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Malignant Lymphoma with Initial Symptoms in the Mandibular Region

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DOI: 10.4236/jct.2015.67060    2,599 Downloads   3,038 Views  

ABSTRACT

Primary intraosseous lymphoma is rare and there are few case reports manifesting with a mass in the mandible. Thus, we retrospectively reviewed and analyzed the clinical characteristics, treatment, and outcome of extranodal non-Hodgkin’s lymphoma (NHL) with initial mandibular symptoms in our department. At initial treatment of dental clinics, dentists had diagnosed as dental or gingival diseases and had performed dental treatment. Neurological disorder to involvement of the inferior alveolar nerve was present in 80.0% of our cases. On dental or panoramic radiography a specific radiolucent lesion in the mandible was not detected, except for dental lesions. On CT, NHL of the mandible region has no widening and no clear destruction but a slit-like the cortex bone destruction pattern with keeping in shape of the mandibular body (62.5% of CT-examined cases), and extraosseous soft tissue mass are clearer on MRI (100.0% of MRI-examined cases). Histopathologically, 80.0% of our cases were diagnosed as diffuse large B cell lymphoma (DLBCL). One case as B-cell lymphoblastic lymphoma and one case as B-cell lymphoma unclassifiable with features intermediate between DLBCL and Burkitt lymphoma were Stage IV (Ann Arbor staging system) and had poor prognosis. The disease-specific survival rate was 77.8% at 5 years. If unexplained non-specific symptoms such as swelling of the jaw, pain, neurological disorder of the inferior alveolar nerve, tooth mobility are observed, oral surgeons and dentists should not perform dental treatments. CT and MRI show disease specific appearance to be able to give a definitive diasnosis as NHL. PET/CT is useful for scaninng of whole body. A deep bone biopsy is preferred for suspected malignant lymphoma.

Conflicts of Interest

The authors declare no conflicts of interest.

Cite this paper

Mochizuki, Y. , Harada, H. , Sakamoto, K. , Kayamori, K. , Nakamura, S. , Ikuta, M. , Kabasawa, Y. , Marukawa, E. , Shimamoto, H. , Tushima, F. and Omura, K. (2015) Malignant Lymphoma with Initial Symptoms in the Mandibular Region. Journal of Cancer Therapy, 6, 554-565. doi: 10.4236/jct.2015.67060.

References

[1] Kuppers, R. (2015) Mechanisms of B-Cell Lymphoma Pathogenesis. Nature Reviews Cancer, 5, 251-262.
http://dx.doi.org/10.1038/nrc1589
[2] Kobler, C. and Effenberger, F. (2005) Stereoselective Synthesis of Cis-p-menth-8-ene-1,7-diol, Cis-p-menthane-1,7-diol, and Cis-p-menthane-1,7,8-triol. Chemistry, 11, 2783-2787.
http://dx.doi.org/10.1002/chem.200401147
[3] Guevaracanales, J.O., Morales-Vadillo, R., de Faria, P.E., Sacsaquispe-Contreras, S.J., Leite, F.P. and Chaves, M.G. (2011) Systematic Review of Lymphoma in Oral Cavity and Maxillofacial Region. Acta Odontológica Latinoamericana, 24, 245-250.
[4] Bachaud, J.M., Coppin, D., Douchez, J., Boutault, F., Paty, E., Saboye, J. and Barthelemy, I. (1992) Primary Malignant Lymphoma of the Mandible. A Study of 3 Cases and a Review of the Literature. Revue de Stomatologie et de Chirurgie Maxillo-Faciale, 93, 372-376.
[5] Huvos, A.G. (1991) Primary Non-Hodgkin’s Lymphoma of Bone. 2nd Edition, Bone Tumours: Diagnosis, Treatment, and Prognosis, Saunders, Philadelphia, 625-637.
[6] Epstein, J.B., Epstein, J.D., Le, N.D. and Gorsky, M. (2001) Characteristics of Oral and Paraoral Malignant Lymphoma a Population Based Review of 361 Cases. Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, and Endodontology, 95, 519-525.
http://dx.doi.org/10.1067/moe.2001.116062
[7] Jaradat, J.M., Potluri, A. and Bilodeau, E.A. (2013) B-Cell Lymphoma, Unclassifiable, with Features Intermediate between Diffuse Large B-Cell Lymphoma and Burkitt Lymphoma: Report of a Case in the Oral Cavity. Indian Journal of Dental Research, 24, 384-386.
http://dx.doi.org/10.4103/0970-9290.118016
[8] Perry, A.M., Crockett, D., Dave, B.J., Althof, P., Winkler, L., Smith, L.M., Aoun, P., Chan, W.C., Fu, K., Greiner, T.C., Bierman, P., Gregory Bociek, R., Vose, J.M., Armitage, J.O. and Weisenburger, D.D. (2013) B-Cell Lymphoma, Unclassifiable, with Features Intermediate between Diffuse Large B-Cell Lymphoma and Burkitt Lymphoma: Study of 39 Cases. British Journal of Haematology, 162, 40-49.
http://dx.doi.org/10.1111/bjh.12343
[9] Mnejja, M., Hammami, B., Kolsi, N., Kallel, S., Chakroun, A., Charfeddine, I., Hdiji, S., Elloumi, M. and Ghorbel, A. (2010) B-Cell Lymphoma of the Mandible. European Annals of Otorhinolaryngology, Head and Neck Diseases, 127, 186-188.
http://dx.doi.org/10.1016/j.anorl.2010.07.009
[10] Kini, R., Saha, A. and Naik, V. (2009) Diffuse Large B-Cell Lymphoma of Mandible: A Case Report. Medicina Oral Patología Oral y Cirugia Bucal, 14, e421-e424.
[11] Lin, P., Jones, D., Dorfman, D.M. and Medeiros, L.J. (2000) Precursor B-Cell Lymphoblastic Lymphoma: A Predominantly Extranodal Tumor with Low Propensity for Leukemic Involvement. The American Journal of Surgical Pathology, 24, 1480-1490.
http://dx.doi.org/10.1097/00000478-200011000-00003
[12] Kelly, J.J. and Karcher, D.S. (2005) Lymphoma and Peripheral Neuropathy: A Clinical Review. Muscle Nerve, 31, 301-313.
http://dx.doi.org/10.1002/mus.20163
[13] Barber, H.D., Stewart, J.C. and Baxter, W.D. (1992) Non-Hodgkin’s Lymphoma Involving the Inferior Alveolar Canal and Mental Foramen: Report of a Case. Journal of Oral and Maxillofacial Surgery, 50, 1334-1336.
http://dx.doi.org/10.1016/0278-2391(92)90240-Z
[14] Ito, J., Batth, T.S., Petzold, C.J., Redding-Johanson, A.M., Mukhopadhyay, A., Verboom, R., Meyer, E.H., Millar, A.H. and Heazlewood, J.L. (2011) Analysis of the Arabidopsis Cytosolic Proteome Highlights Subcellular Partitioning of Central Plant Metabolism. Journal of Proteome Research, 10, 1571-1582.
http://dx.doi.org/10.1021/pr1009433
[15] Gusenbauer, A.W., Katsikeris, N.F. and Brown, A. (1990) Primary Lymphoma of the Mandible: Report of a Case. Journal of Oral and Maxillofacial Surgery, 48, 409-415.
http://dx.doi.org/10.1016/0278-2391(90)90442-5
[16] Pazoki, A., Jansisyanont, P. and Ord, R.A. (2003) Primary Non-Hodgkin’s Lymphoma of the Jaws: Report of 4 Cases and Review of the Literature. Journal of Oral and Maxillofacial Surgery, 61, 112-117.
http://dx.doi.org/10.1053/joms.2003.50018
[17] Parrington, S.J. and Punnia-Moorthy, A. (1999) Primary Non-Hodgkin’s Lymphoma of the Mandible Presenting Following Tooth Extraction. British Dental Journal, 187, 468-470.
http://dx.doi.org/10.1038/sj.bdj.4800308
[18] Eisenbud, L., Sciubba, J., Mir, R. and Sachs, S.A. (1984) Oral Presentations in Non-Hodgkin’s Lymphoma: A Review of Thirty-One Cases. Part II. Fourteen Cases Arising in Bone. Oral Surgery, Oral Medicine, Oral Pathology, 57, 272-280.
http://dx.doi.org/10.1016/0030-4220(84)90183-X
[19] Kawasaki, G., Nakai, M., Mizuno, A., Nakamura, T. and Okabe, H. (1997) Malignant Lymphoma of the Mandible: Report of a Case. Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, and Endodontology, 83, 345-349.
http://dx.doi.org/10.1016/S1079-2104(97)90241-9
[20] Imaizumi, A., Kuribayashi, A., Watanabe, H., Ohbayashi, N., Nakamura, S., Sumi, Y., Sano, T. and Kurabayashi, T. (2012) Non-Hodgkin Lymphoma Involving the Mandible: Imaging Findings. Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology, 113, e33-e39.
http://dx.doi.org/10.1016/j.oooo.2011.10.004
[21] Mealey, B.L, Tunder, G.S. and Pemble, C.W. (2002) Primary Extranodal Malignant Lymphoma Affecting the Periodontium. Journal of Periodontology, 73, 937-941.
http://dx.doi.org/10.1902/jop.2002.73.8.937
[22] Yasumoto, M., Shibuya, H., Fukuda, H., Takeda, M., Mukai, T. and Korenaga, T. (1998) Malignant Lymphoma of the Gingiva: MR Evaluation. American Journal of Neuroradiology, 19, 723-727.
[23] Hicks, D.G., Gokan, T., O’Keefe, R.J., Totterman, S.M., Fultz, P.J., Judkins, A.R., Meyers, S.P., Rubens, D.J., Sickel, J.Z. and Rosier, R.N. (1995) Primary Lymphoma of Bone. Correlation of Magnetic Resonance Imaging Features with Cytokine Production by Tumor Cells. Cancer, 75, 973-980.
http://dx.doi.org/10.1002/1097-0142(19950215)75:4<973::AID-CNCR2820750412>3.0.CO;2-8
[24] Mulligan, M.E., McRae, G.A. and Murphey, M.D. (1999) Imaging Features of Primary Lymphoma of Bone. American Journal of Roentgenology, 173, 1691-1697.
http://dx.doi.org/10.2214/ajr.173.6.10584821
[25] Holzapfel, K., Duetsch, S., Fauser, C., Eiber, M., Rummeny, E.J. and Gaa, J. (2009) Value of Diffusion-Weighted MR Imaging in the Differentiation between Benign and Malignant Cervical Lymph Nodes. European Journal of Radiology, 72, 381-387.
http://dx.doi.org/10.1016/j.ejrad.2008.09.034
[26] King, A.D., Ahuja, A.T., Yeung, D.K., Fong, D.K., Lee, Y.Y., Lei, K.I. and Tse, G.M. (2007) Malignant Cervical Lymphadenopathy: Diagnostic Accuracy of Diffusion-Weighted MR Imaging. Radiology, 245, 806-813.
http://dx.doi.org/10.1148/radiol.2451061804
[27] Longo, F., De Maria, G., Esposito, P. and Califano, L. (2004) Primary Non-Hodgkin’s Lymphoma of the Mandible. Report of a Case. International Journal of Oral and Maxillofacial Surgery, 33, 801-803.
http://dx.doi.org/10.1016/j.ijom.2003.12.003
[28] Djavanmardi, L., Oprean, N., Alantar, A., Bousetta, K. and Princ, G. (2008) Malignant Non-Hodgkin’s Lymphoma (NHL) of the Jaws: A Review of 16 Cases. Journal of Cranio-Maxillofacial Surgery, 36, 410-414.
http://dx.doi.org/10.1016/j.jcms.2008.03.004
[29] Kim, H.J., Lee, T.J. and Choi, Y.S. (2014) Primary B-Lymphoblastic Lymphoma of Gallbladder Involving Mandibular Bone. International Journal of Hematology, 99, 790-793.
http://dx.doi.org/10.1007/s12185-014-1582-2
[30] Cox, D.P., Treseler, P., Dong, R. and Jordan, R.C. (2007) Rare Oral Cavity Presentation of a B-Cell Lymphoblastic Lymphoma. A Case Report and Review of the Literature. Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, and Endodontology, 103, 814-819.
http://dx.doi.org/10.1016/j.tripleo.2005.11.037
[31] de Jong, D. (2009) Novel Lymphoid Neoplasms—The Borderland between Diffuse Large B-Cell Lymphoma and Burkitt’s Lymphoma. Haematologica, 94, 894-896.
http://dx.doi.org/10.3324/haematol.2009.008128
[32] Owosho, A.A., Bilodeau, E.A., Surti, U. and Craig, F.E. (2014) Large B-Cell Lymphoma of the Base of the Tongue and Oral Cavity: A Practical Approach to Identifying Prognostically Important Subtypes. Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology, 118, 338-347.
http://dx.doi.org/10.1016/j.oooo.2014.06.002
[33] Ruijs, C.D., Dekker, A.W., van Kempen-Harteveld, M.L., van Baarlen, J. and Hordijk, G.J. (1994) Treatment of Localized Non-Hodgkin’s Lymphomas of the Head and Neck. Cancer, 74, 703-707.
http://dx.doi.org/10.1002/1097-0142(19940715)74:2<703::AID-CNCR2820740225>3.0.CO;2-P
[34] Donato, V., Iacari, V., Zurlo, A., Nappa, M., Martelli, M., Banelli, E., Enrici, R.M. and Biagini, C. (1998) Radiation Therapy and Chemotherapy in the Treatment of Head and Neck Extranodal Non-Hodgkin’s Lymphoma in Early Stage with a High Grade of Malignancy. Anticancer Research, 18, 547-554.
[35] Beal, K., Allen, L. and Yahalom, J. (2006) Primary Bone Lymphoma: Treatment Results and Prognostic Factors with Long-Term Follow-Up of 82 Patients. Cancer, 106, 2652-2656.
http://dx.doi.org/10.1002/cncr.21930
[36] Pie-Sanchez, J., Petit, J., Figueiredo, R. and Gay-Escoda, C. (2011) Primary Diffuse Large B-Cell Lymphoma of the Mandible: A Case Report. Minerva Stomatologica, 60, 87-92.
[37] Mawardi, H., Cutler, C. and Treister, N. (2009) Medical Management Update: Non-Hodgkin Lymphoma. Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, and Endodontology, 107, e19-e33.
http://dx.doi.org/10.1016/j.tripleo.2008.08.054
[38] Slootweg, P.J., Wittkampf, A.R., Kluin, P.M., de Wilde, P.C. and van Unnik, J.A. (1985) Extranodal Non-Hodgkin’s Lymphoma of the Oral Tissues: An Analysis of 20 Cases. Journal of Maxillofacial Surgery, 13, 85-92.
http://dx.doi.org/10.1016/S0301-0503(85)80022-9
[39] Economopoulos, T., Asprou, N., Stathakis, N., Fountzilas, G., Pavlidis, N., Papaspyrou, S., Dervenoulas, J., Belia, M., Papageorgiou, E., Theoharis, D., et al. (1992) Primary Extranodal Non-Hodgkin’s Lymphoma of the Head and Neck. Oncology, 49, 484-488.

  
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