Primary extranodal non-Hodgkin's lymphoma of oral cavity--a single centre retrospective study

Extra nodal involvements of non-Hodgkin's lymphomas (NHL) are not so uncommon, but the involvement of oral cavity by NHL is very rare.

The present study involved retrospective analysis of patients from year 2001 to 2011, who presented with oral mass and on evaluation were diagnosed to have primary extranodal NHL of oral cavity at a tertiary cancer care centre in South India.

There were seven patients treated for primary NHL of oral cavity at our institute in last 10 years. The median age at presentation was 43.2 years (range 29-65 years). There were five males and two females. Oral tongue was the most common site (three patients) followed by alveolus (two patients). The other sites of involvement included gingivobuccal sulcus in one patient and hard palate in one patient. All patients were initially evaluated at oral oncology department for gradually increasing ulcerative mass in oral cavity. None of the patients had B symptoms. In our study, plasmablastic lymphoma was the most common type of NHL, followed by diffuse large B cell lymphoma (DLBCL) and peripheral T cell lymphoma, not otherwise specified (PTCL, NOS). Out of seven patients, two were HIV positive, both having plasmablastic lymphoma. Four out of the seven patients received a combination of chemotherapy and radiotherapy and three patients received only chemotherapy. Only three patients could complete the prescribed chemotherapy and radiotherapy schedule and were alive and diseases free with a median follow-up of 21 months.

Involvement of oral cavity by lymphoma is rare. Plasmablastic lymphoma was the most common oral cavity NHL in our patients. Although number of cases in present study was less, our data suggests that oral NHL has aggressive course with less favorable outcome. Further large sample studies incorporating rituximab-based chemotherapy and more aggressive chemotherapy for plasmablastic lymphoma will be helpful for better understanding of treatment outcome.