Extranodal lymphoma arising within the maxillary alveolus: a case report

Area of Science:

• Oral oncology
• Diagnostic imaging in dentistry
• Head and neck pathology

Background:

• Extranodal lymphomas of the head and neck are uncommon, rarely involving the jawbones.
• Early detection of jawbone lesions is often incidental during routine dental examinations.

Observation:

• A radiolucent lesion in the maxilla, noted on conventional radiography, presented with a "floating teeth" sign suggestive of malignancy.
• Advanced imaging, including cone beam computed tomography (CBCT), multidetector computed tomography (MDCT), and magnetic resonance imaging (MRI), was utilized.
• The lesion demonstrated rapid growth within a week between MDCT and MRI scans.

Findings:

• Conventional radiography revealed suspicious signs of malignancy but limited evaluation of lesion extent.
• Cross-sectional imaging modalities (CBCT, MDCT, MRI) were employed for detailed assessment.
• Despite advanced imaging, the provisional diagnosis was squamous cell carcinoma, highlighting diagnostic challenges.

Implications:

• Conventional radiography can indicate malignancy but is insufficient for comprehensive evaluation of jawbone lesions.
• CBCT offers a valuable role in imaging complex maxillofacial pathologies, complementing MDCT and MRI.
• Recognizing the absence of central necrosis could have aided in including extranodal lymphoma in the differential diagnosis for maxillary alveolus lesions.