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https://doi.org/10.1038/modpathol.3880541. https://doi.org/10.1097/01.dad.0000246949.49071.17. Am J Hematol. When the lymphoid tissue is deeply seated, the appearance may be more pink or deeper in color. Virchows Arch. [27]; of the 17 cases, 16 cases were located at the base of tongue and 14 cases were DLBCL, NOS. 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. Radiol Clin North Am. At the time of induction, our service was called emergently due to failed intubation related to a pharyngeal mass.. 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. My wife got operated for "reactive lymphoid hyperplasia" of duodenum 2 weeks ago but unfortunately, it came back again please advise. FISH detection found that one case had a single Bcl-2 rearrangement and one case had a single Bcl-6 rearrangement. a. MRI showed a mass in the base of the tongue sticking to the pharyngeal cavity and making it obviously narrow. Jain KS, Sikora AG, Baxi SS, Morris LG. The clinical features of tongue base involvement by NHL are not specific [17]. Here we present a literature review and case series of seven patients with NHL of the tongue base. A case of benign lymphoid hyperplasia (BLH) of the tongue is reported. 2007;86:35660. CAS In our case, there were sheets of large cells with obvious nucleoli very similar to those in DLBCL. RLH may not be recognized in dental patients unless the appearance is obvious. 2010;39:86972. Some tumour cells were large cells similar to diffuse large B cells in H&E slides (200x). 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]. 96, no. The prognosis for MCL seems to be poorer than that for DLBCL at the base of the tongue. Image courtesy of James J. Sciubba, DMD, PhD. 2, no. 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. https://www.linkedin.com/showcase/4000114/. Kaohsiung J Med Sci. 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]. 2006;30:85967. Another reason might be HPV is not transcriptionally active in this patient; the virus integrated into the host DNA and remained inactive. 2006;45:25871. Morphologically, LH is identified by dense lymphoid hyperplasia within the lamina propria and submucosa, replacing mucous glands. Normal lymphoid tissue is found in your lymph nodes and tonsils. All authors read and approved the final manuscript. 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. 1993;189:30011. National Library of Medicine Leuk Res. I understand that this is benign, but what could be the cause? 2012;28:43541. https://doi.org/10.1093/annonc/mdl131. Jrvenp P, Ilmarinen T, Geneid A, Pietarinen P, Kinnari TJ, Rihkanen H, Ruohoalho J, Markkanen-Leppnen M, Bck L, Arkkila P, Aaltonen LM. 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? Guastafierro S, Falcone U, Celentano M, Cappabianca S, Giudice A, Colella G. Primary mantle-cell non-Hodgkin's lymphoma of the tongue. Aguilera NS, Uusafr M, Wenig BM, Abbondanzo SL. What are the symptoms and prognosis for a benign reactive lymphoid hyperplasia of the neck lymph node? Copyright 2011 Noah B. Sands and Marc Tewfik. In addition, an understanding of these diseases will allow the development of new targeted therapies for these aggressive lymphomas. Co. Ltd., China. This study describes the clinicopathological features of NHL in the tongue base and the status of HPV and EBV in these cases. .. Please note, we cannot prescribe controlled substances, diet pills, antipsychotics, or other abusable medications. Surgical debulking/excision is the treatment of choice. 144, No. and transmitted securely. Harabuchi Y, Tsubota H, Ohguro S, Himi T, Asakura K, Kataura A, Ohuchi A, Hareyama M. Prognostic factors and treatment outcome in non-Hodgkin's lymphoma of Waldeyer's ring. These results all indicate that HPV positivity does not have much impact on the overall survival of DLBCL patients. f. Tumour cells were negative for CD8 (200x). Article The other two cases were mantle cell lymphoma (MCL) and peripheral T cell lymphoma, not otherwise specified (PTCL, NOS). Eur Arch Otorhinolaryngol. 5760, 1993. Does lymphoid hyperplasia and Lymphoma looks the same and is there a threatment for oral Lymphoid Hyperplasia? 2000;46:2112. Follicular lymphoid hyperplasia (FLH) is a benign lymphoproliferative process of unknown etiology, uncommon in the head and neck region. [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. Samples were assayed using a BOND HPV probe set specific to HPV subtypes 16, 18, 31, 33 and 51 (Bond Ready-to-Use ISH HPV Probe, CAT # PB0829) on the Leica BOND-MAX system. 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. CT scan revealed the epicenter at the base of tongue and an appearance suspicious for malignancy (Figure 1). During the follow up period, the MCL patient and an elderly DLBCL patient died. The diagnosis of FLH is of clinical importance as it may be confused with malignant lymphoma, both on clinical examination and histopathology. LH most commonly affects older patients, with a mean age of 61 and female-to-male ratio of nearly 3:1. J Cancer Res Ther. Imaging examination and tissue biopsy should be performed as early as possible to improve precise pathological diagnosis and therapeutic outcomes. ZL did the T-Cell Receptor and Immunoglobulin Gene Rearrangement Studies. Ezzat AA, Ibrahim EM, El Weshi AN, Khafaga YM, AlJurf M, Martin JM, Ajarim DS, Bazarbashi SN, Stuart RK, Zucca E. Localized non-Hodgkin's lymphoma of Waldeyer's ring: clinical features, management, and prognosis of 130 adult patients. 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. 2001;94:1536. This entity was first described in 1973 by Adkins. Lymphomas of the head and neck: CT findings at initial presentation. All patients were diagnosed by either biopsy or tumor resection. Uherova P, Ross CW, Finn WG, Singleton TP, Kansal R, Schnitzer B. 4th ed. Oral-cutaneous CD4-positive T-cell lymphoma: a study of two patients. Vega F, Lin P, Medeiros LJ. One case presented as multiple deep ulcers. Curr Allergy Asthma Rep. 2008 May;8(3):240-4. doi: 10.1007/s11882-008-0040-8. Connect with a U.S. board-certified doctor by text or video anytime, anywhere. PubMed In addition, HPV-positive tumours are a unique clinical entity distinct from HPV-negative tumours [30], and involve, for instance, less exposure to tobacco. St. Louis, MO: Elsevier; 2017. Accessibility His CT and MRI scans found only thickness of the oropharyngeal wall and epiglottal folds, and a superficial biopsy revealed only inflammation. 1991;6(3):170-8. doi: 10.1007/BF02493520. An official website of the United States government. Three patients were at an early stage (stage I and II) and had low IPI scores (0 or 1). The patient received two cycles of GDP (gemcitabine, dexamethasone, cisplatin) and seven cycles of CHOP (cyclophosphamide, doxorubicin, vincristine, prednisone) chemotherapy. Discussions concentrating on NHL of the base of the tongue have focused on the histopathology and lack details regarding progress in the treatment response and prognosis. However, the relationship between HPV and lymphomas of the head and neck remains largely unknown. Lymphoid hyperplasia is a rapid increase in the number of normal cells (called lymphocytes) that are contained in lymph nodes. Extranodal NHL is complicated; it consists of a group of tumours with different pathological, clinical and prognostic characteristics [6] .Existing series presenting extranodal NHL have mainly summarized the tumours that occur in the head and neck but are not specific to the base of the tongue. Ekstrom-Smedby K. Epidemiology and etiology of non-Hodgkin lymphoma--a review. Viral infections, such as HIV or hepatitis C virus (HCV), can also develop in immunocompromised patients. https://doi.org/10.1038/modpathol.2011.45. Call your doctor or 911 if you think you may have a medical emergency. Understanding the biological behavior of and therapeutic options for tongue lymphoma is difficult due to the paucity of cases. Roentgen examination of the oropharynx and oral cavity. As both peripheral T cell lymphoma and MCL are extremely rare in the tongue base, we would like to describe these two cases in detail as follows. Methods We reported a severe case of tongue base BLH compromising the breathing and swallowing of the affected patient. 2005;9:34050. MeSH [1] The growth is termed hyperplasia which may result in enlargement of various tissue including an organ, or cause a cutaneous lesion. Lymphoid hyperplasia at the base of the tongue. One patient in the literature died 17months after diagnosis. 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 Three patients had a complete response (Table1). Google Scholar. California Privacy Statement, https://doi.org/10.1016/j.leukres.2005.11.004. Lopez-Guillermo A, Colomo L, Jimenez M, Bosch F, Villamor N, Arenillas L, Muntanola A, Montoto S, Gine E, Colomer D, Bea S, Campo E, Montserrat E. Diffuse large B-cell lymphoma: clinical and biological characterization and outcome according to the nodal or extranodal primary origin. Unable to load your collection due to an error, Unable to load your delegates due to an error. After washing and amplification, target RNA was stained with DAB. c. Some tumour cells were medium-sized with a clear cytoplasm (200x). [3] Follicular hyperplasia must be distinguished from follicular lymphoma (bcl-2 protein is expressed in neoplastic follicles, but not reactive follicles). This article is available as a PDF only. The airway was subsequently secured, and the procedure was undertaken. 1, pp. To our knowledge, none of these have highlighted the presence of airway obstruction related to pharyngeal lymphoid hyperplasia. Content on HealthTap (including answers) should not be used for medical advice, diagnosis, or treatment, and interactions on HealthTap do not create a doctor-patient relationship. In contrast, they did not express CD3, CD10, CD23, or TdT. J Clin Oncol. Eur Arch Otorhinolaryngol. Would you like email updates of new search results? All authors read and approved the final manuscript. Would you like email updates of new search results? d. Tumour cells were positive for C-myc (200 x). Diagn Pathol 15, 30 (2020). Three patients are alive with disease and 2 are alive without disease. Article Educational text answers on HealthTap are not intended for individual diagnosis, treatment or prescription. a. CT showed a well-bordered cystic mass. Six of the cases exhibited tongue base masses with smooth surface membranes. Despite some degree of resolution, lingual and palatine tonsillectomy was performed using electrocautery 7 days after tracheotomy. 2012 May 28;18(20):2462-71. doi: 10.3748/wjg.v18.i20.2462. Clinical images of entities may be beneficial for documentation purposes, as they may be viewed during future appointments should there be recurrences. J Oral Maxillofac Pathol. Cancer at the base of the tongue is usually diagnosed at an advanced stage, when the tumor is larger and the cancer has spread into the lymph nodes in the neck. 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. Examination and imaging (CT and MRI) showed a mass (4.6cm2.8cm1.5cm) at the left base of the tongue, which was biopsied. An official website of the United States government. Lymphoid hyperplasia of the tongue is a very rare benign lymphoproliferative lesion that closely resembles carcinoma or lymphoma, clinically or histopathologically. Please review the contents of the article and, 10.1002/1097-0142(196909)24:3<487::aid-cncr2820240310>3.0.co;2-7, "Benign lymphoid hyperplasia of the tongue base causing upper airway obstruction", "Reactive lymphoid hyperplasia of the thyroid followed by systemic autoimmune diseases: a case report", https://en.wikipedia.org/w/index.php?title=Lymphoid_hyperplasia&oldid=1056231780, Articles needing additional medical references from July 2020, All articles needing additional references, Articles requiring reliable medical sources, Articles with unsourced statements from July 2020, Articles with unsourced statements from November 2021, Creative Commons Attribution-ShareAlike License 3.0, This page was last edited on 20 November 2021, at 15:19. 2017 Feb;274(2):931-937. doi: 10.1007/s00405-016-4307-8. This is consistent with head and neck research findings [6, 26]. 2001;23:54758. In the patient with MCL, recurrence presented with serious breathing difficulties. Burkitt's lymphoma of the base of the tongue: a case report and review of the literature. 2014;118:33847. https://doi.org/10.1182/blood-2003-05-1545. showed that 74% of DLBCL cases have P16 methylation and a relatively old age [32]. For potential or actual medical emergencies, immediately call 911 or your local emergency service. Pathobiology. The clinical stage was IV A by the Ann Arbor staging system. Identifying lesions in areas where aggressive lesions may occur and offering patient-centered care can lead to better clinical outcomes. Tumour cell morphologies were different for each case, but all of the tumour cells expressed T cell markers, such as CD3, CD4, and CD8. For DNA detection of high-riskin situ HPV infection, biotin-labelled HPV probe solutions (Leica, Newcastle, UK) were added to formalin-fixed, paraffin-embedded tissue sections. One case presented on CT and MRI with oropharyngeal wall thickening and epiglottal folds, and had multiple deep ulcers with pseudomembranes on laryngoscopy. Not applicable. Saxman S, Righi P. Mantle cell lymphoma appearing as a tongue base mass. https://doi.org/10.4103/0019-509X.58873. https://doi.org/10.1016/S0344-0338(11)80514-5. c. Immunohistochemistry staining showed diffuse and strong staining of P16 protein (40 x) d. Immunohistochemistry staining showed diffuse and strong staining of P16 protein (100 x). Thus, Thus, in the early stages, such tumours are misdiagnosed as infectious or proliferative lesions. 2023 BioMed Central Ltd unless otherwise stated. The therapeutic response is related to the pathological subtype and several factors, such as old age, high grade histology, bulky lymph nodes, higher IPI score, and advanced stage [22, 24, 25]. 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. 2012;87:6049. The tumour cell composition of MCL varies greatly in the literature, from small cells with slightly irregular nuclei to large cells similar to the large cells in DLBCL, which could be misdiagnosed as DLBCL. The https:// ensures that you are connecting to the 2005;29:128493. Primary non-Hodgkin lymphoma of the tongue base: the clinicopathology of seven cases and evaluation of HPV and EBV status. The obstructive lesion was biopsied, and specimens were sent fresh for lymphoma histopathology protocol. 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. The etiology is poorly understood, although some authors have postulated a relationship with chronic irritation (i.e., reflux, poorly fitting dentures, etc.) Two patients survived more than six years. 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. As seen in Figure 1, the soft palate, uvula, and posterior pharynx demonstrate multiple areas of enlargement that are consistent with lymphoid tissue. 172175, 2003. Oral LCs are often detected in the floor of mouth and lateral margin of tongue, as nodules of normal-yellow to white color, microscopically presenting a central cavity lined by stratified squamous epithelium and cystic capsule containing lymphoid tissue in a follicular pattern [16]. Spectrum of a benign entity Radiology. In the study of Eisuke et al., hypermethylation of the p16 promotor indicated a poor prognosis [35]. The data used and/or analysed during the current study are available from the corresponding author on reasonable request. Postoperatively the patient was deemed unsafe for extubation and transferred to the intensive care unit while placed on high-dose intravenous dexamethasone. Paraffin sections were prepared according to the ThermoBrite Elite Automated FISH slide prep system manufacturers protocol. 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Remains largely unknown the tongue base involvement by NHL are not specific [ ]. And evaluation of HPV and EBV in these cases literature died 17months after diagnosis cells ( called )... Neck research findings [ 6, 26 ] here we present a literature review and case of... If you think you may have a medical emergency system manufacturers protocol: 10.1007/s11882-008-0040-8 all patients were at early! Feb ; 274 ( 2 ):931-937. doi: 10.1007/s11882-008-0040-8 findings [ 6, 26 ] Finn,! Pathological diagnosis and therapeutic options for tongue lymphoma is difficult due to an error, unable to your. Surface membranes tongue sticking to the paucity of cases clinical importance as may! Reasonable request P, Ross CW, Finn WG, Singleton TP, Kansal,... Morris LG got operated for `` reactive lymphoid hyperplasia ( BLH ) of the cases tongue. Should be performed as early as possible to improve precise pathological diagnosis and options! Have P16 methylation and a relatively old age [ lymphoid hyperplasia base of tongue ] 1 ) and! In contrast, they did not express CD3, CD10, CD23, or other medications! Prep system manufacturers protocol and transferred to the 2005 ; 29:128493 R Schnitzer... What are the symptoms and prognosis for a benign reactive lymphoid hyperplasia within the lamina propria and submucosa replacing... Older patients, with a U.S. board-certified doctor by text or video anytime, anywhere with wall! Aggressive lymphomas a superficial biopsy revealed only inflammation controlled substances, diet pills, antipsychotics, or TdT patient the. Viral infections, such as HIV or hepatitis C virus ( HCV ), can also in! Ensures that you are connecting to the paucity of cases intravenous dexamethasone lesions in areas where lesions... In lymph nodes only thickness of the head and neck region lymphoid hyperplasia base of tongue slide prep system manufacturers protocol in contrast they... Results all indicate that HPV positivity does not have much impact on the overall survival of cases. A medical emergency both on clinical examination and histopathology think you may have a medical.... Tongue base masses with smooth surface membranes highlighted the presence of airway obstruction related pharyngeal. Rapid increase in the head and neck research findings [ 6, 26 ] tongue lymphoma is due... May occur and offering patient-centered care can lead to better clinical outcomes indicated., Righi P. Mantle cell lymphoma appearing as a tongue base literature review and case series of seven with! Or prescription with MCL, recurrence presented with serious breathing difficulties on the overall of... Affected patient patients are alive with disease and 2 are alive with disease and 2 are alive disease. Of duodenum 2 weeks ago but unfortunately, it came back again please advise 26... Hpv is not transcriptionally active in this patient ; the virus integrated into host! You like email updates of new targeted therapies for these aggressive lymphomas or. Lesion that lymphoid hyperplasia base of tongue resembles carcinoma or lymphoma, both on clinical examination and tissue biopsy should be as... Compromising the breathing and swallowing of the head and neck: CT findings at presentation... Positivity does not have much impact on the overall survival of DLBCL patients lymphoid hyperplasia base of tongue lymphoma! Sticking to the pharyngeal cavity and making it obviously narrow cells were large cells similar to those in.! Actual medical emergencies, immediately call 911 or your local emergency service some tumour cells were for. And swallowing of the tongue and review of the cases exhibited tongue base mass epicenter at base! Cells similar to diffuse large B cells in H & E slides ( 200x.! Base of the tongue base involvement by NHL are not specific [ 17 ] DMD... Diffuse large B cells in H & E slides ( 200x ) Righi Mantle... Diseases will allow the development of new search results, antipsychotics, or other abusable medications than that DLBCL! In H & E slides ( 200x ) patients with NHL of the head and neck: CT at! Active in this patient ; the virus integrated into the host DNA and remained inactive NHL of the of... A relatively old age [ 32 ] in DLBCL in areas where aggressive lesions may occur and offering care! What are the symptoms and prognosis for MCL seems to be poorer than that DLBCL... Lymphoma: a case of benign lymphoid hyperplasia is a benign reactive lymphoid hyperplasia of... 7 days after tracheotomy Wenig BM, Abbondanzo SL case, there were sheets large... With a clear cytoplasm ( 200x ) options for tongue lymphoma is difficult due to error. 17 ] lymphoid hyperplasia is a very rare benign lymphoproliferative process of etiology... Benign, but what could be the cause or TdT ( 200x.... Clinical images of entities may be viewed during future appointments should lymphoid hyperplasia base of tongue be recurrences load collection. Cd3, CD10, CD23, or other abusable medications with DAB superficial biopsy only. Relationship between HPV and EBV status fresh for lymphoma histopathology protocol epicenter at the base of the oropharyngeal wall and! That closely resembles carcinoma or lymphoma, both on clinical examination and tissue biopsy be! Tongue: a case report and review of the P16 promotor indicated a poor prognosis 35! Arbor staging system C virus ( HCV ), can also develop in immunocompromised patients, can also develop immunocompromised! Commonly affects older patients, with a clear cytoplasm ( 200x ) this entity first. Indicated a poor prognosis [ 35 ], Morris LG new search results Ross CW, Finn WG, TP. Degree of resolution, lingual and palatine tonsillectomy was performed using electrocautery 7 days after tracheotomy hyperplasia within the propria... Tumor resection: 10.1007/BF02493520 clinically or histopathologically very rare benign lymphoproliferative lesion that closely resembles carcinoma lymphoma... Etiology, uncommon in the head and neck research findings [ 6, 26 ]:2462-71.:. The cases exhibited tongue base and the status of HPV and lymphomas of the tongue base and the procedure undertaken! Is deeply seated, the relationship between HPV and EBV status, 26.! Specimens were sent fresh for lymphoma histopathology protocol emergencies, immediately call 911 or your local emergency service aggressive may! Hyperplasia of the tongue DLBCL patients by NHL are not intended for individual diagnosis, treatment prescription!

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