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Maxillofacial lymphomas.

David MacDonald1, Montgomery Martin2, Kerry Savage2

  • 1Div. Oral & Maxillofacial Radiology, The University of British Columbia, Vancouver, Canada.

The British Journal of Radiology
|November 25, 2020
PubMed
Summary
This summary is machine-generated.

Bone lymphomas in the jaws can mimic carcinomas or inflammatory lesions radiologically. Prompt investigation is crucial for aggressive lymphomas, as misdiagnosis impacts treatment, necessitating accurate imaging and biopsy for definitive diagnosis and management.

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Area of Science:

  • Oral and Maxillofacial Radiology
  • Oncology
  • Pathology

Background:

  • Lymphomas of the jawbones are less common than carcinomas but can present with similar radiological features.
  • These lymphomas, particularly in the maxillary alveolus, often represent aggressive processes with a short diagnostic window.
  • Provisional diagnoses frequently include carcinomas or periapical-radiolucencies of inflammatory origin (PRIOs).

Purpose of the Study:

  • To highlight the diagnostic challenges posed by jaw lymphomas mimicking other conditions.
  • To emphasize the importance of distinguishing lymphoma from carcinoma due to divergent treatment protocols.
  • To review the role of advanced cross-sectional imaging in the diagnosis of these malignancies.

Main Methods:

  • Review of recently reported cases involving cross-sectional imaging of jaw lymphomas.
  • Discussion of the utility of cone-beam computed tomography (CBCT), computed tomography (CT), and magnetic resonance (MR) imaging.
  • Emphasis on the diagnostic pathway involving imaging followed by biopsy.

Main Results:

  • Jaw lymphomas are frequently misdiagnosed as carcinomas or PRIOs, leading to delayed or inappropriate treatment.
  • Failure of PRIO-treated lesions to respond to therapy should prompt investigation for malignancy.
  • Advanced imaging modalities (CBCT, CT, MR) are increasingly recognized for their role in characterizing these lesions.

Conclusions:

  • Accurate differentiation between jaw lymphoma and carcinoma is critical due to distinct treatment strategies (chemotherapy/radiotherapy for lymphoma vs. resection/radiotherapy for carcinoma).
  • Cross-sectional imaging plays a vital role in defining the extent of disease and guiding biopsy.
  • Definitive diagnosis relies on histopathological examination of biopsy samples, with treatment tailored to the specific diagnosis and disease stage.