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Primary extra-nodal non-Hodgkin's lymphoma affecting mandibular bone: a case report
Julie Gante1, Ségolène Georg1, Jean-Michel Gabriel Robez2
1Department of Maxillo-Facial Surgery, University Hospital of Toulouse, Paul Sabatier University, Purpan, Toulouse, France.
The Pan African Medical Journal
|June 20, 2022
Summary
Diffuse large B cell lymphoma (DLBCL), a type of non-Hodgkin's lymphoma (NHL), can rarely present as an isolated mandibular osteolytic lesion. Early diagnosis requires advanced imaging and biopsy due to non-specific symptoms.
Area of Science:
- Oncology
- Oral Surgery
- Hematology
Background:
- Non-Hodgkin's lymphoma (NHL) is a significant non-epithelial malignancy in the cervicofacial region.
- Diffuse large B cell lymphoma (DLBCL) is the most prevalent aggressive NHL subtype.
- Primary intraosseous NHL of the jaw is exceptionally rare.
Observation:
- A 44-year-old male presented with isolated dental mobility and a mandibular osteolytic lesion.
- Clinical examination revealed erythematous gums and significant tooth mobility without neurological deficits or deep probing depths.
- Radiography showed a homogeneous, rounded osteolytic lesion in the mandible affecting multiple teeth.
Findings:
- Anatomopathological analysis of a biopsy confirmed DLBCL with a germinal center (GC) phenotype.
- The lesion extended from teeth #42 to #35, causing cortical thinning.
- The patient received R-CHOP 21 immunochemotherapy for 6 cycles.
Implications:
- The non-specific clinical and radiological presentation of intraosseous DLBCL poses diagnostic challenges.
- Definitive diagnosis hinges on advanced radiological examination and histopathological analysis via biopsy.
- Prompt diagnosis and appropriate oncological management are crucial for patient outcomes.
