Costa Sara Ferreira Dos Santos, Silva André Myller Barbosa, Amaral-Silva Gleyson Kleber, Pontes Hélder Antônio Rebelo, Pontes Flávia Sirotheau Corrêa, Fonseca Felipe Paiva, Almeida Oslei Paes de
Department of Oral Surgery and Pathology, School of Dentistry, Federal University of Minas Gerais, Belo Horizonte, Minas Gerais.
Department of Oral Diagnosis, Piracicaba Dental School, State University of Campinas, Piracicaba.
J Craniofac Surg. 2019 May/Jun;30(3):e259-e262. doi: 10.1097/SCS.0000000000005302.
Lymphomas of the oral cavity are rare and the most frequent type is diffuse large B-cell lymphoma (DLBCL). Epstein-Barr virus (EBV) is known to be associated with the development of different lymphomas. In 2008, the World Health Organization provisionally included the EBV-positive DLBCL of the elderly in the classification of hematopoietic and lymphoid tumors as a lymphoma occurring in older individuals without any known immunodeficiency. However, it has since been recognized that this entity may occur in younger individuals and present similar clinical parameters in both age groups. As a result, the 2017 revision has declined the term elderly and modified it to EBV-positive DLBCL, not otherwise specified (NOS). In this report, we describe a rare case of EBV-positive DLBCL, NOS, presenting as a painless swelling in the oral cavity. This entity shows a more aggressive clinical course than EBV-negative DLBCL, and other lymphoproliferative disorders should be considered in the differential diagnosis.
口腔淋巴瘤较为罕见，最常见的类型是弥漫性大B细胞淋巴瘤（DLBCL）。已知爱泼斯坦-巴尔病毒（EBV）与不同淋巴瘤的发生有关。2008年，世界卫生组织临时将老年EBV阳性DLBCL纳入造血和淋巴组织肿瘤分类，作为发生于无任何已知免疫缺陷的老年人的淋巴瘤。然而，此后人们认识到该实体也可能发生于较年轻个体，且在两个年龄组中呈现相似的临床参数。因此，2017年修订版摒弃了“老年”这一术语，将其修改为未另行指定（NOS）的EBV阳性DLBCL。在本报告中，我们描述了一例罕见的未另行指定的EBV阳性DLBCL病例，表现为口腔无痛性肿胀。该实体的临床病程比EBV阴性DLBCL更具侵袭性，鉴别诊断时应考虑其他淋巴增殖性疾病。
