Navarro Cláudia M, Shibli Jamil A, Ferrari Roberto B, d'Avila Susana, Sposto Maria R
Department of Oral Diagnosis and Surgery, Araraquara Dental School, São Paulo State University, Rua Humaitá 1680, Araraquara, SP, Brazil.
J Periodontol. 2008 Mar;79(3):562-6. doi: 10.1902/jop.2008.070229.
Non-Hodgkin's lymphomas (NHLs) are a heterogeneous group of lymphoproliferative malignancies that may be associated with acquired immunodeficiency syndrome (AIDS). NHL can disseminate to extranodal sites; however, its dissemination to the jaws and mouth is not common. This report presents and discusses two unusual cases of gingival primary extranodal non-Hodgkin's lymphoma (PE-NHL) as the first manifestation of AIDS.
Two males presented with asymptomatic gingival swelling. They were examined clinically. Biopsies of the gingival tissue were evaluated using routine histologic techniques and immunohistochemistry. The patients were tested for human immunodeficiency virus (HIV) infection.
The clinicopathological evaluation and the serological HIV examination of the patients led us to the final diagnosis of gingival PE-NHL as the first manifestation of AIDS. Both patients were referred to an oncologist and to an infectious disease specialist and were given antineoplastic chemotherapy and highly active antiretroviral therapy. Only one patient presented a favorable clinical evolution.
The present case reports have important clinical implications; the two unusual presentations of gingival PE-NHL contribute to information about the differential diagnosis of rapidly progressing gingival swelling.
非霍奇金淋巴瘤（NHLs）是一组异质性的淋巴增殖性恶性肿瘤，可能与获得性免疫缺陷综合征（AIDS）相关。NHL可扩散至结外部位；然而，其扩散至颌骨和口腔并不常见。本报告展示并讨论了两例不寻常的牙龈原发性结外非霍奇金淋巴瘤（PE-NHL）病例，这是AIDS的首发表现。
两名男性患者出现无症状性牙龈肿胀。对他们进行了临床检查。使用常规组织学技术和免疫组织化学对牙龈组织活检标本进行评估。对患者进行了人类免疫缺陷病毒（HIV）感染检测。
对患者的临床病理评估和血清学HIV检查使我们最终诊断牙龈PE-NHL为AIDS的首发表现。两名患者均被转诊至肿瘤学家和传染病专家处，并接受了抗肿瘤化疗和高效抗逆转录病毒治疗。只有一名患者呈现出良好的临床进展。
本病例报告具有重要的临床意义；牙龈PE-NHL的这两种不寻常表现有助于了解快速进展性牙龈肿胀的鉴别诊断信息。
