The most common symptoms are varying degrees of discomfort in the pharynx, such as the sensation of a foreign body or choking while drinking. MeSH Only one widely disseminated case has been referenced, which involved cervical nodes, major salivary glands, orbits, and mediastinum [4]. 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. Non-Hodgkin's lymphoma of the head and neck: a 30-year experience at the University of Florida. There were two main cytomorphological variants of the DLBCL, NOS cases: centroblastic and immunoblastic. 2002;15:4205. However, HPV infections have been identified with increasing frequency in patients with oropharyngeal squamous cell carcinoma, which is a predisposing risk factor [29]. St. Louis, MO: Elsevier; 2016. Six of the cases exhibited tongue base masses with smooth surface membranes. Systemic investigations showed lymphadenopathy around the right internal jugular vein and anterior to the sternocleidomastoid. One case presented on CT and MRI with oropharyngeal wall thickening and epiglottal folds, and had multiple deep ulcers with pseudomembranes on laryngoscopy. government site. Improved survival of patients with human papillomavirus-positive head and neck squamous cell carcinoma in a prospective clinical trial. A case of benign lymphoid hyperplasia (BLH) of the tongue is reported. 1991;6(3):170-8. doi: 10.1007/BF02493520. Chi HS, Lee KW, Chiang FY, Tai CF, Wang LF, Yang SF, Lin SF, Kuo WR. 2012 May 28;18(20):2462-71. doi: 10.3748/wjg.v18.i20.2462. The follicles are cytologically polymorphous, are often polarized, and vary in size and shape. Only one patient died of the disease. Some tumour cells were large cells similar to diffuse large B cells in H&E slides (200x). Primary non-Hodgkin lymphoma of the tongue base: the clinicopathology of seven cases and evaluation of HPV and EBV status, https://doi.org/10.1186/s13000-020-00936-w, https://doi.org/10.1016/S0344-0338(11)80514-5, https://doi.org/10.1016/j.kjms.2012.02.014, https://doi.org/10.1080/02841860500531682, https://doi.org/10.1038/modpathol.2016.152, https://doi.org/10.1007/s00428-014-1682-7, https://doi.org/10.1038/modpathol.2011.45, https://doi.org/10.1182/blood-2003-05-1545, https://doi.org/10.1038/modpathol.3880541, https://doi.org/10.1097/01.dad.0000246949.49071.17, https://doi.org/10.1007/s12185-008-0142-z, https://doi.org/10.1016/j.ijom.2004.08.009, https://doi.org/10.1016/j.ijom.2010.03.029, https://doi.org/10.1016/j.anndiagpath.2005.09.020, https://doi.org/10.1016/j.oooo.2014.06.002, https://doi.org/10.1007/978-3-319-22822-8_13, https://doi.org/10.22034/APJCP.2017.18.10.2781, https://doi.org/10.1016/j.leukres.2005.11.004, https://doi.org/10.1309/YHFE-R65B-D3LK-3GGV, https://doi.org/10.11406/rinketsu.58.2033, https://doi.org/10.1017/s0022215100142288, http://creativecommons.org/licenses/by/4.0/, http://creativecommons.org/publicdomain/zero/1.0/. Two probes (EBV and HPV) were used for all seven cases. For immunoglobulin gene rearrangement, we used IdentiClone IGH, IGK and IGL Gene Clonality assays with gel detection (InVivoScribe Technologies, San Diego, CA, USA). Vega F, Lin P, Medeiros LJ. c. Tumour cells diffusely expressed CD20 (200 x). https://doi.org/10.4149/BLL_2017_116. Methods We reported a severe case of tongue base BLH compromising the breathing and swallowing of the affected patient. [citation needed], Paracortical hyperplasia is the preferential stimulation of the T cell compartment. Bethesda, MD 20894, Web Policies Clin Radiol. Almost all cancers in the base of the tongue are squamous cell carcinomas, which form in the thin, flat cells that line the larynx. Pathobiology. One case presented as multiple deep ulcers. Pseudotumours of the oropharynx due to muscular contraction. Mantle cell lymphoma: 2012 update on diagnosis, risk-stratification, and clinical management. 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. Ear Nose Throat J. Two pathologists interpreted the FISH results using an Olympus fluorescence microscope equipped with 100 objective lens and orange/ green/4, 6-diamid-ino-2-phenylindole filters. Briefly, the criteria and parameters for diagnosing and evaluating our cases were as follows: lymphoma classifications were based on the World Health Organization Classification of Tumors of Hematopoietic and Lymphoid Tissues (Revised Fourth Edition), and staging was based on the Ann Arbor Staging System. The majority of existing head and neck reports are of hyperplasia in the oral cavity, namely, of the mucosa overlying the hard palate, and are limited to the dental and pathology literature [3]. The lymphoid follicles at the base of the tongue can be detected when examining the pharynx of adults, but the presence of large follicles, denoted "severe" hypertrophy of the base of the tongue (HBT) is rare. It tends to present as a unilateral, painless, slow-growing, nonulcerated mass. The differential diagnosis includes lymphoma, mesenchymal tumors, salivary gland neoplasms, and adenomatoid hyperplasia [5]. As stated before, the depth of invasion is a major prognostic indicator. At this power, within the germinal center are paler-staining cells that are tingible body macrophages involved in the removal of apoptotic or degenerated lymphocytes. [36] showed that patients with DLBCL located on Waldeyers ring (base of the tongue) often have a better prognosis than nodal DLBCL patients. Lymphoid hyperplasia of the tongue is a very rare benign lymphoproliferative lesion that closely resembles carcinoma or lymphoma, clinically or histopathologically. By using this website, you agree to our 1, pp. The mean size is 2.5cm in the literature (range 15cm). PubMed Int J Oral Maxillofac Surg. Saxman S, Righi P. Mantle cell lymphoma appearing as a tongue base mass. Am J Gastroenterol. Confirmation of the molecular classification of diffuse large B-cell lymphoma by immunohistochemistry using a tissue microarray. This site needs JavaScript to work properly. Lymphoid hyperplasia of the tongue is a very rare benign lymphoproliferative lesion that closely resembles carcinoma or lymphoma, clinically or histopathologically. The population of the compartment is cytologically polymorphous. Common symptoms reported by people with benign lymphoid hyperplasia Common symptoms How bad it is What people are taking for it Fatigue Handicap/Disability Parking Permit Pain doi: 10.1148/radiology.144.4.7111732. Lymphoid (follicular) hyperplasia may occur on the borders of the tongue at the junction of the anterior part ('oral tongue') and the base of the tongue [4]. Blood. 2001;23:54758. I understand that this is benign, but what could be the cause? Eur Arch Otorhinolaryngol. https://doi.org/10.1017/s0022215100142288. Never disregard or delay professional medical advice in person because of anything on HealthTap. Is it always necessary to carry out a biopsy on lymphoid hyperplasia or is endoscopic examination and MRI enough to decide that it is benign? Expression of c-Myc and p53 correlates with clinical outcome in diffuse large B-cell lymphomas. Content on HealthTap (including answers) should not be used for medical advice, diagnosis, or treatment, and interactions on HealthTap do not create a doctor-patient relationship. Bratisl Lek Listy. A case of benign. 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. https://doi.org/10.1053/ajot.2000.8382. Aggregates of lymphoid tissue are all over the oral mucosa, but they are often prominent in the soft palate, uvula, and pharynx. Clinicopathological information including age, gender, tumour location, histological subtype, grading, staging, survival, and response to treatment was acquired from the archives. Mod Pathol. 1984 Apr;151(1):123-6. doi: 10.1148/radiology.151.1.6322222. This is because reactive growth of lymphoid tissue can be difficult to distinguish from the most serious neoplastic lesions.1. Careers. 1991 Jul;86(7):801-8. Google Scholar. a. MRI showed a mass in the base of the tongue sticking to the pharyngeal cavity and making it obviously narrow. FOIA https://doi.org/10.1007/s12185-008-0142-z. Other features include presence of white spaces and lymphocytes (large cells) within sinuses. These included 196 cases of extranodal lymphoma (NHL) occurring in the head and neck, among which seven cases arose from the base of tongue. 2006;30:85967. Sinus hyperplasia may be associated with non-hematolymphoid malignancy. A case of benign lymphoid hyperplasia (BLH) of the tongue is reported. Non-Hodgkins lymphoma (NHL) primarily derived from the base of the tongue, is rare. This might be because HPV subtype for this patient is different and is not covered by RNAscope HPV HR 18(RS-8002),or this case is a little bit old and RNA was not well preserved in formalin-fixed, paraffin-embedded tissue blocks. Educational text answers on HealthTap are not intended for individual diagnosis, treatment or prescription. 2014;10:94550. Histological features include distention or engorgement of both subcapsular and intraparenchymal sinuses by benign histiocytes which may be hemophagocytic. In the patient with MCL, recurrence presented with serious breathing difficulties. Spectrum of a benign entity Radiology. The diagnosis of FLH is of clinical importance as it may be confused with malignant lymphoma, both on clinical examination and histopathology. Parkin DM, Bray F, Ferlay J, Pisani P. Estimating the world cancer burden: Globocan 2000. She was awarded the Dental Professional of the Year in 2017 through the International Pemphigus and Pemphigoid Foundation and is a 2017 Sunstar/RDH Award of Distinction recipient. The authors declare that they have no competing interests. Lewis JS Jr. Morphologic diversity in human papillomavirus-related oropharyngeal squamous cell carcinoma: catch me if you can! ZL did the T-Cell Receptor and Immunoglobulin Gene Rearrangement Studies. Among our cases, there were 1 GC and 3 NGC cases. The site is secure. Pribuisiene R, Uloza V, Siupsinskiene N, Butkus E, Kupcinskas L. Al-Asoom L, Al-Rubaish AM, El-Munshid HA, Al-Nafaie AN, Bukharie HA, Abdulrahman IS. Her IPI score was 3 (high risk group). 2000;113:5128. There was no obvious difference in gender distribution, with four males and three females. The appearance of brown punctate dots in the tumour cell nucleus or cytoplasm was considered positive. This article is available as a PDF only. 2005;29:128493. 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. Bookshelf As seen in Figure 1, the soft palate, uvula, and posterior pharynx demonstrate multiple areas of enlargement that are consistent with lymphoid tissue. Nathu RM, Mendenhall NP, Almasri NM, Lynch JW. 2017;58:203342. 2017;30:S4453. These tissues act as your body's first line of defense against infections. Imaging examination can help identify lesions. government site. 2, no. The site is secure. These cells are designed to fight. In this paper we present a case of severe pharyngeal lymphoid hyperplasia causing airway obstruction and requiring tracheotomy and subsequent surgical debulking. volume15, Articlenumber:30 (2020) Lailatul et al. Primary extra-nodal non-Hodgkin's lymphoma of the cheek. This may have been due to the expression of the cytotoxic marker TIA, Granzyme B, and a much higher Ki-67 index (80%), which may indicate a poor prognosis [41]. Effect of gastroesophageal reflux on hypertrophy of the base of the tongue. This study obtained the approval of the ethics committee of Peking Union Medical College Hospital. One case was P53 positive (Fig. Abstract Background Benign lymphoid hyperplasia (BLH) is a benign proliferation of lymphoid tissue in response to external irritation. Radiology. Positive nucleolus staining was used to identify Bcl-6, mum-1, CyclinD1, SOX11 and Ki-67. Cyclophosphamide, doxorubicin, vincristine, prednisone, Peripheral T cell lymphoma, not otherwise specified. 2015;390:31537. However, the relationship between HPV and lymphomas of the head and neck remains largely unknown. Not applicable. https://doi.org/10.1016/j.anndiagpath.2005.09.020. 5 patients had a pharyngeal foreign body sensation and 2 presented dysphagia with or without choking. His IPI score was 2(low to intermediate risk group). The patient was kept on a three-week course of tapering prednisone and proton-pump inhibitors. Three out of four cases had a high Ki-67 index. 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. X27 ; S first line of defense against infections world cancer burden: 2000. Case of tongue base masses with smooth surface membranes masses with smooth membranes... Subsequent surgical debulking CT and MRI with oropharyngeal wall thickening and epiglottal folds, and clinical management WR. 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