Vardas Emmanouil, Georgaki Maria, Papadopoulou Erofili, Delli Konstantina, Kouroumalis Andreas, Kalfarentzos Evangelos, Lakiotaki Eleftheria, Nikitakis Nikolaos G
DDS, MSc, PhD, Department of Oral Medicine & Pathology and Hospital Dentistry, School of Dentistry, National and Kapodistrian University of Athens, Greece.
DDS, Dr med dent, PhD, Department of Oral Diseases - Oral and Maxillofacial Surgery, University of Groningen, University Medical Center Groningen, Netherlands.
J Clin Exp Dent. 2022 Mar 1;14(3):e303-e309. doi: 10.4317/jced.59346. eCollection 2022 Mar.
Lymphoma is the second most common malignancy in the head and neck area, affecting both nodal and extranodal sites, including oral soft and hard tissues, usually in the form of non-Hodgkin's lymphoma (NHL). However, lymphomas of the jaws, including diffuse large B-cell lymphoma (DLBCL), the most common type of NHL, are very rare and may cause significant diagnostic challenges resembling common jaw pathologies, such as periapical lesions, osteomyelitis and osteonecrosis. The aim of this paper is to present a rare case of DLBCL in an 84-years-old diabetic male patient on methylprednisolone treatment for autoimmune hemolytic anemia. The lesion appeared clinically as exposed necrotic bone of the maxilla with surrounding soft tissue ulceration and radiographically as an extensive osteolytic lesion with ill-defined borders. Despite the resemblance of the lesion with osteonecrosis or osteomyelitis that could be theoretically related to diabetes and/or systemic use of corticosteroids, histopathologic examination, necessitating a repeat biopsy in order to acquire sufficient tissue, revealed the final diagnosis of lymphoma. The need for increased clinical awareness and vigilance of this possible diagnostic conundrum is emphasized. Diffuse large B-cell lymphoma, exposed bone, oral, malignancy, maxilla, jaw osteonecrosis, differential diagnosis.
淋巴瘤是头颈部第二常见的恶性肿瘤，可累及淋巴结和结外部位，包括口腔软硬组织，通常为非霍奇金淋巴瘤（NHL）。然而，颌骨淋巴瘤，包括最常见的NHL类型弥漫性大B细胞淋巴瘤（DLBCL）非常罕见，可能会带来重大的诊断挑战，类似于常见的颌骨病变，如根尖周病变、骨髓炎和骨坏死。本文旨在介绍一例84岁糖尿病男性患者的罕见DLBCL病例，该患者因自身免疫性溶血性贫血正在接受甲泼尼龙治疗。该病变临床外观为上颌骨暴露的坏死骨伴周围软组织溃疡，影像学表现为边界不清的广泛溶骨性病变。尽管该病变与理论上可能与糖尿病和/或全身使用糖皮质激素有关的骨坏死或骨髓炎相似，但组织病理学检查（为获取足够组织需要重复活检）最终确诊为淋巴瘤。强调了提高对这种可能的诊断难题的临床认识和警惕性的必要性。弥漫性大B细胞淋巴瘤、暴露骨、口腔、恶性肿瘤、上颌骨、颌骨骨坏死、鉴别诊断
