Southern California Academy of Oral Pathology
 

Clinical Case Detail

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CPC Case I
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Provided By
Satish Kumar DDS, MDSc - 2012-05-16
Clinical History
47-year-old Guatemalan female referred by her general dentist for evaluation of an a asymptomatic growth on the left lateral border of the tongue which had been present for 4 months.
 
Past Medical History: Heart murmur diagnosed in childhood and recent history of neurocysticercosis which was successfully treated.
 
Clinical Examination: Extraoral within normal limits. Intraoral reveals a single well defined swelling on the left lateral border of the tongue measuring about 1 cm x 0.5 cm, with normal color and smooth surface, soft and non-tender on palpation.

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Differential Diagnosis
 
  • Schwannoma
  • Cysticercosis of the tongue
  • Granular Cell Tumor
  • Solitary Neurofibroma
  • Salivary Gland Neoplasm:
  • Pleomorphic adenoma
  • Mucoepidermoid Carcinoma
Diagnosis
  • Marginal Zone B�]cell Lymphoma with plasmocytoid features

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Clinical Features
Lymphomas: group of malignancies originating in the lymphatic system.
 
Somatic mutation in a lymphocyte progenitor
 
The progeny of the affected cell usually carries the phenotype of a B, T, or natural killer cell as determined by immunophenotyping and/or gene rearrangement studies.
 
Lymphomas are categorized into two main types: Hodgkin�fs Lymphomas, Non Hodgkin Lymphomas (NHL).The later, may initially developed within the lymphatic tissues and subsequently progresses to an extranodal site

Radiographic Findings

Treatment & Prognosis
  • Referred to Norris Cancer Center for furtherevaluation and treatment
  •  No other sites of malignant involvement
  •  Repeated biopsies confirmed diagnosis
  •  Surgical excision and chemotherapy 
  •  On surveillance and no recurrence

     

     


Discussion
Lymphomas in Head & Neck Region
 
Second most common neoplasia, after squamous cell carcinoma.
 ~ 3.5% of all oral malignancies and the most common site is the tonsil followed by the parotid gland.
 When found in the oral cavity they usually represent a part of an already disseminated disease.
 In some cases it represents a localized disease process.
 
References

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