Pié-Sánchez J, Petit J, Figueiredo R, Gay-Escoda C
Oral Surgery and Implantology, University of Barcelona Dental School, Barcelona, Spain.
Minerva Stomatol. 2011 Jan-Feb;60(1-2):87-92.
Diffuse large B-cell lymphoma is the most common type of non-Hodgkin lymphoma and is characterized by the appearance of rapidly developing tumor lesions in the lymph nodes, spleen, liver, bone marrow or other organs. Primary extranodal presentations of this entity in bone are rare (5% of all extranodal lymphomas) and their initial manifestation is usually in the form of a single bone lesion. This paper addresses a case of a 62-year-old male diagnosed with diffuse large B-cell lymphoma in the mandible. The patient had left mandibular swelling with intermittent paresthesia of the left lower lip and chin, without apparent neck adenopathies. No other locations were identified in the several exams performed, and the final diagnosis was an asymptomatic diffuse extranodal large B-cell lymphoma (IE-A) in the body of the left mandible. Four cycles of chemotherapy were given according to the R-CHOP protocol (rituximab, cyclophosphamide, doxorubicin, vincristine, prednisone) plus external radiotherapy targeted to the involved site, resulting in complete remission of the tumor. Such lesions are fairly uncommon in daily clinical practice. However, considering their severity and the importance of an early diagnosis, such conditions should be included in the differential diagnosis of bone lesions in the orofacial region.
弥漫性大B细胞淋巴瘤是最常见的非霍奇金淋巴瘤类型，其特征是在淋巴结、脾脏、肝脏、骨髓或其他器官中迅速出现肿瘤病变。该实体在骨骼中的原发性结外表现很少见（占所有结外淋巴瘤的5%），其最初表现通常为单个骨病变。本文报告一例62岁男性，诊断为下颌骨弥漫性大B细胞淋巴瘤。患者左侧下颌肿胀，左侧下唇和下巴间歇性感觉异常，无明显颈部淋巴结肿大。在进行的多项检查中未发现其他部位有病变，最终诊断为左下颌骨体部无症状性弥漫性结外大B细胞淋巴瘤（IE-A）。根据R-CHOP方案（利妥昔单抗+环磷酰胺+多柔比星+长春新碱+泼尼松）进行了四个周期的化疗，并对受累部位进行了外照射放疗，肿瘤完全缓解。此类病变在日常临床实践中相当少见。然而，考虑到其严重性和早期诊断 的重要性，在口腔颌面部骨病变的鉴别诊断中应考虑到此类情况。
