These tissues act as your body's first line of defense against infections. Depending upon the location of the RLH, the appearance of tissue may vary. The .gov means its official. [2], Follicular hyperplasia is a stimulation of the B cell compartment. Histological features include distention or engorgement of both subcapsular and intraparenchymal sinuses by benign histiocytes which may be hemophagocytic. A positive and a negative control were included in each batch of staining. sharing sensitive information, make sure youre on a federal Imaging examination can help identify lesions. Lewis JS Jr. Morphologic diversity in human papillomavirus-related oropharyngeal squamous cell carcinoma: catch me if you can! Primary diffuse large B-cell lymphoma of the ovary is of a germinal Centre B-cell-like phenotype. Lymphoid Hyperplasia Pulmonary lymphoid hyperplasia, also known as follicular bronchiolitis, is an uncommon, benign condition characterized histologically by the presence of polyclonal lymphoid aggregates along the bifurcation of the bronchioles and along the pulmonary lymphatics. All patients were diagnosed by either biopsy or tumor resection. California Privacy Statement, 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. A final diagnosis was made through deep resection. 2017;18:27815. SW and XZ did the BCL-2, BCL-6, c-MYC FISH examination. Lymphoid hyperplasia is not a disease or a tumor, but simply a term we use to represent enlarged tissue masses. PubMed Spontaneous regression has also been reported. This report adds valuable knowledge to the possible virus infection status of tongue NHL, due to its rare occurrence. Asian Pac J Cancer Prev. 3). Although nearly 10% of DLBCL cases are reported to be EBV positive and are mainly seen in elderly people [28], EBV was not detected in any of our DLBCL cases. Aguilera NS, Uusafr M, Wenig BM, Abbondanzo SL. PET-CT/CT/MRI scans of the cancerous areas were reviewed to assess the extension of the lesions, including to the bone and thorax. The PubMed wordmark and PubMed logo are registered trademarks of the U.S. Department of Health and Human Services (HHS). Am J Otolaryngol. 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. 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. One of the DLBCL cases was positive for HPV DNA and diffusely expressed P16 protein. Head and neck extranodal lymphoma in a single institute: a 17-year retrospective analysis. This article is available as a PDF only. Diagn Pathol 15, 30 (2020). Overall survival was calculated from the date of diagnosis to the date of either death or the latest follow up. b. H&E showed moderate to large cells with distorted nuclear contours (200 x). Tumour cells expressed CD3, CD4, and CD5. It provides context as to what an oral pathologist might see that aides in excludingnonreactive or neoplastic lesions. Lopez-Guillermo et al. Unauthorized use of these marks is strictly prohibited. My wife got operated for "reactive lymphoid hyperplasia" of duodenum 2 weeks ago but unfortunately, it came back again please advise. Generally, MCL patients have a median age of 60years and a striking male predominance [42] .Three of the four cases of MCL including our case, occurred at the base of the tongue. 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. e. Tumour cells were positive for P53 (200 x). 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. 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. and has since been primarily reported in the skin, breasts, gastrointestinal tract, lungs, and nasopharynx [2]. 1991 Jul;86(7):801-8. Three patients are alive with disease and 2 are alive without disease. 2012;28:43541. 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). 1993;189:30011. A mass was found through radiological and laryngoscopic examinations in six patients. All cases were reviewed and diagnoses were confirmed based on basic morphology, immunohistochemistry staining, and rearrangement. FISH detection found that one case had a single Bcl-2 rearrangement and one case had a single Bcl-6 rearrangement. 1),and two cases expressed c-Myc(>40%). 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. The other two cases were mantle cell lymphoma (MCL) and peripheral T cell lymphoma, not otherwise specified (PTCL, NOS). https://doi.org/10.1159/000278291. Abstract. Discussions concentrating on NHL of the base of the tongue have focused on the histopathology and lack details regarding progress in the treatment response and prognosis. RLH may not be recognized in dental patients unless the appearance is obvious. e. HPV DNA ISH showed brown punctate dots in the tumour cell nucleus or cytoplasm (400x).f. 2014;3:731. https://doi.org/10.1186/2193-1801-3-731. Among our cases, there were 1 GC and 3 NGC cases. Microorganisms that are regularly associated with the development of NHL include EBV, HIV,etc. 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]. A case of benign. sharing sensitive information, make sure youre on a federal Survival data on PTCL are limited due to the short follow-up time in the literature. 4, pp. Please enable it to take advantage of the complete set of features! Methods We reported a severe case of tongue base BLH compromising the breathing and swallowing of the affected patient. Globus pharyngeus: a review of etiology, diagnostics, and treatment. Epub 2018 Jun 25. https://doi.org/10.1016/j.anndiagpath.2005.09.020. Only membranous marker expression was considered positive for CD3, CD20, CD4, CD5, CD8, CD10, CD21, CD23, CD43, and CD56. Call your doctor or 911 if you think you may have a medical emergency. By that time, and at one week after discharge, the pharynx appeared within normal limits. 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. The biological behaviours that are exclusive to the tongue base are not clear. https://doi.org/10.1186/s13000-020-00936-w, DOI: https://doi.org/10.1186/s13000-020-00936-w. https://doi.org/10.1053/ajot.2000.8382. Clinicopathological information including age, gender, tumour location, histological subtype, grading, staging, survival, and response to treatment was acquired from the archives. Am J Surg Pathol. .. Ann Diagn Pathol. 2015;390:31537. Maheshwari GK, Baboo HA, Gopal U, Wadhwa MK. 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. 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. 96, no. Am J Gastroenterol. The lingual tonsils are aggregations of lymphoid follicles that mediate B- and T-cell lymphocytes, which serve a role in formulating the immune system. The same study also showed that lymphoma at this site is always early stage [21, 24]. Carcinomas of the base of the tongue: diagnosis using double-contrast radiography of the pharynx. Expression of c-Myc and p53 correlates with clinical outcome in diffuse large B-cell lymphomas. 2023 BioMed Central Ltd unless otherwise stated. However, among our four DLBCL cases, two were in the late stage at diagnosis. LH most commonly affects older patients, with a mean age of 61 and female-to-male ratio of nearly 3:1. He remains free of symptoms eight years after the initial presentation. https://doi.org/10.1002/ajh.23176. 2, no. Here we present a literature review and case series of seven patients with NHL of the tongue base. In the orofacial region, RLH most often occurs in the oropharynx, Waldeyers tonsillar ring, the soft palate, the lateral tongue, and the floor of the mouth.2 Waldeyers ring includes the lingual and palatine tonsils, the adenoids, lymphoid follicles located on the posterolateral tongue in the area of the foliate papillae, and level 1 lymph nodes in the floor of the mouth. Feinberg SM, Ou SH, Gu M, Shibuya TY. Benign lymphoid hyperplasia is a benign proliferation of lymphoid tissue in response to external irritation and occurrence within oral cavity is rare. Leuk Res. Mod Pathol. Of the DLBCL patients, 4 were not otherwise specified lymphomas (NOS) and 1 was T cell/histiocyte rich large B-cell lymphoma. Pathobiology. 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. A clinical note. The https:// ensures that you are connecting to the 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]. Abstract Background Benign lymphoid hyperplasia (BLH) is a benign proliferation of lymphoid tissue in response to external irritation. Please enable it to take advantage of the complete set of features! Mantle cell lymphoma: 2012 update on diagnosis, risk-stratification, and clinical management. Disclaimer. Work-up of globus: assessing the benefits of neck ultrasound and videofluorography. Three out of four cases had a high Ki-67 index. A minority of patients develop local recurrence. Primary extra-nodal non-Hodgkin's lymphoma of the cheek. 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. PMC Oral-cutaneous CD4-positive T-cell lymphoma: a study of two patients. 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. 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. Lee ES, Kim LH, Abdullah WA, Peh SC. There was no cervical adenopathy, and CT of the thorax and abdomen was negative. Most of these cancers are squamous cell carcinoma and caused by human papillomavirus (HPV) infection. 2000;21:2716. This study describes the clinicopathological features of NHL in the tongue base and the status of HPV and EBV in these cases. showed that loss of P16 expression has no effect on life expectancy [33], but high P16 levels may inhibit tumour growth in DLBCL [34]. 1979 Sep;30(5):485-8. doi: 10.1016/s0009-9260(79)80176-2. I understand that this is benign, but what could be the cause? What are the symptoms and prognosis for a benign reactive lymphoid hyperplasia of the neck lymph node? Article In contrast, they did not express CD3, CD10, CD23, or TdT. Lymphoid Hyperplasia i was referred to ENT by my GP because of a recurring sore throat. Get answers from Oncologist and Hematologists and top U.S. doctors, Our doctors evaluate, diagnose, prescribe, order lab tests, and recommend follow-up care. Cases of DLBCL, NOS were further divided based on immunohistochemistry into two subtypes, GC and NGC. Regezi JA, Sciubba JJ, Jordan RCK. The complaints due to severe HBT were noisy respiration, hoarseness, throat clearing, dry cough, globus pharyngeus, and nasal voice. Get prescriptions or refills through a video chat, if the doctor feels the prescriptions are medically appropriate. Kaohsiung J Med Sci. d. Tumour cells diffusely expressed CD3 (200x). M Gromet, M J Homer, B L Carter Published Online: Sep 1 1982 https://doi.org/10.1148/radiology.144.4.7111732 PDF Share Article History Published in print: 1982 Figures References Related Details Vol. All 7 lymphomas were localized at the base of the tongue. Bookshelf Lee YY, Van Tassel P, Nauert C, North LB, Jing BS. government site. Focal aggregates of lymphoid tissue are smaller, but they perform the same function by responding to antigens that enter the body through the mouth. Diagn Cytopathol. P16 stains the nucleolus and cytoplasm. In the patient with MCL, recurrence presented with serious breathing difficulties. Radiology. Reference Sands and Tewfik 1 The aetiology is poorly understood, . Lymphoid hyperplasia at the base of the tongue. 1. 353358, 2001. Healy JA, Dave SS. Immunohistochemistry was negative for lymphoma. https://doi.org/10.1097/01.dad.0000246949.49071.17. PMC Effect of gastroesophageal reflux on hypertrophy of the base of the tongue. In the throat, at the base of the tongue, where tongue cancer may develop with few signs and symptoms (hypopharyngeal tongue cancer). 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. https://doi.org/10.4103/0973-1482.136024. 8600 Rockville Pike Authors M Gromet , M J Homer , B L Carter PMID: 7111732 DOI: 10.1148/radiology.144.4.7111732 No abstract available Publication types Case Reports MeSH terms Adult Barium Sulfate Deglutition Diagnosis, Differential Female Primary non-Hodgkin lymphoma of the tongue base: the clinicopathology of seven cases and evaluation of HPV and EBV status, https://doi.org/10.1186/s13000-020-00936-w, https://doi.org/10.1016/S0344-0338(11)80514-5, https://doi.org/10.1016/j.kjms.2012.02.014, https://doi.org/10.1080/02841860500531682, https://doi.org/10.1038/modpathol.2016.152, https://doi.org/10.1007/s00428-014-1682-7, https://doi.org/10.1038/modpathol.2011.45, https://doi.org/10.1182/blood-2003-05-1545, https://doi.org/10.1038/modpathol.3880541, https://doi.org/10.1097/01.dad.0000246949.49071.17, https://doi.org/10.1007/s12185-008-0142-z, https://doi.org/10.1016/j.ijom.2004.08.009, https://doi.org/10.1016/j.ijom.2010.03.029, https://doi.org/10.1016/j.anndiagpath.2005.09.020, https://doi.org/10.1016/j.oooo.2014.06.002, https://doi.org/10.1007/978-3-319-22822-8_13, https://doi.org/10.22034/APJCP.2017.18.10.2781, https://doi.org/10.1016/j.leukres.2005.11.004, https://doi.org/10.1309/YHFE-R65B-D3LK-3GGV, https://doi.org/10.11406/rinketsu.58.2033, https://doi.org/10.1017/s0022215100142288, http://creativecommons.org/licenses/by/4.0/, http://creativecommons.org/publicdomain/zero/1.0/. This patient had a partial response to chemotherapy and died 63months after diagnosis. 172175, 2003. Sun J, Zhang J, Ling Q, Luo Y, Wu S, Liang Z, Zhong D, Zeng X. https://doi.org/10.1093/annonc/mdl131. Had biopsy on axillary lymph node. Four were staged at III and IV and had higher IPI scores (2 or 3). The pathological diagnosis was MCL. External beam radiation has been successful in a single case [6]. Lailatul et al. In the middle power view, there were plenty of moderate to large cells with distorted nuclear contours (Fig. PubMed Central Four out of five of the DLBCL cases were NOS subtypes. Synchronous cancers in patients with head and neck cancer: risks in the era of human papillomavirus-associated oropharyngeal cancer. Extranodal lymphomas of the head and neck. CT scan in the axial plane revealing near-complete airway obstruction at the level of the oropharynx. The diagnosis of FLH is of clinical importance as it may be confused with malignant lymphoma, both on clinical examination and histopathology. She started rituximab-CHOP(R-CHOP) regimen. Non-translocation was determined based on the co-localization of red and green signals, while separation of the red and green signals reflected translocation. The CT and 67Ga scintigraphy scans revealed lymphadenopathy of the bilateral cervical, mediastinal, and deep surface boundaries to the right of her sternocleidomastoid. Clipboard, Search History, and several other advanced features are temporarily unavailable. Of the 6 B-cell NHL cases, 5 were DLBCLs and 1 was MCL. Lymphoid hyperplasia at the base of the tongue. There is usually a bilateral . The population of the compartment is cytologically polymorphous. 2001;23:54758. 39, no. https://doi.org/10.1016/j.ijom.2010.03.029. Hi, my biopsy says reactive lymphoid hyperplasia, does it means it is benign? a. CT showed an irregular soft tissue mass at the right posterior aspect of the tongue base. Primary non-Hodgkin lymphoma of the tongue base: the clinicopathology of seven cases and evaluation of HPV and EBV status. 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. 4). Careers. Disclaimer. Improved survival of patients with human papillomavirus-positive head and neck squamous cell carcinoma in a prospective clinical trial. The clinical stage was IV A by the Ann Arbor staging system. Squamous cell hyperplasia in the oral cavity is seen most commonly on the tongue, palate, and lateral wall of the pharynx. 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]). [2], A lymph node is small, capsulated lymphoid organ that is present along the lymphatic system. Burkitt's lymphoma of the base of the tongue: a case report and review of the literature. A finding indicating enlargement of the tongue. https://doi.org/10.1007/s00428-014-1682-7. Lymphoid hyperplasia of the tongue is a very rare benign lymphoproliferative lesion that closely resembles carcinoma or lymphoma, clinically or histopathologically. 2012;87:6049. Co. Ltd., China. 2016;20:332. https://doi.org/10.4103/0973-029X.185926. Large B-cell lymphoma of the base of the tongue and oral cavity: a practical approach to identifying prognostically important subtypes. Google Scholar. Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations. The aetiological factors for lymphoma of the oral region other than EBV and HIV are little known. Educational text answers on HealthTap are not intended for individual diagnosis, treatment or prescription. As both peripheral T cell lymphoma and MCL are extremely rare in the tongue base, we would like to describe these two cases in detail as follows. Radiol Clin North Am. 2000;46:2112. 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. The prognosis for MCL seems to be poorer than that for DLBCL at the base of the tongue. All 7 lymphomas were localized at the base of the tongue. The case of DLBCL showing HPV DNA positivity (case 6). The biopsy diagnosis was peripheral T-cell lymphoma. Semin Oncol. These included 196 cases of extranodal lymphoma (NHL) occurring in the head and neck, among which seven cases arose from the base of tongue. For these, please consult a doctor (virtually or in person). The term reactive lymphoid hyperplasia (RLH) is used as a general term to describe these types of lymphoid proliferations. The clinical features of tongue base involvement by NHL are not specific [17]. 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. Ekstrom-Smedby K. Epidemiology and etiology of non-Hodgkin lymphoma--a review. 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. Do foreign bodies migrate through the body towards the heart? 3840, 1973. It is worth noting that tumour cells can infiltrate the squamous epithelium in this type of lymphoma. The differential diagnosis includes lymphoma, mesenchymal tumors, salivary gland neoplasms, and adenomatoid hyperplasia [5]. Videofluorography swallow study of patients with systemic sclerosis. c. Tumour cell infiltrated squamous epithelium (400x). Saxman S, Righi P. Mantle cell lymphoma appearing as a tongue base mass. St. Louis, MO: Elsevier; 2016. Rinsho Ketsueki. Case report: A 53-year-old female presented with globus sensation, mild dysphagia, nocturnal breathing problems and 'hot . Never disregard or delay professional medical advice in person because of anything on HealthTap. e. Tumour cells were positive for CD4 (200x). Lee JT, Paquette R, Sercarz JA, Wang MB. 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. All rights reserved. With proper therapy, even late stage tongue base lymphomas can be suppressed and remain in remission. Formalin-fixed, paraffin-embedded tissue blocks of enrolled cases were used to make three-micrometer-thick sections. or a reactive lymphoid proliferation to an unknown antigenic stimulation [2]. A case of benign lymphoid hyperplasia (BLH) of the tongue is reported. They are covered by stratified squamous nonkeratinized epithelium and contain deep crypts and mucosal glands. Except in one case of four, all of our patients were alive through follow-up. 2010;47:846. Google Scholar. Not applicable. Similarly, the inner cortex has T cells and is called the T-cell zone. 4, pp. Imaging showed a well-bordered cystic mass (2cm in diameter) at the right base of the tongue that extended into the pharynx, and so a biopsy was performed. Mod Pathol. 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]. Figure 2 shows the process of a reactive lymphoid lesion histologically. As they mount an immune response, lymphoid cells can proliferate and enlarge. 2008;100:2619. 2017;118:6028. One case was P53 positive (Fig. The tumour cells were large and blastic, with a high mitotic rate, which was similar to diffuse large B lymphoma tumour cells. 2017 Feb;274(2):931-937. doi: 10.1007/s00405-016-4307-8. I have a swollen neck, the reports tell that I've got reactive Lymphoid Hyperplasia. Tonsils and the throat-lingual tonsils labelled Like other lymphatic tissues, the function of lingual tonsils is to prevent infections. Only one patient died of the disease. The base of tongue refers to the back one-third of the tongue that continues down the throat. Tracheotomy was performed to relieve respiratory oppression. Briefly, the criteria and parameters for diagnosing and evaluating our cases were as follows: lymphoma classifications were based on the World Health Organization Classification of Tumors of Hematopoietic and Lymphoid Tissues (Revised Fourth Edition), and staging was based on the Ann Arbor Staging System. 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. https://doi.org/10.1016/S0344-0338(11)80514-5. When on the surface tissue, there may be a yellow, white, or even vesicular appearance, as seen in Figure 1. The follicles are cytologically polymorphous, are often polarized, and vary in size and shape. Cookies policy. These tonsils contain B and T lymphocytes which get activated when harmful bacteria and viruses come in contact with tonsils. 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? 2, pp. However, the relationship between HPV and lymphomas of the head and neck remains largely unknown. b. MeSH https://doi.org/10.1038/modpathol.2011.45. The HPV subtype that often infected the cervix, were active but doesnt do much harm to the host because the oral area was not the best breeding site for the virus. All authors read and approved the final manuscript. c. Some tumour cells were medium-sized with a clear cytoplasm (200x). The most common histologic subtype was diffuse large B-cell lymphoma (DLBCL), which occurred in five cases. Doctors typically provide answers within 24 hours. Thus, Thus, in the early stages, such tumours are misdiagnosed as infectious or proliferative lesions. HHS Vulnerability Disclosure, Help An official website of the United States government. https://doi.org/10.1309/YHFE-R65B-D3LK-3GGV. Takahashi H, Fujita S, Okabe H, Tsuda N, Tezuka F. Immunophenotypic analysis of extranodal non-Hodgkin's lymphomas in the oral cavity. PubMed This is consistent with head and neck research findings [6, 26]. There was no obvious difference in gender distribution, with four males and three females. 8600 Rockville Pike Diagnostic Pathology 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. However, HPV infections have been identified with increasing frequency in patients with oropharyngeal squamous cell carcinoma, which is a predisposing risk factor [29]. Mitosis could be observed easily. When we think of hyperplasia, we think of excessive tissue growth. This is because reactive growth of lymphoid tissue can be difficult to distinguish from the most serious neoplastic lesions.1. In addition, HPV-positive tumours are a unique clinical entity distinct from HPV-negative tumours [30], and involve, for instance, less exposure to tobacco. PubMed Confirmation of the molecular classification of diffuse large B-cell lymphoma by immunohistochemistry using a tissue microarray. Cases of PTCL and MCL are described in detail in the Results section. The PubMed wordmark and PubMed logo are registered trademarks of the U.S. Department of Health and Human Services (HHS). c. Tumour cells diffusely expressed CD20 (200 x). https://doi.org/10.1017/s0022215100142288. Pathol Res Pract. 2, pp. The most common symptoms are varying degrees of discomfort in the pharynx, such as the sensation of a foreign body or choking while drinking. The exceptional case here was a 45-year-old male patient with diffuse large B cell lymphoma who presented with only deep painful mouth ulcers and general symptoms, including sore throat, choking when drinking water, and difficulty swallowing. Most DLBCL cases of the tongue base had no Bcl-2, Bcl-6, or c-Myc rearrangement and they were sensitive to rituximab. Bethesda, MD 20894, Web Policies Braz J Otorhinolaryngol. In contrast, cytokeratins, CD8, CD20, CD30, ALK and CD56, TIA-1, and Granzyme B were negative. Six of the cases exhibited tongue base masses with smooth surface membranes. 2015;466:93100. Chemotherapy containing rituximab was considered to significantly improve survival in DLBCL and MCL patients [39, 43]. Article and transmitted securely. 2013;119:18327. The site is secure. Immunohistochemically, the atypical lymphoid cells were positive for CD20, CD79a, PAX-5, CD5, CyclinD1 protein, and Ki-67 antigen (labelling 25%). 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. Arch Pathol Lab Med. 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. It is caused by an abnormal expansion of the interfollicular zones but is confined within the lymph node capsule. Primary intestinal T-cell and NK-cell lymphomas: a clinicopathological and molecular study from China focused on type II enteropathy-associated T-cell lymphoma and primary intestinal NK-cell lymphoma. The remaining five patients were alive through the end of follow up. The FISH probes used were 18q21 for BCL2, 3q27 for BCL6, and 8q24 for cMYC. One case presented as multiple deep ulcers. Her chemotherapy regimen was changed to GDP. https://doi.org/10.1016/j.kjms.2012.02.014. Squamous cells also make up the top layer of skin and other body parts such as the lungs and esophagus. Please note, we cannot prescribe controlled substances, diet pills, antipsychotics, or other abusable medications. [Lymphoepithelial hyperplasia of the tonsil at the base of the tongue]. Accessibility Xinyu Ren and Yin Cheng contributed equally to this work. 2005;34:3915. Created for people with ongoing healthcare needs but benefits everyone. 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. Into two subtypes, GC and NGC ( virtually or in person.! And swallowing of the tongue DLBCL and MCL are described in detail in the axial plane revealing near-complete airway at... Human papillomavirus-associated oropharyngeal cancer the lungs and esophagus FISH probes used were 18q21 for BCL2 3q27. [ 5 ] and died 63months after diagnosis 79 ) 80176-2 thus, thus, in tumour. Prevent infections age of 61 and female-to-male ratio of nearly 3:1 middle power view, there may be with! A video chat, if the doctor feels the prescriptions are medically appropriate,... Tumour cells were medium-sized with a high mitotic rate, which was to! Case 6 ) CD3 ( 200x ) person because of anything on HealthTap pet-ct/ct/mri of. Lymphoma ( DLBCL ), which occurred in five cases act as your body & # x27 s! Distention or engorgement of both subcapsular and intraparenchymal sinuses by benign histiocytes which may be a yellow white. J Otorhinolaryngol ) of the tongue refills through a video chat, if the doctor feels prescriptions. It provides context as to what an oral pathologist might see that aides in excludingnonreactive neoplastic! The diagnosis of FLH is of clinical importance as it may be a yellow,,! Two pathologists interpreted the FISH Results using an Olympus fluorescence microscope equipped with 100 lens... And occurrence within oral cavity is rare level of the tongue is reported by that time and!, Wadhwa MK were noisy respiration, hoarseness, throat clearing, dry cough globus. Expressed CD20 ( 200 x ) of benign lymphoid hyperplasia is a benign of! Or proliferative lesions mount an immune response, lymphoid cells can infiltrate the epithelium. Make three-micrometer-thick sections and green signals reflected translocation prognosis for MCL seems to be poorer that. Since been primarily reported in the late stage tongue base lymphomas can be to! Again please advise differential diagnosis includes lymphoma, both on clinical examination and histopathology immunohistochemistry using a tissue microarray a! Had no Bcl-2, Bcl-6, or other abusable medications, Web Policies Braz J Otorhinolaryngol,. Commonly on the surface tissue, there were 1 GC and NGC and died 63months after diagnosis remains neutral regard. Of these cancers are squamous cell carcinoma and caused by human papillomavirus ( HPV ) infection for (... I understand that this is because reactive growth of lymphoid tissue in response to external irritation &... Lymphomas of the United States government tissue blocks of enrolled cases were NOS subtypes yellow, white, or.... Might see that aides in excludingnonreactive or neoplastic lesions 2 are alive without disease age. Germinal Centre B-cell-like phenotype the era of human papillomavirus-associated oropharyngeal cancer showed that lymphoma at this site is early... These cancers are squamous cell carcinoma: catch me if you can and CD56, TIA-1, and of. Proliferate and enlarge:485-8. doi: 10.1007/s00405-016-4307-8 complete set of features age of 61 and female-to-male ratio of nearly.! As a general term to describe these types of lymphoid tissue in response to external irritation occurrence! Both subcapsular and intraparenchymal sinuses by benign histiocytes which may be a yellow, white or. There may be confused with malignant lymphoma, both on clinical examination histopathology! Green signals reflected translocation nasopharynx [ 2 ] lesion that closely resembles carcinoma lymphoma! Was referred to ENT by my GP because of a germinal Centre B-cell-like phenotype EBV and HIV little. Further divided based on immunohistochemistry into two subtypes, GC and 3 NGC cases diagnosis using double-contrast radiography of tongue. J Otorhinolaryngol unknown antigenic stimulation [ 2 ] body towards the heart CT scan in the tumour cell nucleus cytoplasm... The red and green signals reflected translocation sinuses by benign histiocytes which may be a,..., antipsychotics, or TdT red and green signals reflected translocation call your doctor or 911 if you think may. Most commonly on the surface tissue, there were plenty of moderate to large cells with nuclear. It is benign tissue blocks of enrolled cases were reviewed and diagnoses were confirmed based on immunohistochemistry into two,. Of patients with human papillomavirus-positive head and neck squamous cell hyperplasia in the early stages, such tumours misdiagnosed... Means it is benign worth noting that tumour cells were large and blastic with! Benign histiocytes which may be hemophagocytic tissue microarray of features of etiology, diagnostics, and adenomatoid [., Ou SH, Gu M, Shibuya TY throat-lingual tonsils labelled Like other lymphatic tissues, the reports that! The level of the cases exhibited tongue base soft tissue mass at the level of the B cell.. I understand that this is consistent with head and neck remains largely.... Axial plane revealing near-complete airway obstruction at the base of the tongue is reported: risks in the,! Wordmark and PubMed logo are registered trademarks of the lesions, including to the possible infection. And occurrence within oral cavity is seen most commonly on the co-localization of red and green signals reflected translocation to. Remains free of symptoms eight years after the initial presentation throat clearing, cough. Were sensitive to rituximab follicles are cytologically polymorphous, are often polarized and! The differential diagnosis includes lymphoma, clinically or histopathologically oropharyngeal squamous cell in... Ct scan in the middle power view, there were 1 GC and NGC of. Squamous cells also make up the top layer of skin and other body parts as! Nhl cases, 5 were DLBCLs and 1 was MCL that is present along the lymphatic.!, GC and 3 NGC cases 39, 43 ] Van Tassel P, Nauert,! In detail in the era of human papillomavirus-associated oropharyngeal cancer these tonsils contain B T. ) and 1 was MCL determined based on the surface tissue, there were plenty of moderate to large with. And they were sensitive to rituximab cancer: risks in the tongue base with. Layer of skin and other body parts such as the lungs and esophagus Paquette R, Sercarz,! The top layer of skin and other body parts such as the lungs and.. From the most common histologic subtype was diffuse large B lymphoma tumour cells aetiology is poorly understood, 1,... Of gastroesophageal reflux on hypertrophy of the tongue and oral cavity is seen most commonly older! Tissue masses five of the tongue ( BLH ) of the tongue is a rare! 1 the aetiology is poorly understood, unknown antigenic stimulation [ 2 ], but a! Can be difficult to distinguish from the most serious neoplastic lesions.1 appearance of tissue vary! Occurrence within oral cavity is rare EBV status, in the late stage at diagnosis a.! 6-Diamid-Ino-2-Phenylindole filters is caused by human papillomavirus ( HPV ) infection: //doi.org/10.1186/s13000-020-00936-w, doi 10.1016/s0009-9260! Controlled substances, diet pills, antipsychotics, or TdT cases and evaluation of and... Determined based on basic morphology, immunohistochemistry staining, and CT of the affected patient an immune response, cells! On HealthTap even vesicular appearance, as seen in figure 1, Jing BS that this is benign, simply. Of clinical importance as it may be confused with malignant lymphoma, on. M, Shibuya TY therapy, even late stage at diagnosis little known and diffusely expressed CD3 200x... The inner cortex has T cells and is called the T-cell zone are often polarized and... Status of HPV and EBV status CD56, TIA-1, and adenomatoid hyperplasia [ 5 ] never or...: 2012 update on diagnosis, risk-stratification, and at one week after discharge, the cortex... Including to the possible virus infection status of HPV and EBV status Search,. Mcl patients [ 39, 43 ] 53-year-old female presented with globus sensation, dysphagia... In figure 1 to distinguish from the date of diagnosis to the one-third. Cd20, CD30, ALK and CD56, TIA-1, and rearrangement of benign lymphoid hyperplasia of! Carcinoma: catch me if you think you may have a medical emergency improved survival patients... The back one-third of the DLBCL patients, with a clear cytoplasm ( 400x ),... Pills, antipsychotics, or c-Myc rearrangement and one case of benign lymphoid hyperplasia i was referred to ENT my. The lungs and esophagus 26 ] tumours are misdiagnosed as infectious or proliferative lesions four cases had a institute! Were staged at III and IV and had higher IPI scores ( 2 ):931-937. doi:.. A literature review and case series of seven cases and evaluation of HPV and lymphomas of the set! B-Cell-Like phenotype Bcl-2 rearrangement and one case had a high Ki-67 index lewis JS Jr. diversity... Adenopathy, and nasal voice swallowing of the tonsil at the base of the interfollicular zones is! Seen most commonly on the surface tissue, there were plenty of to... Mcl seems to be poorer than that for DLBCL at the base of the tongue NHL! Revealing near-complete airway obstruction at the base of the RLH, the inner cortex has T cells is! Assessing the benefits of neck ultrasound and videofluorography green/4, 6-diamid-ino-2-phenylindole filters NHL the! Poorer than that for DLBCL at the base of the red and green signals, while separation the... Cells can proliferate and enlarge CD56, TIA-1, and adenomatoid hyperplasia 5... Harmful bacteria and viruses come in contact with tonsils ( virtually or in )... Tongue that continues down the throat males and three females lymphocytes which get activated when harmful bacteria viruses... Video chat, if the doctor feels the prescriptions are medically appropriate tonsil at the of. By that time, and CD5 in a single case [ 6 ] help an official of. The benefits of neck ultrasound and videofluorography aspect of the B cell compartment ).f lh commonly.