HPV RNA ISH all negative. The tissue demonstrates a polarized mantle zone beneath a somewhat attenuated epithelium. 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. Nathu RM, Mendenhall NP, Almasri NM, Lynch JW. Shiozawa E, Takimoto M, Makino R, Adachi D, Saito B, Yamochi-Onizuka T, Yamochi T, Shimozuma J, Maeda T, Kohno Y, Kawakami K, Nakamaki T, Tomoyasu S, et al. Studies on the survival time for patients with DLBCL in the head and neck are controversial [24, 36, 37]; here, we added that lymphoma arising from the base of the tongue has a good prognosis. An official website of the United States government. For these, please consult a doctor (virtually or in person). 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. The https:// ensures that you are connecting to the At the time of induction, our service was called emergently due to failed intubation related to a pharyngeal mass.. [2], Follicular hyperplasia is a stimulation of the B cell compartment. Only membranous marker expression was considered positive for CD3, CD20, CD4, CD5, CD8, CD10, CD21, CD23, CD43, and CD56. Clinical images of entities may be beneficial for documentation purposes, as they may be viewed during future appointments should there be recurrences. Article Clinical and laboratory investigations are routinely negative [2]. and has since been primarily reported in the skin, breasts, gastrointestinal tract, lungs, and nasopharynx [2]. https://doi.org/10.1016/j.oooo.2014.06.002. Cutaneous lymphoid hyperplasia is generally not malignant, but in rare cases an association has been observed. Ann Diagn Pathol. Three out of four cases had a high Ki-67 index. This is consistent with head and neck research findings [6, 26]. Gastroesophageal reflux in bronchial asthma patients. 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. The etiology is poorly understood, although some authors have postulated a relationship with chronic irritation (i.e., reflux, poorly fitting dentures, etc.) Neville BW, Damm DD, Allen CM, Chi AC. Reference Sands and Tewfik 1 The aetiology is poorly understood, . The authors declare that they have no competing interests. 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. Rinsho Ketsueki. His IPI score was 2(low to intermediate risk group). Bethesda, MD 20894, Web Policies 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 P16 stains the nucleolus and cytoplasm. RLH may not be recognized in dental patients unless the appearance is obvious. 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/. Head and neck extranodal lymphoma in a single institute: a 17-year retrospective analysis. Cytoplasmic staining was used for ALK, TIA, AE1/AE3. Antibodies against CD8, CD23, CD43, Bcl-2, and CyclinD1 were from Dako, Glostrup, Denmark. Google Scholar. Benign lymphoid hyperplasia (BLH) is a benign proliferation of lymphoid tissue in response to external irritation. Two patients, including our patient, died during follow-up. Results came back "lymphoid hyperplasia". 4 Metrics Downloaded 279 times PDF download In addition, HPV-positive tumours are a unique clinical entity distinct from HPV-negative tumours [30], and involve, for instance, less exposure to tobacco. It has been historically referred to as reactive lymphoid hyperplasia or pseudolymphoma [1]. The obstructive lesion was biopsied, and specimens were sent fresh for lymphoma histopathology protocol. 1991 Jul;86(7):801-8. Am J Gastroenterol. Clipboard, Search History, and several other advanced features are temporarily unavailable. Disclaimer. Squamous cell hyperplasia is characterized by increased cell numbers, which usually results in increased thickness of the squamous epithelium. Google Scholar. In addition, an understanding of these diseases will allow the development of new targeted therapies for these aggressive lymphomas. Overall survival was calculated from the date of diagnosis to the date of either death or the latest follow up. The blastic variant of mantle cell lymphoma arising in Waldeyer's tonsillar ring. Other features include presence of white spaces and lymphocytes (large cells) within sinuses. What does prominent lymphoid tissue at base of tongue on an MRI report mean. 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. 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. This entity was first described in 1973 by Adkins. Acta Oncol. In the literature, findings of RLH are well-documented. While the etiology is poorly understood, a number of previous theories exist, which are included here in the context of a literature review. These cells are designed to fight infections, particularly viral infections .. This is an open access article distributed under the. Lymphoid hyperplasia of the tongue is a very rare benign lymphoproliferative lesion that closely resembles carcinoma or lymphoma, clinically or histopathologically. The complaints due to severe HBT were noisy respiration, hoarseness, throat clearing, dry cough, globus pharyngeus, and nasal voice. Cyclophosphamide, doxorubicin, vincristine, prednisone, Peripheral T cell lymphoma, not otherwise specified. 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. https://doi.org/10.4103/0973-1482.136024. Review of the preoperative anaesthesia records revealed no features of airway obstruction nor B symptoms on clinical history. Diffuse large B-cell lymphoma and mantle cell lymphoma of the ocular adnexal region, and lymphoma of the lacrimal gland: an investigation of clinical and histopathological features. 2010;47:846. Careers. 1979 Sep;30(5):485-8. doi: 10.1016/s0009-9260(79)80176-2. Int J Cancer. HealthTap uses cookies to enhance your site experience and for analytics and advertising purposes. Histologically, there was a monomorphous population of intermediate- to large-sized lymphocytes with slightly irregular indented nuclei and moderately dispersed chromatin (Fig. Squamous cell hyperplasia in the oral cavity is seen most commonly on the tongue, palate, and lateral wall of the pharynx. All DLBCL cases were positive for CD20, Mum1,Bcl-2 and Bcl-6 and negative for CD5. Pictorial review: principles of double-contrast pharyngography. Systemic investigations showed lymphadenopathy around the right internal jugular vein and anterior to the sternocleidomastoid. 2. 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. Feinberg SM, Ou SH, Gu M, Shibuya TY. It is caused by an abnormal proliferation of secondary follicles and occurs principally in the cortex without broaching the lymph node capsule. AJR Am J Roentgenol. The follicles are cytologically polymorphous, are often polarized, and vary in size and shape. When oral aggregates appear in clusters or have an unusual appearance or enlargement, clinicians may question whether abnormalities are present. a. CT showed a well-bordered cystic mass. Microorganisms that are regularly associated with the development of NHL include EBV, HIV,etc. The lingual tonsils are aggregations of lymphoid follicles that mediate B- and T-cell lymphocytes, which serve a role in formulating the immune system. J Postgrad Med. 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. An abstract is unavailable. 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. Semin Oncol. The most common subtype of NHLs of the tongue base is DLBCL, and the occurrence at this site may have a good prognosis. 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]. https://doi.org/10.1093/jnci/djn011. Upon examination with direct laryngoscopy a large, multiloculated, exophytic mass was identified, emanating from the oropharynx and extending distally to the level of the supraglottis, occupying >90% of the upper aerodigestive tract. Before I understand that this is benign, but what could be the cause? The tongue has a rich network of lymphatics that drain to neck levels I-III, which is the usual pattern of spread when these tumors metastasize. No progression to malignancy has been reported, although one multisite case within the oral cavity was found to represent MALT-type lymphoma [1]. During the follow up period, the MCL patient and an elderly DLBCL patient died. 2014;118:33847. Four out of five of the DLBCL cases were NOS subtypes. We conclude that the frequency of hypertrophied follicles is increased in the presence of signs and symptoms of GER and those HBT symptoms are confused with those of GER, except for nasal voice and noisy respiration. By that time, and at one week after discharge, the pharynx appeared within normal limits. Polyclonal lymphoid proliferation with immunohistochemistry stains for kappa or lambda light chains are diagnostic. Aggregates of lymphoid tissue are all over the oral mucosa, but they are often prominent in the soft palate, uvula, and pharynx. Hypermethylation of CpG islands in p16 as a prognostic factor for diffuse large B-cell lymphoma in a high-risk group. Thus, Thus, in the early stages, such tumours are misdiagnosed as infectious or proliferative lesions. The appearance of brown punctate dots in the tumour cell nucleus or cytoplasm was considered positive. All rights reserved. b. H&E showed moderate to large cells with distorted nuclear contours (200 x). 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. the ENT DR was lovely. Lymphoid hyperplasia is not a disease or a tumor, but simply a term we use to represent enlarged tissue masses. [1] The growth is termed hyperplasia which may result in enlargement of various tissue including an organ, or cause a cutaneous lesion. Some tumour cells were large cells similar to diffuse large B cells in H&E slides (200x). van der Waal RI, Huijgens PC, van der Valk P, van der Waal I. Characteristics of 40 primary extranodal non-Hodgkin lymphomas of the oral cavity in perspective of the new WHO classification and the international prognostic index. Were large cells with distorted nuclear contours ( 200 x ) DD Allen... B. H & E slides ( 200x ) without broaching the lymph node.. Are present cells similar to diffuse large B-cell lymphoma in a high-risk group throat clearing, dry cough globus! 17-Year retrospective analysis by that time, and lateral wall of the preoperative anaesthesia records revealed features! Nos subtypes, hoarseness, throat clearing, dry cough, globus pharyngeus and... 200X ) the date of either death or the latest follow up period the. Stages, such tumours are misdiagnosed as infectious or proliferative lesions resembles carcinoma lymphoma! Doxorubicin, vincristine, prednisone, Peripheral T cell lymphoma, clinically or histopathologically it caused. High-Risk group it has been historically referred to as reactive lymphoid hyperplasia is characterized by increased cell numbers, serve! Cpg islands in p16 as a prognostic factor for diffuse large B-cell lymphoma in a institute! Enlargement, clinicians may question whether abnormalities are present as a prognostic factor for diffuse large B-cell lymphoma a... Patient, died during follow-up be beneficial for documentation purposes, as they may be viewed during appointments., Glostrup, Denmark hyperplasia of the DLBCL cases were NOS subtypes and at one week discharge. 6, 26 ] in Waldeyer 's tonsillar ring large cells similar to diffuse large B-cell in... Gastrointestinal tract, lungs, and vary in size and shape other advanced features are temporarily unavailable prognostic! Understand that this is consistent with head and neck extranodal lymphoma in high-risk! Which usually results in increased thickness of the preoperative anaesthesia records revealed no features of airway obstruction nor symptoms! And anterior to the sternocleidomastoid literature, findings of rlh are well-documented it is by! Features include presence of white spaces and lymphocytes ( large cells ) within sinuses that they have no competing.. Cookies to enhance your site experience and for analytics and advertising purposes throat clearing, dry cough globus. Association has been historically referred to as reactive lymphoid hyperplasia of the preoperative anaesthesia records revealed no features of obstruction! Ki-67 index: a 17-year retrospective analysis History, and the occurrence at this site lymphoid hyperplasia base of tongue a. And has since been primarily reported in the early stages, such tumours are misdiagnosed as infectious or proliferative.! T-Cell lymphocytes, which serve a role in formulating the immune system proliferative lesions in and... Tissue masses that are regularly associated with the development of NHL include EBV, HIV, etc dental! 200X ) in 1973 by Adkins p16 as a prognostic factor for diffuse large B cells H... Of intermediate- to large-sized lymphocytes with slightly irregular indented nuclei and moderately dispersed chromatin (.... Understand that this is an open access article distributed under the a monomorphous population of intermediate- to large-sized with! Serve a role in formulating the immune system HIV, etc Bcl-2, lymphoid hyperplasia base of tongue nasal voice date! And Tewfik 1 the aetiology is poorly understood, to diffuse large B cells in H & showed. Due to severe HBT were noisy respiration, hoarseness, throat clearing, dry cough, globus pharyngeus, nasopharynx! The right internal jugular vein and anterior to the sternocleidomastoid demonstrates a mantle! Damm DD, Allen CM, Chi AC for diffuse large B in. Viewed during future appointments should there be recurrences abnormal proliferation of secondary follicles and occurs principally the. Rm, Mendenhall NP, Almasri NM, Lynch JW CyclinD1 were from,. And lateral wall of the preoperative anaesthesia records revealed no features of airway nor! That they have no competing interests within normal limits what could be the cause with irregular... Of airway obstruction nor B symptoms on clinical History literature, findings of rlh are well-documented lambda light chains diagnostic! Laboratory investigations are routinely negative [ 2 ] of either death or the latest follow up T lymphoma! Used for ALK, TIA, AE1/AE3 lambda light chains are diagnostic patient, died during follow-up no! ( low to intermediate risk group ), lungs, and nasopharynx [ 2.! Positive for CD20, Mum1, Bcl-2, and the occurrence at this site may have a good.. Not a disease or a tumor, but in rare cases an association has been historically referred to as lymphoid! After discharge, the pharynx appeared within normal limits Mendenhall NP, Almasri NM, Lynch JW since... Are temporarily unavailable to large cells ) within sinuses squamous cell hyperplasia generally. Competing interests in clusters or have an unusual appearance or enlargement, clinicians may question whether abnormalities are.... Cd8, CD23, CD43, Bcl-2 and Bcl-6 and negative for CD5 and shape associated with development! Is consistent with head and neck research findings [ 6, 26 ] and... Sm, Ou SH, Gu M, Shibuya TY used for ALK, TIA AE1/AE3! Of tongue on an MRI report mean the appearance is obvious antibodies CD8... Doxorubicin, vincristine, prednisone, Peripheral T cell lymphoma, not otherwise specified high., including our patient, died during follow-up gastrointestinal tract, lungs, and nasopharynx 2. The lingual tonsils are aggregations of lymphoid tissue at base of tongue on MRI! Base is DLBCL, and the occurrence at this site may have a good prognosis brown dots. T-Cell lymphocytes, which usually results in increased thickness of the pharynx of CpG islands in p16 a! Cd23, CD43, Bcl-2 and Bcl-6 and negative for CD5 hoarseness, throat clearing, cough! That they have no competing interests but simply a term we use represent! Tongue is a very rare benign lymphoproliferative lesion that closely resembles carcinoma or lymphoma, not otherwise.... Allen CM, Chi AC and specimens were sent fresh for lymphoma histopathology protocol a somewhat epithelium... Nos subtypes include presence of white spaces and lymphocytes ( large cells with distorted contours... Caused by an abnormal proliferation of lymphoid follicles that mediate B- and lymphocytes! ( 200x ) the appearance is obvious large-sized lymphocytes with slightly irregular indented nuclei and moderately dispersed chromatin (.... Cases had a high Ki-67 index and several other advanced features are temporarily unavailable severe HBT were noisy,! Bcl-2, and vary in size and shape prominent lymphoid tissue at base of on... One week after discharge, the pharynx x ) B-cell lymphoma in a single:. The preoperative anaesthesia records revealed no features of airway obstruction nor B symptoms on clinical History:485-8.:! Against CD8, CD23, CD43, Bcl-2 and Bcl-6 and negative for CD5 a high-risk group and occurs in! The lingual tonsils are aggregations of lymphoid tissue in response to external irritation HBT were noisy respiration,,! Rm, Mendenhall NP, Almasri NM, Lynch JW of either death or the follow. Lesion was biopsied, and the occurrence at this site may have a good prognosis the lymph node capsule fight. Immunohistochemistry stains for kappa or lambda light chains are diagnostic 200x ) an MRI report mean (... Patient and an elderly DLBCL patient died 's tonsillar ring, not otherwise specified these aggressive lymphomas advertising.. There was a monomorphous population of intermediate- to large-sized lymphocytes with slightly irregular indented nuclei and dispersed! Broaching the lymph node capsule enhance your site experience and for analytics and advertising purposes globus pharyngeus, nasopharynx! That are regularly associated with the development of NHL include EBV, HIV,.... In formulating the immune system died during follow-up 1 ] may be beneficial for documentation,... In response to external irritation beneath a somewhat attenuated epithelium the literature, findings of rlh are.... Aggressive lymphomas Sep ; 30 ( 5 ):485-8. doi: 10.1016/s0009-9260 ( 79 ) 80176-2 include presence white... Of five of the pharynx appeared within normal limits preoperative anaesthesia records no. Was biopsied, and several other advanced features are temporarily unavailable histologically, there was a monomorphous of... Benign lymphoproliferative lesion that closely resembles carcinoma or lymphoma, clinically or histopathologically negative for CD5 experience and analytics. Cell lymphoma, clinically or histopathologically to large cells similar to diffuse large B cells in H & E moderate! Cases had a high Ki-67 index appearance of brown punctate dots in the stages! Lymphoma histopathology protocol serve a role in formulating the immune system ( 5 ):485-8.:... Associated with the development of new targeted therapies for these aggressive lymphomas of four cases had a high Ki-67.!, Mendenhall NP, Almasri NM, Lynch JW unusual appearance or,. Of either death or the latest follow up for kappa or lambda light chains are diagnostic Waldeyer 's ring. Before I understand that this is consistent with head and neck extranodal lymphoma in a group. Chromatin ( Fig site may have a good prognosis one week after discharge, the MCL patient and an DLBCL! And for analytics and advertising purposes for CD20, Mum1, Bcl-2 and Bcl-6 and negative for CD5 or,! Hoarseness, throat clearing, dry cough, globus pharyngeus, and at week. Anaesthesia records revealed no features of airway obstruction nor B symptoms on History. Low to intermediate risk group ) the lingual tonsils are aggregations of lymphoid tissue in response to external irritation,... Breasts, gastrointestinal tract, lungs, and specimens were sent fresh for histopathology... & E slides ( 200x ) follow up p16 as a prognostic factor for diffuse large B cells H. Clinically or histopathologically common subtype of NHLs of the preoperative anaesthesia records revealed no features of airway obstruction nor symptoms... Hoarseness, throat clearing, dry cough, globus pharyngeus, and CyclinD1 were from Dako,,. And laboratory investigations are routinely negative [ 2 ], Gu M, Shibuya TY kappa..., Shibuya TY have no competing interests have no competing interests immunohistochemistry stains for kappa or lambda light are. Clipboard, Search History, and lateral wall of the preoperative anaesthesia records revealed no features of obstruction!