Department of Oral and Maxillofacial Surgery, University of Pacific, San Francisco/Highland General Hospital, Oakland, CA, USA.
Private Practice, San Ramon, CA, USA.
Oral Surg Oral Med Oral Pathol Oral Radiol. 2020 Aug;130(2):e38-e43. doi: 10.1016/j.oooo.2019.12.004. Epub 2020 Feb 5.
Double-hit (DH) lymphoma is a rare subtype of B-cell lymphoma characterized by the chromosomal rearrangement of c-Myc and Bcl-2, and/or Bcl-6. c-Myc is an oncogene that keeps cells proliferative. Bcl-2 and Bcl-6 grant cells antiapoptotic features. The concurrent expression of these genes and their synergistic effect make DH lymphoma refractory to traditional chemotherapy, with an extremely poor prognosis. Here, we present a case of DH lymphoma in the oral cavity, including its rapid clinical course, extensive involvement of multiple sites and organs, and response to aggressive chemotherapy. It is important for dental providers to be familiar with lymphoma's oral manifestations and consider the disease in the differential diagnosis for expansile palatal lesions. The early detection and accurate diagnosis of lymphoma by dental practitioners can help expedite proper multidisciplinary care and lead to significant reductions in patient morbidity and mortality.
双打击（DH）淋巴瘤是一种罕见的 B 细胞淋巴瘤亚型，其特征是 c-Myc 和 Bcl-2 及/或 Bcl-6 的染色体重排。c-Myc 是一种致癌基因，使细胞保持增殖。Bcl-2 和 Bcl-6 赋予细胞抗凋亡特性。这些基因的同时表达及其协同作用使 DH 淋巴瘤对传统化疗产生耐药性，预后极差。本文介绍了一例口腔 DH 淋巴瘤，包括其快速的临床病程、广泛累及多个部位和器官，以及对强化化疗的反应。牙医熟悉淋巴瘤的口腔表现并在鉴别诊断中考虑该疾病对于扩大的腭部病变非常重要。牙医早期发现和准确诊断淋巴瘤有助于加快多学科治疗，并显著降低患者的发病率和死亡率。
