f. Ki-67 staining of the tumour cells (200x). 2017;18:27815. Connect with a U.S. board-certified doctor by text or video anytime, anywhere. Ann Diagn Pathol. b. H&E showed immunoblastic large cells with an obvious nucleolus (200 x). Improved survival of patients with human papillomavirus-positive head and neck squamous cell carcinoma in a prospective clinical trial. 37, no. Positive nucleolus staining was used to identify Bcl-6, mum-1, CyclinD1, SOX11 and Ki-67. https://doi.org/10.1007/978-3-319-22822-8_13. Lymphoid hyperplasia is not a disease or a tumor, but simply a term we use to represent enlarged tissue masses. Mantle cell lymphoma: 2012 update on diagnosis, risk-stratification, and clinical management. Otolaryngol Head Neck Surg. Then he looked down my throat through my nose. Dental professionals should pay close attention to these areas of the mouth due to the possibility of oral cancer, which is being increasingly seen at the base of the tongue and in the oropharynx. Diagn Pathol 15, 30 (2020). Bookshelf In the orofacial region, RLH most often occurs in the oropharynx, Waldeyers tonsillar ring, the soft palate, the lateral tongue, and the floor of the mouth.2 Waldeyers ring includes the lingual and palatine tonsils, the adenoids, lymphoid follicles located on the posterolateral tongue in the area of the foliate papillae, and level 1 lymph nodes in the floor of the mouth. Narla S, Annapurneswari S, Parameswaran A, Nair S. Peripheral T-cell lymphoma of tongue: Report of a rare case and review of literature. Bratisl Lek Listy. government site. Educational text answers on HealthTap are not intended for individual diagnosis, treatment or prescription. Postoperatively the patient was deemed unsafe for extubation and transferred to the intensive care unit while placed on high-dose intravenous dexamethasone. Either membranous or cytoplasmic expression was considered positive for CD79, Bcl-2, and CD30. https://doi.org/10.4103/0973-1482.136024. While the etiology is poorly understood, a number of previous theories exist, which are included here in the context of a literature review. Bone marrow involvement was identified at relapse. Provided by the Springer Nature SharedIt content-sharing initiative. As stated before, the depth of invasion is a major prognostic indicator. Head and neck extranodal lymphoma in a single institute: a 17-year retrospective analysis. Primary intestinal T-cell and NK-cell lymphomas: a clinicopathological and molecular study from China focused on type II enteropathy-associated T-cell lymphoma and primary intestinal NK-cell lymphoma. Patients first experienced from varying degrees of throat discomfort and commit to the hospital with no B symptoms. Epub 2009 Jun 26. Five cases of severe HBT were detected among 306 patients submitted to videolaryngoscopy over a period of 2 years, corresponding to 1.6% (5/306) of the total sample studied. One patient in the literature died 18months after diagnosis despite being in an early stage. 2005;9:34050. The biological behaviours that are exclusive to the tongue base are not clear. Six of the cases exhibited tongue base masses with smooth surface membranes. Lymphoid hyperplasia is the rapid proliferation of normal lymphocytic cells that resemble lymph tissue which may occur with bacterial or viral infections. Although nearly 10% of DLBCL cases are reported to be EBV positive and are mainly seen in elderly people [28], EBV was not detected in any of our DLBCL cases. A poor prognostic case of peripheral T-cell lymphoma in the base of tongue with chemotherapy followed by radiation therapy. From: The Teaching Files: Chest, 2010 View all Topics 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? The patient was kept on a three-week course of tapering prednisone and proton-pump inhibitors. Ear Nose Throat J. 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. Although our case with MCL received rituximab during his second cycle of chemotherapy, he relapsed two years after the primary diagnosis. e. Tumour cells were positive for P53 (200 x). Before These cells are designed to fight. sharing sensitive information, make sure youre on a federal J Postgrad Med. https://doi.org/10.1097/01.dad.0000246949.49071.17. Cyclophosphamide, doxorubicin, vincristine, prednisone, Peripheral T cell lymphoma, not otherwise specified. Cite this article. In the literature, findings of RLH are well-documented. 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. Lymphoid hyperplasia of the tongue is a very rare benign lymphoproliferative lesion that closely resembles carcinoma or lymphoma, clinically or histopathologically. These results all indicate that HPV positivity does not have much impact on the overall survival of DLBCL patients. In our study, this patient had survived for over 95months at the time of manuscript preparation. [Lymphoepithelial hyperplasia of the tonsil at the base of the tongue]. The base of tongue refers to the back one-third of the tongue that continues down the throat. Hi, my biopsy says reactive lymphoid hyperplasia, does it means it is benign? Pseudotumours of the oropharynx due to muscular contraction. When the lymphoid tissue is deeply seated, the appearance may be more pink or deeper in color. Am J Hematol. Polyclonal lymphoid proliferation with immunohistochemistry stains for kappa or lambda light chains are diagnostic. Benign Lymphoid Hyperplasia of the Tongue Base Causing Upper Airway Obstruction Severe benign lymphoid hyperplasia (LH) is unusual in the head and neck region, but the diagnosis of LH is of clinical importance as it may be confused with malignant lymphoma, both on clinical examination and pathologically. The most common site for all cases was at the base of the tongue. HPV RNA ISH all negative. 88, no. Oral Pathology: Clinical Pathologic Correlations. Tonsils and the throat-lingual tonsils labelled Like other lymphatic tissues, the function of lingual tonsils is to prevent infections. Mod Pathol. Immunohistochemically, the atypical lymphoid cells were positive for CD20, CD79a, PAX-5, CD5, CyclinD1 protein, and Ki-67 antigen (labelling 25%). The prognosis for MCL seems to be poorer than that for DLBCL at the base of the tongue. https://doi.org/10.1309/YHFE-R65B-D3LK-3GGV. 2013;119:18327. Indian J Cancer. Bookshelf Acta Oncol. The site is secure. Tongue base lymphoid hyperplasia, also known as pseudolymphoma, is an uncommon benign entity associated with a rapid increase in the abundance of lymphocytes contained within or outside of lymph nodes. Springerplus. ZL, BW, XR and YC reviewed all the cases together. https://www.linkedin.com/showcase/4000114/. Three out of four cases had a high Ki-67 index. TIA, SOX10 was obtained from Beijing XiYaJinQiao Biological Technology Co. Ltd. China. Four were staged at III and IV and had higher IPI scores (2 or 3). Only one patient died of the disease. Head Neck. PubMedGoogle Scholar. Two probes (EBV and HPV) were used for all seven cases. Chi HS, Lee KW, Chiang FY, Tai CF, Wang LF, Yang SF, Lin SF, Kuo WR. 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. Careers. Cancer. Clinically this lesion presented as a painless ulcer, which mimicked carcinoma of the tongue. These tissues act as your body's first line of defense against infections. Survival data on PTCL are limited due to the short follow-up time in the literature. https://doi.org/10.1016/j.leukres.2005.11.004. 2014;3:731. https://doi.org/10.1186/2193-1801-3-731. A final diagnosis was made through deep resection. A case of benign lymphoid hyperplasia (BLH) of the tongue is reported. It is composed of cortex and medulla. Dysphagia. Squamous cell hyperplasia in the oral cavity is seen most commonly on the tongue, palate, and lateral wall of the pharynx. statement and Cutaneous lymphoid hyperplasia is generally not malignant, but in rare cases an association has been observed. Ann Oncol. Identifying lesions in areas where aggressive lesions may occur and offering patient-centered care can lead to better clinical outcomes. The number of cases in the present study was low, so further studies will be needed to better understand the relationship between HPV infection and lymphoma of the base of the tongue. 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]. Methods We reported a severe case of tongue base BLH compromising the breathing and swallowing of the affected patient. Spontaneous regression has also been reported. https://doi.org/10.4103/0019-509X.58873. The complaints due to severe HBT were noisy respiration, hoarseness, throat clearing, dry cough, globus pharyngeus, and nasal voice. 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. [7]. Rinsho Ketsueki. 2010;47:846. https://doi.org/10.1016/S0344-0338(11)80514-5. Sinus hyperplasia may be associated with non-hematolymphoid malignancy. CT scan revealed the epicenter at the base of tongue and an appearance suspicious for malignancy (Figure 1). d. Tumour cells diffusely expressed CD3 (200x). 2, pp. Google Scholar. The outer cortex is composed of follicles of B cells so that it is called the B-cell zone. 1970 Dec;8(3):413-24. 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. Kaohsiung J Med Sci. The same study also showed that lymphoma at this site is always early stage [21, 24]. XS and QL did the HPV ISH. After washing and amplification, target RNA was stained with DAB. Severe HBT was considered to be present when the follicles prevented the view of the epiglottis or were massively distributed through the pharynx and larynx. Accessibility Unauthorized use of these marks is strictly prohibited. In addition, rituximab, an anti-CD20 chimeric antibody that has dramatically and favourably improved the survival rate [39], was not added to the therapeutic regimen of this case for some reason. This procedure was carried out under general anesthetic in the form of a modified adenotonsillectomy, using a Boyle Davis gag for exposure and a combination of monopolar cautery for the palatine tonsils and suction cautery for subtotal ablation of the lingual tonsils. The clinical stage was IV A. We not only report on the general clinicopathological features, including age, gender, tumour location, histological subtypes, grading and staging, but also provide important information related to prognosis and treatment. Most of these cancers are squamous cell carcinoma and caused by human papillomavirus (HPV) infection. May SA, Jones D, Medeiros LJ, Duvic M, Prieto VG, Lazar AJ. Squamous cell hyperplasia is characterized by increased cell numbers, which usually results in increased thickness of the squamous epithelium. Lailatul et al. a. CT showed an irregular soft tissue mass at the right posterior aspect of the tongue base. sharing sensitive information, make sure youre on a federal e. HPV DNA ISH showed brown punctate dots in the tumour cell nucleus or cytoplasm (400x).f. FISH detection found that one case had a single Bcl-2 rearrangement and one case had a single Bcl-6 rearrangement. Mohd Ridah LJ, A Talib N, Muhammad N, Hussain FA, Zainuddin N. p16 Tumor Suppressor Gene Methylation in Diffuse Large B Cell Lymphoma: A Study of 88 Cases at Two Hospitals in the East Coast of Malaysia. Am J Gastroenterol. Article PubMed Central This is slightly different from the cases reported by Owosho AA et al. 39, no. HPV is considered to be associated with the occurrence of oropharyngeal squamous cell carcinoma [8], therefore, we detected the infection status of the the two viruses in lymphoma of the base of the tongue. The clinical stage was IV A by the Ann Arbor staging system. Article A 64-year-old African Canadian female with a history of urinary incontinence was admitted for an elective bladder suspension procedure by the gynaecology service in our institution. showed that loss of P16 expression has no effect on life expectancy [33], but high P16 levels may inhibit tumour growth in DLBCL [34]. Vose JM. a. H&E showed a diffuse infiltrate of large cells with an obvious nucleolus and abundant cytoplasm (200 x). Please note, we cannot prescribe controlled substances, diet pills, antipsychotics, or other commonly abused medications. Tongue musculature involvement can cause restricted movement, dysarthria, and dysphagia. 2009 Mar-Apr;75(2):195-9. doi: 10.1016/s1808-8694(15)30778-3. Three reactive samples, either tonsils or lymph nodes, were included to establish cut-off values. Imaging and pathological findings of PTCL (case 3). 2012 May 28;18(20):2462-71. doi: 10.3748/wjg.v18.i20.2462. The appearance of brown punctate dots in the tumour cell nucleus or cytoplasm was considered positive. A lymphoid follicle under microscope is shown in Figure 2. Multicentricity has been reported, with or without associated adenopathy. PubMed Departments of Pathology, Molecular Pathology Research Center, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Science, Dongdan district Shuaifuyuan 1st, 100730, Beijing, China, Xinyu Ren,Shafei Wu,Xuan Zeng,Xiaohua Shi,Qing Ling&Zhiyong Liang, Departments of Pathology, Beijing Childrens Hospital, Capital Medical University, National Center for Childrens Health, Beijing, 100045, China, Department of Biochemistry and Molecular Medicine, The George Washington University School of Medicine and Health Sciences, Washington, DC, USA, Department of Pathology and Otolaryngology, UC Irvine School of Medicine, UC Irvine Medical Center, Irvine, USA, You can also search for this author in
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