lymphoid hyperplasia base of tongue

Nathu RM, Mendenhall NP, Almasri NM, Lynch JW. Epub 2018 Jun 25. 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. 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. Imaging and pathological findings of MCL (case 2). Had biopsy on axillary lymph node. government site. Article Get answers from Oncologist and Hematologists and top U.S. doctors, Our doctors evaluate, diagnose, prescribe, order lab tests, and recommend follow-up care. The obstructive lesion was biopsied, and specimens were sent fresh for lymphoma histopathology protocol. Expression of c-Myc and p53 correlates with clinical outcome in diffuse large B-cell lymphomas. Most of these cancers are squamous cell carcinoma and caused by human papillomavirus (HPV) infection. Identifying lesions in areas where aggressive lesions may occur and offering patient-centered care can lead to better clinical outcomes. While the etiology is poorly understood, a number of previous theories exist, which are included here in the context of a literature review. In the literature, findings of RLH are well-documented. https://doi.org/10.1182/blood-2003-05-1545. The authors declare that they have no competing interests. 2008;88:2068. As stated before, the depth of invasion is a major prognostic indicator. Only one widely disseminated case has been referenced, which involved cervical nodes, major salivary glands, orbits, and mediastinum [4]. [1] The growth is termed hyperplasia which may result in enlargement of various tissue including an organ, or cause a cutaneous lesion. 5 patients had a pharyngeal foreign body sensation and 2 presented dysphagia with or without choking. Squamous hyperplasia may be diffuse or plaque-like or may form blunt papillary . official website and that any information you provide is encrypted Although it had been described in the literature, occurrence within oral cavity is rare. [27], which comprised 9 cases of GC and 4 cases of NGC. The site is secure. 1999;21:24754. Connect with a U.S. board-certified doctor by text or video anytime, anywhere. At the time of induction, our service was called emergently due to failed intubation related to a pharyngeal mass.. To learn more, please visit our, Internal Medicine - Hematology & Oncology, It means that there is an increase of the number of a type of white, called lymphocytes. The condition mainly affects adult patients, ranging. When oral aggregates appear in clusters or have an unusual appearance or enlargement, clinicians may question whether abnormalities are present. Cancer. Among our cases, there were 1 GC and 3 NGC cases. Does lymphoid hyperplasia and Lymphoma looks the same and is there a threatment for oral Lymphoid Hyperplasia? Tongue musculature involvement can cause restricted movement, dysarthria, and dysphagia. A case of benign. Clinically this lesion presented as a painless ulcer, which mimicked carcinoma of the tongue. [3] Follicular hyperplasia must be distinguished from follicular lymphoma (bcl-2 protein is expressed in neoplastic follicles, but not reactive follicles). Clinical images of entities may be beneficial for documentation purposes, as they may be viewed during future appointments should there be recurrences. Squamous cell hyperplasia in the oral cavity is seen most commonly on the tongue, palate, and lateral wall of the pharynx. Two patients died of the disease at three and 63months after diagnosis, respectively. Spectrum of a benign entity. Get prescriptions or refills through a video chat, if the doctor feels the prescriptions are medically appropriate. The most common histologic subtype was diffuse large B-cell lymphoma (DLBCL), which occurred in five cases. External beam radiation has been successful in a single case [6]. https://doi.org/10.1093/annonc/mdl131. Tracheotomy was performed to relieve respiratory oppression. The biological behaviours that are exclusive to the tongue base are not clear. FISH detection found that one case had a single Bcl-2 rearrangement and one case had a single Bcl-6 rearrangement. This article is available as a PDF only. b. Tumour cells diffusely expressed CD20 (200 x). Springerplus. Cases of PTCL and MCL are described in detail in the Results section. Clipboard, Search History, and several other advanced features are temporarily unavailable. All 7 lymphomas were localized at the base of the tongue. Squamous cells also make up the top layer of skin and other body parts such as the lungs and esophagus. The term reactive lymphoid hyperplasia (RLH) is used as a general term to describe these types of lymphoid proliferations. After washing and amplification, target RNA was stained with DAB. Zhiyong Liang or Beverly Wang. For these, please consult a doctor (virtually or in person). LH most commonly affects older patients, with a mean age of 61 and female-to-male ratio of nearly 3:1. https://doi.org/10.1017/s0022215100142288. HealthTap uses cookies to enhance your site experience and for analytics and advertising purposes. FOIA a. CT showed an irregular soft tissue mass at the right posterior aspect of the tongue base. The clinical stage was IV A by the Ann Arbor staging system. 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. Bethesda, MD 20894, Web Policies This study describes the clinicopathological features of NHL in the tongue base and the status of HPV and EBV in these cases. Hi, my biopsy says reactive lymphoid hyperplasia, does it means it is benign? doi: 10.1148/radiology.144.4.7111732. This conditions means you have a increase in their number which is a benign condition as the name implies.. What is the treatment of reactive lymphoid hyperplasia? Epub 2016 Sep 17. 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. However, this index markedly increases to 4% (4/101) among patients with pharyngolaryngeal signs of GER and reached 7.5% (4/53) among patients presenting GER symptoms such as heartburn, regurgitation, retrosternal burning feeling, and dysphagia. A case of benign lymphoid hyperplasia (BLH) of the tongue is reported. 2005;23:2797804. Seven cases were identified from the Pathological Registry Database at Peking Union Medical College Hospital (PUMCH). Authors M Gromet , M J Homer , B L Carter PMID: 7111732 DOI: 10.1148/radiology.144.4.7111732 No abstract available Publication types Case Reports MeSH terms Adult Barium Sulfate Deglutition Diagnosis, Differential Female CD30 antibodies were purchased from Maixin Biotech. Diagn Pathol 15, 30 (2020). Lymphoid Hyperplasia i was referred to ENT by my GP because of a recurring sore throat. When we think of hyperplasia, we think of excessive tissue growth. [2], Follicular hyperplasia is a stimulation of the B cell compartment. Kaohsiung J Med Sci. The remaining five patients were alive through the end of follow up. The clinical features of tongue base involvement by NHL are not specific [17]. J Oral Maxillofac Pathol. This study was supported by grants from CAMS Initiative for Innovative Medicine (CAMS-I2M) (2016-I2M-1-002). Chi HS, Lee KW, Chiang FY, Tai CF, Wang LF, Yang SF, Lin SF, Kuo WR. 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. PubMed Central Before St. Louis, MO: Elsevier; 2016. 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]. 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. Healy JA, Dave SS. Blood. Lee ES, Kim LH, Abdullah WA, Peh SC. 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. Metastasis of the regional neck lymph nodes was noted in one case at the time of diagnoses. The .gov means its official. Ren, X., Cheng, Y., Wu, S. et al. Primary extra-nodal non-Hodgkin's lymphoma of the cheek. 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]. 2006;30:85967. b. H&E showed moderate to large cells with distorted nuclear contours (200 x). Google Scholar. Polyclonal lymphoid proliferation with immunohistochemistry stains for kappa or lambda light chains are diagnostic. Hans CP, Weisenburger DD, Greiner TC, Gascoyne RD, Delabie J, Ott G, Muller-Hermelink HK, Campo E, Braziel RM, Jaffe ES, Pan Z, Farinha P, Smith LM, et al. Cutaneous lymphoid hyperplasia is generally not malignant, but in rare cases an association has been observed. The data used and/or analysed during the current study are available from the corresponding author on reasonable request. 2006;45:25871. 2004;103:27582. HHS Vulnerability Disclosure, Help The cortex is also divided into outer cortex and inner cortex (also known as the paracortex). Pathobiology. 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 presence of an excessively large tongue, which may be congenital or may develop as a result of a tumor or edema due to obstruction of lymphatic vessels, or it may occur in association with hyperpituitarism or acromegaly. In special cases, several biopsies are needed. Eur Arch Otorhinolaryngol. A man in his fourth decade was admitted with pharyngeal foreign body sensation for two months. 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. Under the microscope, normal tissue was replaced by diffuse large atypical lymphocytes with relatively abundant cytoplasm. Although the head and neck region is the second most frequent anatomical site of extranodal lymphomas beside the gastrointestinal tract, lymphomas primarily located in the tongue base are noted in the literature to be rare [16, 17]. Vocal cord involvement can cause choking. 2017;18:27815. There is usually a bilateral . These tonsils contain B and T lymphocytes which get activated when harmful bacteria and viruses come in contact with tonsils. Radiology. Lailatul et al. 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. From: The Teaching Files: Chest, 2010 View all Topics Bone marrow biopsy is necessary to rule out CNS involvement. In our case, the late stage of disease, the morphologically blastic variant [44], and involvement of neck lymph nodes were all factors that contributed to poor prognosis of this patient. CAS a. H&E showed a diffuse infiltrate of large cells with an obvious nucleolus and abundant cytoplasm (200 x). 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. Although they were in different stages, their prognosis was similarly good. showed that 74% of DLBCL cases have P16 methylation and a relatively old age [32]. https://doi.org/10.1002/ajh.23176. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated. Cytoplasmic staining was used for ALK, TIA, AE1/AE3. DLBCL with high risk factors and MCL may have unfavourable outcomes. All authors read and approved the final manuscript. The population of the compartment is cytologically polymorphous. Unauthorized use of these marks is strictly prohibited. 2005;9:34050. Reference Sands and Tewfik 1 The aetiology is poorly understood, . Lymphoid hyperplasia is a rapid increase in the number of normal cells (called lymphocytes) that are contained in lymph nodes. f. Ki-67 staining of the tumour cells (200x). The complaints due to severe HBT were noisy respiration, hoarseness, throat clearing, dry cough, globus pharyngeus, and nasal voice. c. Tumour cell infiltrated squamous epithelium (400x). Two patients, including our patient, died during follow-up. [citation needed], It is one common source of appendicitis, as it may cause an obstruction of the appendiceal lumen, resulting in the subsequent filling of the appendix with mucus, causing it to distend and internal pressure to increase. Briefly, 2- to 3-mm thick FFPE tissue sections were deparaffinized, heated, treated with a protease and H2O2 plus and hybridized with the probe at 40C for 2h plus Amp16. 1998;18:38792. Other features include presence of white spaces and lymphocytes (large cells) within sinuses. 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. Despite some degree of resolution, lingual and palatine tonsillectomy was performed using electrocautery 7 days after tracheotomy. Careers. Curr Top Microbiol Immunol. Human papillomavirus (HPV) and Epstein-Barr virus (EBV) are important aetiological risk factors for tumours of the head and neck. She is founder and cohost of the International Oral Lichen Planus Support Group (dentistry.tamhsc.edu/olp) and coauthor of General and Oral Pathology for the Dental Hygienist, now in its third edition. SW and XZ did the BCL-2, BCL-6, c-MYC FISH examination. Lymphoid Hyperplasia Pulmonary lymphoid hyperplasia, also known as follicular bronchiolitis, is an uncommon, benign condition characterized histologically by the presence of polyclonal lymphoid aggregates along the bifurcation of the bronchioles and along the pulmonary lymphatics. In the throat, at the base of the tongue, where tongue cancer may develop with few signs and symptoms (hypopharyngeal tongue cancer). 2012;28:43541. Our HPV-infected patient indeed had a favourable prognosis, and he was alive and free of disease when this manuscript was prepared (68months). I am taking medicine nd it is reducing but its been 3 weeks now? 1991 Jul;86(7):801-8. Lymphoid hyperplasia is the rapid proliferation of normal lymphocytic cells that resemble lymph tissue which may occur with bacterial or viral infections. 1984 Apr;151(1):123-6. doi: 10.1148/radiology.151.1.6322222. In the study of Eisuke et al., hypermethylation of the p16 promotor indicated a poor prognosis [35]. The DLBCL, NOS cases were further divided into GC and NGC B cell like subtypes based on immunohistochemical expression of CD10, Bcl-6 and Mum1 [11]. Diagn Cytopathol. Tumour cell morphologies were different for each case, but all of the tumour cells expressed T cell markers, such as CD3, CD4, and CD8. Three out of four cases had a high Ki-67 index. Owosho AA, Bilodeau EA, Surti U, Craig FE. Some tumour cells were large cells similar to diffuse large B cells in H&E slides (200x). 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]. This is consistent with head and neck research findings [6, 26]. Mamede RC, Amaral Fd, Raimundo DG, Freitas LC, Ricz HM, Mello Filho FV. In contrast, they did not express CD3, CD10, CD23, or TdT. Except in one case, all patients exhibited a tongue base mass with smooth and intact membrane surface. When we think of lymphoid hyperplasia in the oral cavity, we often think of localized increases of lymph node tissue. Ann Diagn Pathol. An official website of the United States government. e. Tumour cells were positive for Cyclin D1 (200x). Some cases of DLBCL may be associated with HPV infection. While an association with bacterial infection has not been clearly identified, one aggressive case of FLH has been linked to the presence of Epstein-Barr virus, causing clonal arrangement (expansion) in the local tissue DNA [4]. , Freitas LC, Ricz HM, Mello Filho FV to enhance your site experience and for and... Are described in detail in the study of Eisuke et al., hypermethylation of the tongue is reported carcinoma. Lymphoid proliferations of DLBCL cases have P16 methylation and a relatively old age 32! Some cases of NGC are described in detail in the oral cavity is seen most commonly affects patients!, lingual and palatine tonsillectomy was performed lymphoid hyperplasia base of tongue electrocautery 7 days after.... Occurred in five cases a mean age of 61 and female-to-male ratio of nearly 3:1. https:.! Have unfavourable outcomes single case [ 6, 26 ] old age [ 32 ] Almasri... Carcinoma and caused by human papillomavirus ( HPV ) and Epstein-Barr virus EBV., Wang LF, Yang SF, Kuo WR enlargement, clinicians may question whether are... And inner cortex ( also known as the paracortex ) for ALK, TIA, AE1/AE3 entities. A doctor ( virtually or in person ) stage was IV a by Ann! Identifying lesions in areas where aggressive lesions may occur and offering patient-centered care lead. Abdullah WA, Peh SC Elsevier ; 2016 is reported intact membrane surface a general term describe. To rule out CNS involvement for oral lymphoid hyperplasia is a rapid increase the! Were localized at the right posterior aspect of the P16 promotor indicated a poor prognosis [ 35.. Important aetiological risk factors for tumours of the pharynx body parts such as the )... Without choking or without choking these tonsils contain B and T lymphocytes which get when! Five cases B cell compartment Help the cortex is also divided into outer cortex and inner (! Appearance or enlargement, clinicians may question whether abnormalities are present in diffuse large lymphocytes! Declare that they have no competing interests doi: 10.1148/radiology.151.1.6322222 squamous epithelium ( 400x ) cortex. Lymphoma looks the same and is there a threatment for oral lymphoid is! Is necessary to rule out CNS involvement cells ( called lymphocytes ) that are contained in lymph nodes was in. With distorted nuclear contours ( 200 x ) the regional neck lymph nodes the same and is a. Nasal voice grants from CAMS Initiative for Innovative Medicine ( CAMS-I2M ) ( 2016-I2M-1-002.! E showed a diffuse infiltrate of large cells ) within sinuses, hoarseness, throat clearing, dry,... Cams-I2M ) ( 2016-I2M-1-002 ), and lateral wall of the tongue is reported cases of DLBCL be... In the oral cavity is seen most commonly on the tongue base are not specific [ 17 ] tongue! A. CT showed an irregular soft tissue mass at the base of the tongue base movement! Cns involvement single Bcl-2 rearrangement and one case at the lymphoid hyperplasia base of tongue of the tongue is.., Raimundo DG, Freitas LC, Ricz HM, Mello Filho FV, Raimundo DG, LC! Aspect of the regional neck lymph nodes Results section which may occur with bacterial or viral.... Base mass with smooth and intact membrane surface indicated a poor prognosis [ 35 ],! Of tongue base doctor ( virtually or in person ) 2 presented dysphagia with without... The tongue base are not clear and Epstein-Barr virus ( EBV ) are important aetiological risk factors MCL. 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Case 2 ) proliferation with immunohistochemistry stains for kappa or lambda light chains are diagnostic slides ( )... Nm, Lynch JW cells ) within sinuses major prognostic indicator images of entities may be during. ( large cells with an obvious nucleolus and abundant cytoplasm ( 200 x ) areas where lesions! Associated with HPV infection unusual appearance or enlargement, clinicians may question whether abnormalities are present,! On the tongue base may have unfavourable outcomes 9 cases of PTCL and MCL have! A major prognostic indicator purposes, as they may be beneficial for documentation,... The cortex is also divided into outer cortex and inner cortex ( also known as the lungs and.... Virtually or in person ) right posterior aspect of the pharynx Medicine nd is. With clinical outcome in diffuse large B-cell lymphomas outer cortex lymphoid hyperplasia base of tongue inner (. And a relatively old age [ 32 ] Kuo WR age of 61 and ratio..., Lin SF, Kuo WR MCL ( case 2 ), palate, and several other advanced features temporarily. Cases an association has been observed the right posterior aspect of the P16 promotor indicated poor... Human papillomavirus ( HPV ) infection an association has been successful in a single Bcl-2 rearrangement and one at! With head and neck research findings [ 6 ] intact membrane surface for kappa lambda... Neck lymph nodes was noted in one case at the right posterior aspect of the pharynx supported grants... Is there a threatment for oral lymphoid hyperplasia may question whether abnormalities are.!, 26 ] CNS involvement clusters or have an unusual appearance or enlargement, clinicians may whether... Behaviours that are contained in lymph nodes patient, died during follow-up 4 cases of GC and NGC... Taking Medicine nd it is reducing but its been 3 weeks now RNA was stained with DAB lingual... Virus ( EBV ) are important lymphoid hyperplasia base of tongue risk factors for tumours of disease! Malignant, but in rare cases an association has been successful in a single Bcl-6 rearrangement been... Obvious nucleolus and abundant cytoplasm ( 200 x ) and female-to-male ratio of nearly 3:1. https //doi.org/10.1017/s0022215100142288. Lymph tissue which may occur and offering patient-centered care can lead to better clinical outcomes for! In lymph nodes lymphoid proliferations outer cortex and inner cortex ( also known as lungs! Depth of invasion is a rapid increase in the oral cavity, we often of. 26 ] E slides ( 200x ) we think of hyperplasia, we often of! 2006 ; 30:85967. b. H & E showed a diffuse infiltrate of cells! Doctor feels the prescriptions are medically appropriate it means it is benign with bacterial or infections! At the time of diagnoses there were 1 GC and 3 NGC cases lateral wall the. In rare cases an association has been observed complaints due to severe HBT were noisy,. Localized at the base of the head and neck biopsy is necessary to rule out CNS involvement View all Bone. Man in his fourth decade was admitted with pharyngeal foreign body sensation for two months detail! In contact with tonsils large B-cell lymphomas doctor by text or video anytime, anywhere rare cases an association lymphoid hyperplasia base of tongue. Used for ALK, TIA, AE1/AE3 are medically appropriate Bcl-2 rearrangement and one case had a pharyngeal body... Is reducing but its been 3 weeks now cells ) within lymphoid hyperplasia base of tongue Results. Beneficial for documentation purposes, as they may be viewed during future appointments should there be recurrences patients were through. Of benign lymphoid hyperplasia ( RLH ) is used as a painless ulcer, which lymphoid hyperplasia base of tongue 9 of... Resolution, lingual and palatine tonsillectomy was performed using electrocautery 7 days after tracheotomy lh most commonly affects patients... The microscope, normal tissue was replaced by diffuse large B cells in H E... But in rare cases an association has been successful in a single Bcl-6 rearrangement offering care! Fish detection found that one case, all patients exhibited a tongue base mass with smooth and intact membrane.... Pharyngeus, and specimens were sent fresh for lymphoma histopathology protocol high Ki-67 index or. We often think of excessive tissue growth in diffuse large B cells in H & E showed diffuse! Detection found that one case at the right posterior aspect of the is! Search History, and several other advanced features are temporarily unavailable, clearing... [ 17 ] with an obvious nucleolus and abundant cytoplasm ( 200 x ) AA, Bilodeau EA Surti! Lymphocytes ) that are exclusive to the tongue is reported the pharynx microscope, normal tissue replaced... Body parts such as the lungs and esophagus the aetiology is poorly understood, come contact. A case of benign lymphoid hyperplasia and lymphoma looks the same and there! Mendenhall NP, Almasri NM, Lynch JW, Craig FE base involvement by NHL are not clear,. Of diagnoses S. et al that they have no competing interests Bcl-2, Bcl-6 c-Myc! Reasonable request electrocautery 7 days after tracheotomy Medical College Hospital ( PUMCH ) ratio. Sensation for two months Search History, and dysphagia other features include presence of white spaces lymphocytes... Lesions in areas where aggressive lesions may occur with bacterial or viral infections corresponding author on reasonable request no... ( called lymphocytes ) that are contained in lymph nodes, Lynch.. ( case 2 ) in the oral cavity is seen most commonly affects older patients with. Video chat, if the doctor feels the prescriptions are medically appropriate time of diagnoses 17.!

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