Benign lymphoid hyperplasia of the palate

Seven patients with benign lymphoid hyperplasia of the palate are reported. Clinically, these lesions presented as painless non-ulcerated masses that were unilateral in 6 of the cases and bilateral in one. Microscopically, the lesions were characterized by a mixed lymphoid infiltrate, germinal centres and vascular channels with hyperplasia of endothelial cells. The patients were followed for 3–10 years subsequent to diagnosis. One patient had 2 sequential lesions on opposite sides of the palate. Another patient with lesions of both submandibular salivary glands in addition to the palate developed rheumatoid arthritis, xerophthalmia and serologic changes consistent with systemic autoimmune disease. To date, none of the patients developed signs and symptoms of lymphoma or leukemia. The etiology of these lesions is unknown. Their distinction from lymphoma of the palate, as well as their possible relationship to the benign lymphoepithelial lesion of palatal mucous glands, is discussed.     

Benign lymphoid hyperplasia of the tongue masquerading as carcinoma: case report and literature review

Lymphoid hyperplasia of the tongue is a very rare benign lymphoproliferative lesion that closely resembles carcinoma or lymphoma, clinically or histopathologically. A case of benign lymphoid hyperplasia (BLH) of the tongue is reported. Clinically this lesion presented as a painless ulcer, which mimicked carcinoma of the tongue. Microscopy showed typical histologic features of multiple germinal centers with a rim of small mature lymphocytes together with a mixed, mainly mononuclear infiltrate which clinched the diagnosis of benign lymphoid hyperplasia. This diagnosis averted extensive investigations and major surgery. The etiology of these lesions is unknown. Their distinction from carcinoma and lymphoma is discussed.     

Follicular lymphoid hyperplasia of the palate: report of a case and review of the literature

The follicular lymphoid hyperplasia of the palate is a very rare benign lymphoproliferative lesion that closely resembles lymphomas, clinically or histopathologically or both. A case of follicular lymphoid hyperplasia of the palate is reported. Clinically, the lesion presented as a firm, painless, nonulcerated, nonfluctuant and slowly growing swelling on one side of the palate. The biopsy showed the typical histologic features: multiple germinal centers with a rim of well-differentiated B lymphocytes together with a mixed, mainly mononuclear infiltrate with many plasmacytoid lymphocytes. The clinicopathologic features are described and integrated into a review of the 19 previously recorded cases. The diagnosis of a follicular lymphoid hyperplasia should always be considered in cases of palatal swelling.     

Chromosomal aberrations in adenomatoid hyperplasia of palatal minor salivary gland

Adenomatoid hyperplasia of minor salivary glands is rare, idiopathic, and benign, and typically presents as a tumour-like mass in the hard or soft palate. Its exact nature is not clear and histological examination usually shows an excess of normal-appearing minor salivary glands. To our knowledge, cytogenetic analysis of it in a minor salivary gland of the palate has not previously been reported. We present the cytogenetic analysis of adenomatoid hyperplasia in the hard palate of a 52-year-old woman.     

Lymphoid lesions of salivary glands: malignant and benign

Lesions of salivary glands with a prominent lymphoid component are a heterogeneous group of diseases that include benign reactive lesions and malignant neoplasms. Occasionally, these pathologic entities present difficulties in the clinical and pathological diagnosis and prognosis. Lymphoepithelial sialadenitis, HIV-associated salivary gland disease, chronic sclerosing sialadenitis, Warthin tumor, and extranodal marginal zone B-cell lymphoma are examples of this pathology that are sometimes problematic to differentiate from one another. In this paper the author reviewed the main clinical, pathological and prognostic features of these lesions.     

Image findings of B cell lymphoma of the palate

In this report, we describe image findings in a case of a 78-year-old man with malignant lymphoma of the palate, which had progressively developed 8 years after malignant lymphoma of the neck. The patient was referred to our hospital with a complaint of painless swelling of the left palate. A slightly enhanced mass without apparent bone destruction was observed in the left palate on computed tomography (CT) images. The mass showed homogeneous signal intensity by both T1- and T2-weighted magnetic resonance imaging (MRI) and the anterior part of the mass exhibited inhomogeneous enhancement, but most of the mass demonstrated homogeneous signal intensity with slight enhancement by enhanced MRI. On the basis of these image findings, the lesion was diagnosed as a benign tumor of the minor salivary glands in the palate. Histopathological examination revealed findings consistent with non-Hodgkin’s lymphoma, diffuse large B cell type (World Health Organization classification). On a gallium-67 scintigram, only the site of the lesion was positive.     

Adenomatoid hyperplasia of mucous salivary glands. Report of two cases

Adenomatoid hyperplasia of the mucous salivary glands is an uncommon benign tumor of the oral cavity. Two cases of palatal involvement are presented. Since clinical differentiation between benign and malignant growth of the palate cannot be established, microscopic examination is necessary. The palate is the most common location of this lesion, and as such it is useful for the periodontist to be aware of this tumor.     

Lymphoid papillary hyperplasia: report of a case

A rare case of papillary lymphoid hyperplasia is reported in a 16-year-old girl. The case presented as papillomatous lesions of both palatine tonsils. Histopathologic findings revealed an unusual form of lymphoid hyperplasia. It is important to recognize this peculiar lesion because it exhibits clinical features suggestive of benign (papillomas) and malignant (carcinoma) neoplasia. Papillary lymphoid hyperplasia is a benign process, probably non-neoplastic, and easily cured by tonsillectomy.     

Adenomatoid hyperplasia in the palate: another sheep in wolf's clothing.

Adenomatoid hyperplasia is a rare idiopathic non-inflammatory, non-neoplastic and benign lesion of minor salivary glands, that typically presents with a tumour-like mass in the palate. A 77-year-old patient is described.     

Tumor-associated lymphoid proliferation in the parotid gland: A potential diagnostic pitfall

A substantial proportion of neoplastic and nonneoplastic parotid diseases have a prominent lymphoid component. The lymphoid element in lesions such as papillary cystadenoma lymphomatosum, sebaceous lymphadenoma, and lymphoepithelial carcinoma are readily recognized as a required diagnostic element. However, when other types of benign and malignant salivary gland neoplasms demonstrate tumor-associated lymphoid proliferation, the tumor may be either misclassified or misinterpreted as metastatic disease. Examples of primary benign and malignant parotid neoplasms exhibiting tumor-associated lymphoid proliferation are documented and illustrated. Other parotid lesions that may have a lymphoid element include sialadenitis, cysts with associated lymphoid tissue, parenchymal neoplasms with an expected lymphoid component or those that arise within an intraparotid lymph node, autoimmune disease, malignant lymphoma, and metastatic disease. An approach to recognition and separation of these entities is discussed.     

Necrotizing sialometaplasia in a patient who is HIV positive: a case report

Necrotizing sialometaplasia (NS) is a self‐limiting, benign, inflammatory disease of the minor salivary glands of the hard palate. The main significance of the NS lesion lies in the fact that it may be mistaken for mucoepidermoid or squamous cell carcinoma. A case report is presented of a patient with NS who was HIV positive; the lesion was located in the minor salivary glands of the hard palate. Clinically, the lesion presented as a deep ulcer with slightly elevated irregular borders and a necrotic base in the hard palate. Histologically, the tissue was characterized by squamous metaplasia of ducts and acini, lobular coagulation necrosis, and pseudoepitheliomatous hyperplasia of the overlying epithelium. The lesion disappeared completely after 2 weeks.     

Rare case report of an aggressive follicular lymphoid hyperplasia in maxilla

Follicular lymphoid hyperplasia is a very rare though benign reactive process of an unknown pathogenesis that may resemble a follicular lymphoma, clinically and histologically. Oral reactive follicular hyperplasia (RFH) has been described on the hard or soft palate and at the base of the tongue. We describe here the first case of RFH presenting as an aggressive tumor on the right posterior side of the maxilla in a 24-year-old male patient. The lesion had a clinical evolution of 18 months and was noticed after the surgical extraction of the right third molar, although we cannot assume a cause-effect relation with that surgical event whatsoever. His medical history was unremarkable. Following an incisional biopsy, histological examination revealed lymphoid follicles comprised by germinal centers surrounded by well-defined mantle zones. The germinal centers were positive for Bcl-6, CD10, CD20, CD21, CD23, CD79a, and Ki-67, while negative for Bcl-2, CD2, CD3, CD5, and CD138. The mantle and interfollicular zones were positive for Bcl-2, CD2, CD3, CD5, CD20, and CD138. Both areas were diffusively positive for kappa and lambda, showing polyclonality. The patient underwent a vigorous curettage of the lesion with no reoccurrences at 36 months of follow-up. This case report demonstrates that morphologic and immunohistochemical analyses are crucial to differentiate RFH from follicular lymphoma, leading to proper management.     

Sialoadenoma papilliferum

2 additional examples of sialoadenoma papilliferum, one occurring in the palate of a 32-year-old woman and the other in the palate of a 43-year-old man, have been added to the previously reported 11 cases. 9 of the 13 reported cases occurred in the palate with a 5.5:1 prevalence in men. The age at discovery ranged from 32 to 77 years. Whether these lesions represent a benign salivary gland tumor or hyperplasia of duct epithelium remains debatable. Surgical excision apparently effects a cure as no recurrences have been reported.     

小涎腺局灶性增生的临床病理观察

目的：涎腺局灶性增生为发生于口腔小涎腺的少见病，临床常误诊为良性肿瘤或其他病变，为提高临床病理诊断水平，本文进行了总结。方法：复习628例小涎 肿瘤及瘤样病变的病理切片中，有9例属于本病。结果：9例的发生部位以腭部最多见（4／9），其次为上唇（2／9）、颊、磨牙后垫及舌各1例，临床表现增生物较小，为柔软的实性团块，与周围组织之间无明显界限。病理表现为大量粘液腺泡的聚集，腺导管基本正常，无炎症或散在少量慢性炎症细胞，偶见少量腺泡的细胞膜消失，腺泡融合，增生物与周围腺体之间无明显界限。结论：本病临床表现为缓慢增生的肿块，作为准确诊较困难，只有手术后病理检查才能确诊。     

Minor salivary gland hyalinisation and amyloidosis in low-grade lymphoma of MALT

Two patients with low-grade lymphoma of mucosa-associated lymphoid tissue (MALT) arising in primary Sjögren's syndrome developed solitary nodules in their lips. Histologically both lesions showed enlargement and hyalinisation of single minor salivary glands with acinar atrophy, loss of most ducts and conversion into almost acellular sclerotic eosinophilic masses. In one case the lesion was shown to contain an amyloid component. No amyloid was detected in the second case but deposition of collagen and basement membrane and sclerotic neoplasm were excluded.     

Atypical histiocytic granuloma of the tongue: case report.

Primary malignant lymphomas of the tongue have rarely been described, and reported cases are usually related to the posterior part of the tongue which is rich in lymphoid tissue, forming part of Waldeyer's ring. Making a distinction between pseudolymphoma and malignant lymphoma is important. Pseudolymphoma is a benign lesion not requiring aggressive therapy. Several lesions in the oral cavity, including atypical histiocytic granuloma, angiolymphoid hyperplasia with eosinophilia, and traumatic ulcerative granuloma with stromal eosinophilia have been described as having certain microscopic features similar to those of pseudolymphoma. Atypical histiocytic granuloma is not associated with systemic disease or dissemination and heals spontaneously despite its microscopic appearance.     

Some unusual oral lesions in HIV infection: Comments on the current classification

Of the numerous oral lesions reported in HIV-infected patients, four entities will be discussed in this paper: linear gingival erythema; cystic lymphoid hyperplasia of the parotid gland; oral non-Hodgkin's lymphoma; and oral squamous cell carcinoma. Based on the literature and the author's personal experience, it appears that linear gingival erythema is perhaps a specific HIV-associated periodontal lesion, but that insufficient data are available in the literature yet to classify this periodontal lesion as a lesion that is strongly associated with HIV infection. On the other hand, cystic lymphoid hyperplasia of the parotid gland has been rather widely reported and has characteristic histopathological features that would justify consideration of this lesion as highly indicative of an underlying HIV infection. Oral non-Hodgkin's lymphoma, at present regarded as a lesion ‘strongly associated with HIV infection’, is less characteristic in this respect and should merely be classified as ‘a lesion seen in HIV infection’. Oral squamous cell carcinomas, not included in the most recent International Classification of Oral Manifestations of HIV infection, should be listed in Group 3 of that classification, representing ‘lesions seen in HIV infection’. Further criteria should be developed that will enable distinctions to be made between lesions ‘strongly associated with’, ‘less commonly associated with’, and ‘seen in’ HIV infection.     

Imaging characteristics of diffuse large cell extra nodal non-Hodgkin's lymphoma involving the palate and maxillary sinus: a case report

Non-Hodgkin's lymphomas are a group of highly diverse malignancies and have a strong tendency to affect organs and tissues that do not ordinarily contain lymphoid cells. Primary extra nodal lymphoma of the hard palate is rare. Here, we present a case of diffuse large B cell lymphoma in a 60-year-old male patient that manifested as slightly painful ulcerated growth on the edentulous right maxillary alveolar ridge extending onto the palate, closely resembling carcinoma of the alveolar ridge. Computed tomography images showed the involvement of the maxillary sinus and right nasal cavity, along with destruction of hard palate, superiorly extending into the orbit. This case report highlights the importance of imaging to evaluate the exact extent of such large malignant lesions, which is essential for treatment planning.     

Focal epithelial hyperplasia. A rare disease in our area

Focal epithelial hyperplasia is a benign, asymptomatic disease, occurring with very low frequency within our population. It appears as papules, principally on the lower lip, although it can also be found on the retro-commissural mucosa and tongue, and less frequently on the upper lip, gingiva and palate. We present the clinical case of a 9-year-old Saharan girl with lesions that clinically and histologically corresponded to a focal epithelial hyperplasia.