Lee KW, Chiang FY, Tai CF, Wang LF, Yang SF, Lin SF, Kuo WR. Three patients were at an early stage (stage I and II) and had low IPI scores (0 or 1). In our case, the late stage of disease, the morphologically blastic variant [44], and involvement of neck lymph nodes were all factors that contributed to poor prognosis of this patient. 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. doi: 10.1148/radiology.144.4.7111732. 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]). Positive staining was indicated by brown punctate dots in the cytoplasm. https://doi.org/10.1080/02841860500531682. It is caused by an abnormal expansion of the interfollicular zones but is confined within the lymph node capsule. The most common subtype of NHLs of the tongue base is DLBCL, and the occurrence at this site may have a good prognosis. The obstructive lesion was biopsied, and specimens were sent fresh for lymphoma histopathology protocol. With proper therapy, even late stage tongue base lymphomas can be suppressed and remain in remission. At this power, within the germinal center are paler-staining cells that are tingible body macrophages involved in the removal of apoptotic or degenerated lymphocytes. Vose JM. Mohd Ridah LJ, A Talib N, Muhammad N, Hussain FA, Zainuddin N. p16 Tumor Suppressor Gene Methylation in Diffuse Large B Cell Lymphoma: A Study of 88 Cases at Two Hospitals in the East Coast of Malaysia. 2001;94:1536. Get prescriptions or refills through a video chat, if the doctor feels the prescriptions are medically appropriate. https://doi.org/10.4149/BLL_2017_116. All 7 lymphomas were localized at the base of the tongue. PubMed 4, pp. 2010;77:96105. https://doi.org/10.1016/j.ijom.2010.03.029. Lymphoid hyperplasia is the rapid proliferation of normal lymphocytic cells that resemble lymph tissue which may occur with bacterial or viral infections. A poor prognostic case of peripheral T-cell lymphoma in the base of tongue with chemotherapy followed by radiation therapy. 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. The blastic variant of mantle cell lymphoma arising in Waldeyer's tonsillar ring. Two probes (EBV and HPV) were used for all seven cases. This distribution is similar to that in previous reports [18,19,20,21,22] .The most common location was the base of the tongue. The lingual tonsils are aggregations of lymphoid follicles that mediate B- and T-cell lymphocytes, which serve a role in formulating the immune system. Sinus hyperplasia may be associated with non-hematolymphoid malignancy. 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. Mod Pathol. The diagnosis of FLH is of clinical importance as it may be confused with malignant lymphoma, both on clinical examination and histopathology. Clipboard, Search History, and several other advanced features are temporarily unavailable. This conditions means you have a increase in their number which is a benign condition as the name implies.. What is the treatment of reactive lymphoid hyperplasia? Six of the cases exhibited tongue base masses with smooth surface membranes. Lailatul et al. Unauthorized use of these marks is strictly prohibited. and transmitted securely. MeSH Paraffin sections were prepared according to the ThermoBrite Elite Automated FISH slide prep system manufacturers protocol. Ren, X., Cheng, Y., Wu, S. et al. he started bty saying 90% of urgent referrals were viral so should be fine. Neville BW, Damm DD, Allen CM, Chi AC. Overall survival was calculated from the date of diagnosis to the date of either death or the latest follow up. Three reactive samples, either tonsils or lymph nodes, were included to establish cut-off values. https://doi.org/10.4103/0019-509X.58873. https://doi.org/10.1016/j.oooo.2014.06.002. 1991;6(3):170-8. doi: 10.1007/BF02493520. A finding indicating enlargement of the tongue. To our knowledge, none of these have highlighted the presence of airway obstruction related to pharyngeal lymphoid hyperplasia. As shown in Table1, all primary lesion locations were considered at the base of the tongue. https://doi.org/10.11406/rinketsu.58.2033. Yuen A, Jacobs C. Lymphomas of the head and neck. Primary extra-nodal non-Hodgkin's lymphoma of the cheek. 2013;91 Thesis 5:127. J Clin Oncol. a. CT showed an irregular soft tissue mass at the right posterior aspect of the tongue base. The tumour cells were large and blastic, with a high mitotic rate, which was similar to diffuse large B lymphoma tumour cells. https://doi.org/10.1016/j.leukres.2005.11.004. 2001;23:54758. Work-up of globus: assessing the benefits of neck ultrasound and videofluorography. https://doi.org/10.1007/s12185-008-0142-z. Lee ES, Kim LH, Abdullah WA, Peh SC. e. HPV DNA ISH showed brown punctate dots in the tumour cell nucleus or cytoplasm (400x).f. Similarly, the inner cortex has T cells and is called the T-cell zone. 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. A mass was identified in the right base of the tongue that caused breathing difficulties. 1, pp. Hypermethylation of CpG islands in p16 as a prognostic factor for diffuse large B-cell lymphoma in a high-risk group. Video chat with a U.S. board-certified doctor 24/7 in a minute. Lee JH, Lee SH. Diagn Cytopathol. Article TIA, SOX10 was obtained from Beijing XiYaJinQiao Biological Technology Co. Ltd. China. Owosho AA, Bilodeau EA, Surti U, Craig FE. Parkin DM, Bray F, Ferlay J, Pisani P. Estimating the world cancer burden: Globocan 2000. Patricia Uherova et al. 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). 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. .. J Oral Maxillofac Pathol. 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. Semin Oncol. Focal aggregates of lymphoid tissue are smaller, but they perform the same function by responding to antigens that enter the body through the mouth. Dysphagia. https://doi.org/10.4103/0973-1482.136024. A lymphoid follicle under microscope is shown in Figure 2. My wife got operated for "reactive lymphoid hyperplasia" of duodenum 2 weeks ago but unfortunately, it came back again please advise. This is consistent with the findings from 17 DLBCL cases reported by Owosho AA et al. [2], Follicular hyperplasia is a stimulation of the B cell compartment. 1. Oral Surg Oral Med Oral Pathol Oral Radiol. https://doi.org/10.1159/000278291. 2000;21:2716. The site is secure. Follicular lymphoid hyperplasia (FLH) is a benign lymphoproliferative process of unknown etiology, uncommon in the head and neck region. This article is available as a PDF only. Bone marrow involvement was identified at relapse. All cases were negative for EBV ISH but one case was positive for HPV DNA ISH while the other six cases were negative for HPV DNA ISH. Guastafierro S, Falcone U, Celentano M, Cappabianca S, Giudice A, Colella G. Primary mantle-cell non-Hodgkin's lymphoma of the tongue. Asian Pac J Cancer Prev. This is an open access article distributed under the. DNA was extracted from paraffin-embedded tissue using standard DNA isolation kits (QIAGEN, 56404). 1999;26:33845. 2006;17:143440. This is consistent with head and neck research findings [6, 26]. May SA, Jones D, Medeiros LJ, Duvic M, Prieto VG, Lazar AJ. Most of these cancers are squamous cell carcinoma and caused by human papillomavirus (HPV) infection. Mamede RC, Amaral Fd, Raimundo DG, Freitas LC, Ricz HM, Mello Filho FV. The .gov means its official. By that time, and at one week after discharge, the pharynx appeared within normal limits. 2017;58:203342. 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. HHS Vulnerability Disclosure, Help Imaging examination and tissue biopsy should be performed as early as possible to improve precise pathological diagnosis and therapeutic outcomes. Provided by the Springer Nature SharedIt content-sharing initiative. 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. Lymphoid hyperplasia at the base of the tongue. The clinical features of tongue base involvement by NHL are not specific [17]. Three patients had a complete response (Table1). Clinicopathological information including age, gender, tumour location, histological subtype, grading, staging, survival, and response to treatment was acquired from the archives. One of the DLBCL cases was positive for HPV DNA and diffusely expressed P16 protein. Three patients are alive with disease and 2 are alive without disease. Clinical and laboratory investigations are routinely negative [2]. 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. All cases were reviewed and diagnoses were confirmed based on basic morphology, immunohistochemistry staining, and rearrangement. 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]. This may be because the case occurred before drugs such as rituximab were widely available. The most common site for all cases was at the base of the tongue. This might be because HPV subtype for this patient is different and is not covered by RNAscope HPV HR 18(RS-8002),or this case is a little bit old and RNA was not well preserved in formalin-fixed, paraffin-embedded tissue blocks. 1997;76:356. This is the first study to report on both HPV and EBV infection status in tongue base lymphoma. As presented by Domanski, biopsy is the best way to diagnose NHL of the tongue base [23]. Except in one case of four, all of our patients were alive through follow-up. Improved survival of patients with human papillomavirus-positive head and neck squamous cell carcinoma in a prospective clinical trial. Acta Oncol. By using this website, you agree to our Radiology. Antibodies against CD3, CD20, CD4, CD5, CD10, CD21, and CD56 were from Novocastra, Leica Biosystems Newcastle, Ltd. Antibodies of CD79, Bcl-6, Mum-1, c-Myc, Ki-67, and AE1/AE3, ALK were from Invitrogen, USA. Reported cases involve the conjunctiva, liver, gastrointestinal tract, stomach, lungs, paranasal sinuses, and many cutaneous areas. Cases of PTCL and MCL are described in detail in the Results section. 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. Postoperatively the patient was deemed unsafe for extubation and transferred to the intensive care unit while placed on high-dose intravenous dexamethasone.
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