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[下颌管扩大及下唇感觉减退揭示下颌骨非霍奇金淋巴瘤]

[Enlargement of mandibular canal and lower lip hypoesthesia revealing non-Hodgkin’s lymphoma of the mandible].

作者信息

Hakkou F, Chbicheb S, El Wady W

出版信息

Odontostomatol Trop. 2016 Jun;39(154):9-14.

Abstract

INTRODUCTION

Primary lymphoma of the mandible are rare and most often revealed by painless swelling. They are often confused with odontogenic lesions. Hence, their diagnosis is delayed. The authors report the case of an isolated mandibular lymphoma revealed by hypoesthesia of the lower lip and enlargement of the left mandibular canal.

CASE REPORT

A 35-year-old woman patient consulted for hemi-mandibular pain with episodes of left labial hypoesthesia. Clinically, we noted the presence of a vestibular tumor in front of tooth 34. A panoramic radiograph revealed that the left mandibular canal was widely enlarged, extending from the mandibular foramen to the mental foramen. The biopsy revealed a B-cell lymphoma. No other localization was found. After treatment with seven courses of a chemotherapy based on R-CHOP followed by local radiotherapy, the patient was in remission eighteen months after treatment.

DISCUSSION

Primitive lymphoma of the mandible are rare; they represent about 0.6% of extra-nodal non-Hodgkin lymphoma. They occur at any age and mainly affect males. They most often come out as a painless swelling, sometimes ulcerated in the mouth. They are often misdiagnosed as a dental problem. Treatment combines variably radiotherapy and/or chemotherapy. The prognosis of bone lymphoma is more favorable than others malignancies bone, with a survival rate of 40-50% at five years.

摘要

引言

下颌原发性淋巴瘤较为罕见,最常见的表现是无痛性肿胀。它们常与牙源性病变相混淆,因此诊断往往会延迟。作者报告了一例以下唇感觉减退和左下颌管扩大为表现的孤立性下颌淋巴瘤病例。

病例报告

一名35岁女性患者因半侧下颌疼痛并伴有左侧唇部感觉减退前来就诊。临床上,我们注意到在34号牙前方存在前庭肿物。全景X线片显示左下颌管广泛扩大,从下颌孔延伸至颏孔。活检显示为B细胞淋巴瘤,未发现其他部位受累。在接受了7个疗程基于R-CHOP方案的化疗并随后进行局部放疗后,患者在治疗18个月后病情缓解。

讨论

下颌原发性淋巴瘤罕见,约占结外非霍奇金淋巴瘤的0.6%。可发生于任何年龄,主要累及男性。最常表现为无痛性肿胀,有时口腔内有溃疡。常被误诊为牙科问题。治疗方法包括放疗和/或化疗。骨淋巴瘤的预后比其他骨恶性肿瘤更有利,五年生存率为40-50%。

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