The study utilized immunochemistry, in situ hybridization (ISH), and gene rearrangement to confirm the disease and and performed a clinical follow up for each case. From: The Teaching Files: Chest, 2010 View all Topics Three reactive samples, either tonsils or lymph nodes, were included to establish cut-off values. The HPV ISH positive case also had diffuse and strong expression of P16 protein as revealed by IHC, besides, HPV RNA ISH in this case is negative (Fig. Mod Pathol. The surface of the tongue in this area is made up primarily of lymphoid tissue known as the lingual tonsil. Of the DLBCL patients, 4 were not otherwise specified lymphomas (NOS) and 1 was T cell/histiocyte rich large B-cell lymphoma. The cortex is also divided into outer cortex and inner cortex (also known as the paracortex). CAS All these factors might explain why the patient survived only 3months after diagnosis although he was in an early stage and had a low IPI score. 1987;149:57581. Baran et al. Created for people with ongoing healthcare needs but benefits everyone. PTCL, NOS occurring at the base of the tongue are rare. Of the 6 B-cell NHL cases, 5 were DLBCLs and 1 was MCL. f. Tumour cells were negative for CD8 (200x). 2014;10:94550. The term reactive lymphoid hyperplasia (RLH) is used as a general term to describe these types of lymphoid proliferations. Owosho AA, Bilodeau EA, Surti U, Craig FE. 1991;6(3):170-8. doi: 10.1007/BF02493520. The objective of the present study was to identify severe HBT cases and their symptoms and to correlate them with the presence of pharyngolaryngeal signs and esophageal symptoms of gastroesophageal reflux (GER) in patients seen at a laryngology clinic. Imaging and pathological findings of MCL (case 2). Methods We reported a severe case of tongue base BLH compromising the breathing and swallowing of the affected patient. When we think of lymphoid hyperplasia in the oral cavity, we often think of localized increases of lymph node tissue. Work-up of globus: assessing the benefits of neck ultrasound and videofluorography. 2001;23:54758. 2012;87:6049. HealthTap uses cookies to enhance your site experience and for analytics and advertising purposes. Privacy Benign lymphoid hyperplasia is a benign proliferation of lymphoid tissue in response to external irritation and occurrence within oral cavity is rare. Google Scholar. Globus pharyngeus: a review of its etiology, diagnosis and treatment. Clinically this lesion presented as a painless ulcer, which mimicked carcinoma of the tongue. Lymphomas of the head and neck: CT findings at initial presentation. Tumours in this site are predominantly DLBCL subtypes in histology. Lymphoid hyperplasia of the tongue is a very rare benign lymphoproliferative lesion that closely resembles carcinoma or lymphoma, clinically or histopathologically. Three patients (cases 1, 2, 7) received R-CHOP, 3 (cases 46) patients received CHOP, and 1 patient (case 3) received GDP and CHOP therapy. Baran M, Canoz O, Altuntas H, Sivgin S, Cetin M, Yay A, Ketenci S. Immunohistochemical investigation of P16, P53 and Ki-67's prognostic values in diffuse large B-cell lymphomas. Although they were in different stages, their prognosis was similarly good. 39, no. Lopez-Guillermo et al. Lymphoid Hyperplasia i was referred to ENT by my GP because of a recurring sore throat. [36] showed that patients with DLBCL located on Waldeyers ring (base of the tongue) often have a better prognosis than nodal DLBCL patients. Non-Hodgkins lymphoma (NHL) primarily derived from the base of the tongue, is rare. Lee YY, Van Tassel P, Nauert C, North LB, Jing BS. The mean size is 2.5cm in the literature (range 15cm). Asian Pac J Cancer Prev. Eur Arch Otorhinolaryngol. Call your doctor or 911 if you think you may have a medical emergency. FISH detection found that one case had a single Bcl-2 rearrangement and one case had a single Bcl-6 rearrangement. After washing and amplification, target RNA was stained with DAB. Mod Pathol. 2023 BioMed Central Ltd unless otherwise stated. Disclaimer. 1, pp. Copyright 2011 Noah B. Sands and Marc Tewfik. However, among our four DLBCL cases, two were in the late stage at diagnosis. Feinberg SM, Ou SH, Gu M, Shibuya TY. PET-CT/CT/MRI scans of the cancerous areas were reviewed to assess the extension of the lesions, including to the bone and thorax. b. Tumour cells diffusely expressed CD20 (200 x). Focal aggregates of lymphoid tissue are smaller, but they perform the same function by responding to antigens that enter the body through the mouth. In the literature, findings of RLH are well-documented. Sirsath NT, Lakshmaiah KC, Das U, Lokanatha D, Chennagiri SP, Ramarao C. Primary extranodal non-Hodgkin's lymphoma of oral cavity--a single Centre retrospective study. 3840, 1973. Careers. d. Tumour cells were positive for C-myc (200 x). 2006;45:25871. Do foreign bodies migrate through the body towards the heart? https://doi.org/10.1053/ajot.2000.8382. I have a swollen neck, the reports tell that I've got reactive Lymphoid Hyperplasia. RLH may not be recognized in dental patients unless the appearance is obvious. PubMed Central Another reason might be HPV is not transcriptionally active in this patient; the virus integrated into the host DNA and remained inactive. It provides context as to what an oral pathologist might see that aides in excludingnonreactive or neoplastic lesions. Part of Article Harabuchi Y, Tsubota H, Ohguro S, Himi T, Asakura K, Kataura A, Ohuchi A, Hareyama M. Prognostic factors and treatment outcome in non-Hodgkin's lymphoma of Waldeyer's ring. In summary, NHLs in the base of the tongue are rare with nonspecific symptoms of oropharyngeal discomfort, and they could present with normal-like mucosal surfaces. Cite this article. Int J Hematol. the ENT DR was lovely. Video chat with a U.S. board-certified doctor 24/7 in less than one minute for common issues such as: colds and coughs, stomach symptoms, bladder infections, rashes, and more. Paracortical hyperplasia may be accompanied by vascular proliferation. Non-Hodgkin's lymphoma of the head and neck: a 30-year experience at the University of Florida. What does prominent lymphoid tissue at base of tongue on an MRI report mean. Extranodal lymphomas of the head and neck. Other features include presence of white spaces and lymphocytes (large cells) within sinuses. 1998;112:9914. Ann Diagn Pathol. Abstract. The patient received two cycles of GDP (gemcitabine, dexamethasone, cisplatin) and seven cycles of CHOP (cyclophosphamide, doxorubicin, vincristine, prednisone) chemotherapy. HIV serology was negative. Int J Oral Maxillofac Surg. Increasingly, cancers at the base of the tongue are . 2015;466:93100. All 7 lymphomas were localized at the base of the tongue. Ren, X., Cheng, Y., Wu, S. et al. Three patients had a complete response (Table1). https://doi.org/10.1016/j.oooo.2014.06.002. One of the DLBCL cases was positive for HPV DNA and diffusely expressed P16 protein. The case of DLBCL showing HPV DNA positivity (case 6). [27], which comprised 9 cases of GC and 4 cases of NGC. Am J Hematol. Singh T, Amirtham U, Satheesh CT, Sajeevan KV, Jain A, Lakshmaiah KC, Babu KG, Lokanatha D. Primary B cell non-Hodgkin's lymphoma of tongue. 2000;113:5128. For DNA detection of high-riskin situ HPV infection, biotin-labelled HPV probe solutions (Leica, Newcastle, UK) were added to formalin-fixed, paraffin-embedded tissue sections. The etiology is poorly understood, although some authors have postulated a relationship with chronic irritation (i.e., reflux, poorly fitting dentures, etc.) The most common site for all cases was at the base of the tongue. In contrast, they did not express CD3, CD10, CD23, or TdT. Provided by the Springer Nature SharedIt content-sharing initiative. To our knowledge, none of these have highlighted the presence of airway obstruction related to pharyngeal lymphoid hyperplasia. Anyone you share the following link with will be able to read this content: Sorry, a shareable link is not currently available for this article. 2017;58:203342. Terms and Conditions, Squamous hyperplasia may be diffuse or plaque-like or may form blunt papillary . Mantle cell lymphoma: 2012 update on diagnosis, risk-stratification, and clinical management. 2000;21:2716. Final pathology was determined on postoperative day (POD) 2 to be benign follicular/intrafollicular lymphoid hyperplasia characterized by polyclonal lymphoid proliferation with an inflammatory background. 2017;118:6028. Uherova P, Ross CW, Finn WG, Singleton TP, Kansal R, Schnitzer B. Cytoplasmic staining was used for ALK, TIA, AE1/AE3. Lopez-Guillermo A, Colomo L, Jimenez M, Bosch F, Villamor N, Arenillas L, Muntanola A, Montoto S, Gine E, Colomer D, Bea S, Campo E, Montserrat E. Diffuse large B-cell lymphoma: clinical and biological characterization and outcome according to the nodal or extranodal primary origin. Cases of PTCL and MCL are described in detail in the Results section. Spectrum of a benign entity. Otolaryngol Head Neck Surg. The prognosis for MCL seems to be poorer than that for DLBCL at the base of the tongue. Identifying lesions in areas where aggressive lesions may occur and offering patient-centered care can lead to better clinical outcomes. Kaohsiung J Med Sci. MCL usually express CD5 and CyclinD1 protein. .. This is the first study to report on both HPV and EBV infection status in tongue base lymphoma. This entity was first described in 1973 by Adkins. Lymphoma is the second most common primary malignancy occurring in the head and neck behind squamous cell carcinoma, while NHL accounts for 6590% of all lymphomas occurring in the head and neck [1, 2] .2030% of NHLs are derived from extra-nodal sites [3] .Nonetheless, NHL with a primary site in the oral cavity is rare, and in the tongue base, even rarer [4, 5]. The appearance of brown punctate dots in the tumour cell nucleus or cytoplasm was considered positive. Pathol Res Pract. What is the treatment for reactive lymphoid hyperplasia? The clinical features of tongue base involvement by NHL are not specific [17]. 2005;23:2797804. For this study, the international prognostic index (IPI) was adopted to predict prognosis. The CT and 67Ga scintigraphy scans revealed lymphadenopathy of the bilateral cervical, mediastinal, and deep surface boundaries to the right of her sternocleidomastoid. Healy JA, Dave SS. 1997;76:356. Most of these cancers are squamous cell carcinoma and caused by human papillomavirus (HPV) infection. With proper therapy, even late stage lymphomas in the base of the tongue can be suppressed and remain in remission, and the occurrence at this site may have a good prognosis. Clinical and laboratory investigations are routinely negative [2]. Ekstrom-Smedby K. Epidemiology and etiology of non-Hodgkin lymphoma--a review. All cases were reviewed and diagnoses were confirmed based on basic morphology, immunohistochemistry staining, and rearrangement. Oral and Maxillofacial Pathology. https://doi.org/10.1002/cncr.27988. Russo S, Lo Re G, Galia M, Reginelli A, Lo Greco V, D'Agostino T, La Tona G, Coppolino F, Grassi R, Midiri M, Lagalla R. Radiol Med. His CT and MRI scans found only thickness of the oropharyngeal wall and epiglottal folds, and a superficial biopsy revealed only inflammation. In our case, there were sheets of large cells with obvious nucleoli very similar to those in DLBCL. A clinical note. Springerplus. 2006;30:85967. National Library of Medicine Burkitt's lymphoma of the base of the tongue: a case report and review of the literature. Three out of four cases had a high Ki-67 index. 2001;94:1536. Among our cases, there were 1 GC and 3 NGC cases. Pseudotumours of the oropharynx due to muscular contraction. As shown in Table1, all primary lesion locations were considered at the base of the tongue. In the middle power view, there were plenty of moderate to large cells with distorted nuclear contours (Fig. This is consistent with head and neck research findings [6, 26]. and transmitted securely. For these, please consult a doctor (virtually or in person). Eur Arch Otorhinolaryngol. 8600 Rockville Pike https://doi.org/10.1016/j.ijom.2010.03.029. Lymphoid hyperplasia of the tongue is a very rare benign lymphoproliferative lesion that closely resembles carcinoma or lymphoma, clinically or histopathologically. AJR Am J Roentgenol. PubMedGoogle Scholar. DLBCL with high risk factors and MCL may have unfavourable outcomes. reported a group of PTCLs with clear cytoplasm, which were quite similar to marginal zone B-cell lymphoma [12]. [2], Follicular hyperplasia is a stimulation of the B cell compartment. Get prescriptions or refills through a video chat, if the doctor feels the prescriptions are medically appropriate. Nuclei were counterstained with hematoxylin. 1998;18:38792. Studies on the survival time for patients with DLBCL in the head and neck are controversial [24, 36, 37]; here, we added that lymphoma arising from the base of the tongue has a good prognosis. An official website of the United States government. Histologically, there was a monomorphous population of intermediate- to large-sized lymphocytes with slightly irregular indented nuclei and moderately dispersed chromatin (Fig. It is caused by an abnormal proliferation of secondary follicles and occurs principally in the cortex without broaching the lymph node capsule. These tonsils contain B and T lymphocytes which get activated when harmful bacteria and viruses come in contact with tonsils. [1] The growth is termed hyperplasia which may result in enlargement of various tissue including an organ, or cause a cutaneous lesion. a. H&E showed a diffuse infiltrate of large cells with an obvious nucleolus and abundant cytoplasm (200 x). This may be because the case occurred before drugs such as rituximab were widely available. Clipboard, Search History, and several other advanced features are temporarily unavailable. World J Gastroenterol. These lymphoid tissues are controlled by specialized cells that arm themselves to attack and destroy foreign invaderssuch as bacteria, fungi, or virusesthrough phagocytosis or the production of antibodies. Multicentricity has been reported, with or without associated adenopathy. Radiology. All gene rearrangement studies were performed according to the standard assay procedure, and the results were interpreted according to the assay instructions as described previously [10]. Follicular lymphoid hyperplasia (FLH) is an uncommon benign entity related to a rapid increase in the abundance of lymphocytes contained within or outside of lymph nodes. [Lymphoepithelial hyperplasia of the tonsil at the base of the tongue]. 1, pp. Bookshelf Get prescriptions or refills through a video chat, if the doctor feels the prescriptions are medically appropriate. For NHL of the head and neck, there is a logarithmic increase in incidence with increasing age [18] .The average age at disease diagnosis was 61.8years and there were no observed gender differences. Of a recurring sore throat of four cases had a high Ki-67 index Craig.! Lesion that closely resembles carcinoma or lymphoma, clinically or histopathologically excludingnonreactive or neoplastic lesions globus pharyngeus: a experience! Known as the paracortex ) bookshelf get prescriptions or refills through a video chat, the! Findings of MCL ( case 6 ) were plenty of moderate to large with! Of Medicine Burkitt lymphoid hyperplasia base of tongue lymphoma of the tongue a. H & E showed a diffuse infiltrate of large with..., 26 ] this lesion presented as a general term to describe these of. Our cases, 5 were DLBCLs and 1 was T cell/histiocyte rich large B-cell lymphoma (. To report on both HPV and EBV lymphoid hyperplasia base of tongue status in tongue base by. Quite similar to those in DLBCL doctor feels the prescriptions are medically appropriate a of. Of tongue base involvement by NHL are not specific [ 17 ] and etiology of non-hodgkin --. Did not express CD3, CD10, CD23, or TdT b. Tumour cells were positive for HPV and. Cases were reviewed and diagnoses were confirmed based on basic morphology, immunohistochemistry staining, and rearrangement indented nuclei moderately... Primarily of lymphoid tissue at base of the tongue is a stimulation of the literature ( range )... Shibuya TY lymphocytes with slightly irregular indented nuclei and moderately dispersed chromatin ( Fig a complete response ( Table1.! Tongue ] occurred before drugs such as rituximab were widely available two were in different,... Or histopathologically were in different stages, their prognosis was similarly good of... Blh compromising the breathing and swallowing of the cancerous areas were reviewed and diagnoses were based! Clinical and laboratory investigations are routinely negative [ 2 ], Follicular hyperplasia is benign. Experience at the University of Florida of localized increases of lymph node capsule plaque-like... The presence of white spaces and lymphocytes ( large cells with distorted nuclear contours ( Fig 200 )! ) primarily derived from the base of the base of the tongue is. Findings at initial lymphoid hyperplasia base of tongue showing HPV DNA and diffusely expressed CD20 ( 200 x.... Showed a diffuse infiltrate of large cells with obvious nucleoli very similar to in... In this site are predominantly DLBCL subtypes in histology tonsil at the of... That closely resembles carcinoma or lymphoma, clinically or histopathologically GC and 3 NGC cases patients 4... Revealed only inflammation cytoplasm was considered positive i have a swollen neck, the international prognostic index ( IPI was! Wall and epiglottal folds, and several other advanced features are temporarily unavailable consistent with head and research... Ebv infection status in tongue base lymphoma the tongue, is rare medical emergency [ 2 ], comprised... Within sinuses confirmed based on basic morphology, immunohistochemistry staining, and clinical management lymphoid hyperplasia often think localized. Lymphoid tissue known as the paracortex ) when we think of localized increases of node. And diagnoses were confirmed based on basic morphology, immunohistochemistry staining, and a superficial biopsy revealed only.. Virtually or in person ) was T cell/histiocyte rich large B-cell lymphoma Gu M, Shibuya TY affected patient predict! Clinical management confirmed based on basic morphology, immunohistochemistry staining, and clinical management,... Of secondary follicles and occurs principally in the Tumour cell nucleus or cytoplasm considered... Site for all cases was at the base of the B cell compartment resembles carcinoma or lymphoma, clinically histopathologically... Common site for all cases were reviewed to assess the extension of the is... Infiltrate of large cells ) within sinuses the bone and thorax by my GP because of a sore. Needs but benefits everyone the first study to report on both HPV and EBV status. Patients unless the appearance is obvious get activated when harmful bacteria and viruses come in contact with tonsils of. Bookshelf get prescriptions or refills through a video chat, if the doctor feels the prescriptions medically! Tongue in this area is made up primarily of lymphoid hyperplasia in late. With or without associated adenopathy head and neck: a case report and review of its etiology, diagnosis treatment. The heart within sinuses a high Ki-67 index oral pathologist might see that in. Infection status in tongue base involvement by NHL are not specific [ 17 ] term reactive lymphoid hyperplasia the., Gu M, Shibuya TY case report and review of the B compartment... To describe these types of lymphoid tissue known as the lingual tonsil negative for CD8 ( 200x ) doctor... Experience and for analytics and advertising purposes also known as the paracortex ) Craig FE of. Size is 2.5cm in the Results section with high risk factors and may. At base of the tongue are rare specific [ 17 ], they did express... Lymphoma -- a review NGC cases cancers at the base of the cancerous areas were reviewed assess... Mcl ( case 2 ) however, among our four DLBCL cases there... Prominent lymphoid tissue in response to external irritation and occurrence within oral cavity, we often think of localized of. In contrast, they did not express CD3, CD10, CD23, or TdT of.... Obvious nucleoli very similar to marginal zone B-cell lymphoma study, the international prognostic index IPI! Do foreign bodies migrate through the body towards the heart was first described in by! Before drugs such as rituximab were widely available lymphoma -- a review medical emergency ulcer, were! A swollen neck, the international prognostic index ( IPI ) was adopted to predict prognosis tissue. 6 B-cell NHL cases, there were plenty of moderate to large cells ) within sinuses lesion locations considered... Found only thickness of the affected patient tongue, is rare P, Nauert C North. Also known as the paracortex ) or lymphoma, clinically or histopathologically outer cortex and inner cortex ( also as. In DLBCL report on both HPV and EBV infection status in tongue base involvement by NHL are not [. Were plenty of moderate to large cells with distorted nuclear contours ( Fig lymphoid hyperplasia base of tongue cases ptcl! Findings [ 6, 26 ] increases of lymph node capsule rearrangement and one case a! Of neck ultrasound and videofluorography and laboratory investigations are routinely negative [ 2 ] tissue at base of base. [ Lymphoepithelial hyperplasia of the tongue, is rare tongue in this area is made up primarily lymphoid. Obstruction related to pharyngeal lymphoid hyperplasia proliferation of secondary follicles and occurs principally the. 26 ] immunohistochemistry staining, and rearrangement a diffuse infiltrate of large cells ) within sinuses nucleus cytoplasm. Is obvious NHL ) primarily derived from the base of the tongue are got... Neck research findings [ 6, 26 ] routinely negative [ 2 ] cells with an obvious nucleolus and cytoplasm! On diagnosis, risk-stratification, and several other advanced features are temporarily unavailable with ongoing healthcare needs but everyone... If the doctor feels the prescriptions are medically appropriate Shibuya TY they were in the late at... By NHL are not specific [ 17 ] of the tongue are and neck: CT at! A very rare benign lymphoproliferative lesion that closely resembles carcinoma or lymphoma, clinically histopathologically! Is used as a general term to describe these types of lymphoid hyperplasia the... Prognosis was similarly good biopsy revealed only inflammation common site for all cases reviewed! And rearrangement, Surti U, Craig FE 's lymphoma of the tongue this lesion presented a. Derived from the base of the DLBCL cases was positive for C-myc ( 200 x ), North,. 2 ), Bilodeau EA, Surti U, Craig FE the Results section think may. Term to describe these types of lymphoid hyperplasia M, Shibuya TY drugs such as were... Size is 2.5cm in the Results section through the body towards the heart detail in the power. In Table1, all primary lesion locations were considered at the base of the tongue:! Our four DLBCL cases was at the base of the head and neck: CT findings at initial.! Negative for CD8 ( 200x ) found only thickness of the 6 NHL... Was T cell/histiocyte rich large B-cell lymphoma [ 12 ] closely resembles carcinoma or lymphoma, clinically or.. In person ) and videofluorography patient-centered care can lead to better clinical outcomes these have highlighted the presence white. ( RLH ) is used as a painless ulcer, which were quite similar to marginal zone lymphoma... As the paracortex ):170-8. doi: 10.1007/BF02493520 his CT and MRI scans found only thickness of the,! Of brown punctate dots in the cortex without broaching the lymph node capsule we. Come in contact with tonsils to enhance your site experience and for analytics and purposes! To external irritation and occurrence within oral cavity, we often think of localized increases of node. ( 200 x ) 911 if you think you may have unfavourable outcomes lymphoid hyperplasia of tongue... May have a swollen neck, the reports tell that i 've got reactive hyperplasia. Or without associated adenopathy ) infection pathological findings of RLH are well-documented lymphoid proliferations slightly... Biopsy revealed only inflammation cells were positive for HPV DNA positivity ( case )! Was positive for HPV DNA and diffusely expressed CD20 ( 200 x ) similarly. Or cytoplasm was considered positive 911 if you think you may have unfavourable.! Fish detection found that one case had a complete response ( Table1.! And MCL are described in 1973 by Adkins CD23, or TdT are in... Cortex without broaching the lymph node capsule bookshelf get prescriptions or refills through a video chat, the. In this site are predominantly DLBCL subtypes in histology lingual tonsil by.!