Lymphomas of the head and neck 1: Nasofacial T-cell lymphoma

Nasofacial T-cell lymphoma includes diseases otherwise called “lethal midline granuloma” and “necrosis with atypical cells”. It is characterised by relentless destruction of nose and palate in particular but the lymphoma remains localised to the head and neck. The age of onset ranges from 10 to 87 and the survival ranges from a few months to several years. The histological appearances are of a polymorphic infiltrate but including atypical T cells in a background of macrophages. There is a strong association with Epstein-Barr virus infection.     

Neoplastic disease in the head and neck of patients with AIDS.

Immunosuppression increases the risk of developing malignancies. In immunosuppression due to human immunodeficiency virus (HIV) disease the common head and neck tumors are Kaposi's sarcoma and non-Hodgkin's lymphoma. Squamous cell carcinoma has also been reported. Kaposi's sarcoma is the commonest neoplastic disease in AIDS. The incidence of lymphoma is rapidly increasing. This article reviews the incidence, clinical presentation and management of these diseases in the head and neck in AIDS patients.     

Midline "nonhealing" granuloma

Destructive processes of the midface can occur in a wide variety of diseases. Intrinsic in consideration of these is a cluster of lesions, including Wegener's granulomatosis (WG), idiopathic midline granuloma (IMG), polymorphic reticulosis (PR), and lymphoma. Although there is still confusion as to whether the latter three represent a spectrum of the same malignant process, there is general agreement that WG is a separate entity on the basis of clinical presentation and therapeutic response. It is probable that PR is an emergent lymphoma, with the same prognostic and therapeutic features. Idiopathic midline granuloma is clinically similar to PR and lymphoma, but histologically it appears to be inflammatory in nature with no clearly definable malignant cell type present. At this point in time three diseases are best collectively referred to as midline "nonhealing" granuloma. The cases presented represent the spectrum of this enigmatic process.     

Diffuse large B-cell lymphoma with oral manifestations

Non-Hodgkin lymphomas (NHLs) are a heterogenic group of lymphoproliferative diseases with their different behavior pattern and response to treatments. As a Hodgkin disease, NHL occurs from lymphoid tissues and can spread to other organs. Prognosis depends on histologic type, grade, and treatment. In the World Health Organization classification, aggressive B-cell lymphomas are diffuse large B-cell lymphoma, Burkitt lymphoma/leukemia, and precursor lymphoblastic leukemia/lymphoma. They may present either nodal or extranodal disease, which may be either localized or disseminated. Diffuse large B-cell lymphoma is the most common type of lymphoma in adults and is clinically, morphologically, and genetically a heterogeneous group of malignant proliferations of mature B cells, too. Diffuse large B-cell lymphoma is the most common type of NHL and accounts for about 30% of the cases. In this clinical report, we evaluated clinically and histopathologically a 64-year-old male patient who had mild pain and edema in his mandibular premolar region, and the excisional biopsy showed diffuse large B-cell lymphoma.     

Serious jaw osteolytic lesions

Among oral and maxillofacial diseases, the maxillary osteolytic lesions constitute a rich and investigated field to define the more appropriate diagnosis and treatment. In the maxillary region, the same tumors of the other bones (osteogenic sarcoma, chondroma, etc.) cause found together with tumors and dysembryoplasias connected with the teeth development (ameloblastoma, odontoma, odontogenic myxoma, etc.). Moreover in the medullary spaces of the bones, there are reticular and hematopoietic cells that are connected with different diseases (leucemia, myeloma, lymphoma, etc.). What's more, due to the possible presence of pseudotumors (fibrous dysplasia, giant cell tumor, etc.) and metastases of tumors of other regions (breast, lung, prostate gland, etc.), the diagnosis of this disease could be difficult. In this paper the more important pictures of this disease, that due to its recurrence or malignity needs an accurate diagnosis by imaging like CT, CT-3D, MR, etc, are analyzed. The more suitable surgical approach is presented, according to the forms of the disease.     

Sjogren syndrome: a review of the literature and a case report

Sj?gren syndrome is one of the most prevalent autoimmune diseases in which the body's immune system mistakenly attacks its own moisture producing glands. Although Sj?gren syndrome occurs in all age groups in both women and men, women in their fourties are the most affected. Sj?gren's syndrome can occur alone or in the presence of another connective tissue disease, respectively called primary and secundary Sj?gren syndrome. When two of the three clinical hallmarks: keratoconjunctivitis sicca, xerostomia or connective tissue disease are present, Sj?gren 's syndrome should be considered. To confirm the diagnosis of Sj?gren's syndrome several tests are required. e.g. blood tests, ophthalmologic tests and oral tests. Rheumatologists have the primary responsibility for managing Sj?gren's syndrome. Other specialists can treat the related symptoms. The incidence of lymphoma is higher in patients with Sj?gren's syndrome than in the general population. Therefore patients must be monitored carefully for the development of related autoimmune diseases, lymphoma and other complications. Sj?gren's syndrome is serious but generally not fatal if complications are diagnosed and treated early.     

环境因素在非霍奇金淋巴瘤病因中作用的研究进展

非霍奇金淋巴瘤是最为常见的恶性肿瘤之一,近30年来其发病率有明显的增加趋势.它的发病原因广泛,发病过程复杂.不同病理亚型的非霍奇金淋巴瘤具有不同的病因,这使对于非霍奇金淋巴瘤生成的环境因素及其作用的研究更加重要.本文就近年来环境因素在非霍奇金淋巴瘤病因中作用的研究进展作一综述.     

Adult T-cell leukemia/lymphoma of the tongue

A case of posterior tongue lymphoma associated with adult T-cell leukemia (ATL) that occurred as a lesion in the lingual dorsal portion is reported in a 64-year-old woman. Initially, a diagnosis of Hodgkin's lymphoma was considered as no findings associated with ATL except lymphadenopathy and serum anti-ATLA antibodies were present. Combined radiotherapy and chemotherapy were administered with favorable results; however, 4 months later, Pneumocystis carinii pneumonia developed, and 2 months later, generalized lymphadenopathy and hypercalcemia evolved. At this time, a diagnosis of ATL was made. The patient died of renal dysfunction 6 months after the initial presentation. In suspected cases of ATL and malignant diseases of T-cell lineage, namely, malignant lymphoma and mycosis fungoides, the presence of HTLV-1 infection should be confirmed by testing for anti-ATLA antibodies.     

颌骨及上颌窦Burkitt淋巴瘤1例报告及文献复习

Burkitt淋巴瘤也称为非洲淋巴瘤,多发于非洲儿童。本文报告1例发生于双侧下颌骨及左侧上颌骨及上颌窦的Burkitt淋巴瘤,并结合相关文献,对该病的发病因素、临床特征、诊断和鉴别诊断、治疗原则及预后等进行讨论。     

The orofacial manifestation of various hemoblastoses]

In everyday practice the stomatologist is sometimes confronted with symptoms that are indicative of malignant diseases. For malignant lymphoma, lymphogranulomatosis and myeloic leucosis, as examples, the authors present in tabular form orofacial symptoms such as bleedings, gingival hyperplasia, ulcerations and others, the occurrence of which requires diagnostic assessment.     

Non-Hodgkin's lymphoma of the hard palate.

In the past decades many changes have taken place in the classification of lymphoreticular malignancies. At present two main groups are recognized--Hodgkin's lymphomas and non-Hodgkin's lymphomas. Hodgkin's lymphomas rarely affect the oral cavity. The mouth, especially the soft tissues, is somewhat more frequently involved in cases of non-Hodgkin's lymphoma. There seems to be some predilection for the mucosa of the palate. The present report describes eight patients in whom a swelling of the palatal mucosa led to the diagnosis of non-Hodgkin's lymphoma. The emphasis is on the clinical and microscopic aspects. The present most accepted histologic classifications have been applied and are briefly discussed.     

DNA microarray technology: insights for oral and maxillofacial surgeons

Since the discovery of DNA and the recent sequencing of the entire human genome, there have been great advances in our understanding of the genetic basis of many diseases, including cancer. An exciting recent development is DNA microarray technology. This technique allows many genes to be studied in the same experiment rather than one gene at a time. It can therefore provide large amounts of data much more quickly than was previously possible. This has great implications for diseases such as cancer, which often show genetic damage in many parts of the genome. DNA microarray technology has now been used in the investigation of many tumours including melanoma, breast cancer, and lymphoma, as well as in the understanding of the genetic basis of metabolic diseases. However, it seems that our specialty knows little about the technique and its possible clinical applications. We give here a simple introduction to the technology and its likely role in the future management of oral cancer.     

Effects of cancer therapy on dental and maxillofacial development in children: report of case

Malignant lymphoma is one of the most common hematological diseases of children. The prognosis is fairly good with multimodal cancer therapy. We reported a boy with Burkitt's lymphoma in the nasal cavity who received chemotherapy and irradiation of the head and neck area at four years of age. During seven years of follow-up, we studied the developmental effects of cancer therapy, including general growth, maxillofacial bones, and dentition. Compared with boys of matching age, the development of his entire body and maxillofacial bones was delayed. In the irradiated areas, the roots of teeth were short or poorly developed and the root apices showed premature closure. After the patient was in remission from the tumor in his early childhood, the long-term effects of cancer therapy on dental and maxillofacial development are worth our further evaluation and follow-up.     

Sporadic Burkitt's lymphoma of the jaws: the essentials of prompt life-saving referral and management

Burkitt's lymphoma is an undifferentiated non-Hodgkin's B-cell lymphoma. Three clinical subtypes are recognized: African (endemic), American (sporadic) and HIV associated. Sporadic Burkitt's lymphoma is a rare malignancy among western populations. This report describes a case of sporadic Burkitt's lymphoma of the jaws with an alarmingly rapid spread associated with acute renal failure. This type of rapid progression bespeaks the need for prompt recognition and life-saving referral by the dental practitioner. The clinical features of Burkitt's lymphoma involving the jaws include severely hypermobile, ectopically displaced and supra-erupted teeth. The purpose of this case report and review of the literature is to illustrate the clinical and histopathologic features of Burkitt's lymphoma to help clinicians recognize such cases readily and facilitate prompt and potentially life-saving referral.     

口腔颌面颈部恶性淋巴瘤56例临床分析

目的：探讨头颈部恶性淋巴瘤的发病特点、临床表现以及预后的相关性分析。方法：搜集56例头颈部恶性淋巴瘤病例,采用HE染色法进行观察,分析临床特点及预后情况。结果：56例头颈部恶性淋巴瘤患者中非霍奇金恶性淋巴瘤和霍奇金恶性淋巴瘤患者分别为47例（83.93%）和9例（16.07%）,常见临床体征是包块（痛性及无痛性）,感染溃疡。49例回访,7例失访。在回访中,22例（44.90%）复发,经分析表明复发率与患者的年龄及累计部位的差异具有统计学意义（P〈0.05）。发病部位依次为颈部、颌下、颏下。仅有头颈部症状者48例（85.71%）。初次诊断不明确者46例（82.14%）。1次病理诊断的确诊率为84.8%。治疗主要为手术＋化疗。患者5年生存率58%。结论：结外型恶性淋巴瘤的临床表现及组织学形态多样化,容易与临床上其他疾病相混淆。应通过病理检查及免疫组织化学检查以明确诊断。累犯≥2个部位和年龄〉50岁头颈部恶性淋巴瘤患者的复发率较高。     

Human immunodeficiency virus (HIV)-associated extranodal T cell non-Hodgkin lymphoma of the oral cavity

T cell non-Hodgkin lymphoma is characterized by uncontrolled cellular proliferation of immature malignant clones. HIV-associated T cell non-Hodgkin lymphoma comprises a heterogeneous group of lymphoproliferative neoplastic entities classified according to morphological, immunological, genetic and clinical features. Extranodal T cell non-Hodgkin lymphoma of the oral cavity is uncommon. A case is presented with extranodal T cell non-Hodgkin lymphoma as an initial sign of HIV-infection. The characteristics of HIV-associated non-Hodgkin lymphoma are discussed.     

Periodontal diseases in HIV-infected patients

Abstract Periodontal diseases may be the first clinical sign of human immunodeficiency virus (HIV)-infection. Since the immunosuppression and subsequent susceptibility may alter the responses of the oral tissues as well as the microflora, both periodontal treatment and result of therapy may be modified. The periodontal diseases in HIV-seropositive patients include common as well as less conventional forms of gingivitis and periodontitis, and bacteria, mycotic and viral infections are seen. Neoplasias may also involve the periodontium; most common are Kaposi's sarcoma and non-Hodgkin's lymphoma. Recent studies of unselected groups of patients indicate that periodontal health in at least some groups of HIV-seropositive patients is better than previously reported.     

Head and neck malignancies associated with HIV infection.

Immunosuppressed persons are at greater risk of developing malignancies. In human immunodeficiency virus (HIV) immunosuppression the most common oral cancers are Kaposi's sarcoma and non-Hodgkin's lymphoma. Squamous cell carcinoma has also been reported to be associated with HIV disease. Kaposi's sarcoma is the most frequent neoplastic disease in acquired immunodeficiency syndrome and is by far the most common in the head and neck area. This article reviews the prevalence, clinical features, and management of these diseases in HIV infection.     

Primary lymphoma of the mandible: report of a case

A case involving primary lymphoma of the mandible is presented. The difficulties in diagnosis of this particular pathology are highlighted. The features of primary lymphoma of the mandible are described based on a review of the literature. Malignant lymphoma must be considered in the differential diagnosis of unexplained dental pain, swelling, ulceration, and radiographic evidence of rarefaction.     

颌面部原发性皮肤间变大细胞淋巴瘤1例报告及文献复习

[提要]原发性CD30+间变性大细胞淋巴瘤是一种少见的非霍奇金淋巴瘤,该病主要好发于60岁左右,常发生于四肢和躯干,临床检查为质韧、边界清楚、结节状肿物.组织病理学检查显示皮下组织内有大量淋巴细胞,形态学结合免疫组织化学是诊断本病较为有效的方法.皮肤原发性病变临床少见,原发于颌面部者更为罕见.本文对临床上发现的1例原发...