Wongpattaraworakul Wattawan, Krongbaramee Tadkamol, Lanzel Emily A, Hellstein John W, Teixeira Fabricio B
Department of Oral Pathology, Radiology and Medicine, College of Dentistry and Dental Clinics, University of Iowa, Iowa City, IA, USA; Division of Oral Diagnostic Sciences, Faculty of Dentistry, Thammasat University, Pathumthani, Thailand.
Division of Endodontics, Department of Restorative Dentistry & Periodontology, Chiang Mai University, Chiang Mai, Thailand.
Oral Surg Oral Med Oral Pathol Oral Radiol. 2025 Jan;139(1):e1-e12. doi: 10.1016/j.oooo.2024.07.011. Epub 2024 Aug 5.
Hematolymphoid neoplasms originating in the periapical region of a tooth are rare occurrences. Their signs, symptoms, and radiographic findings can also mimic lesions of endodontic origin. History-taking and clinical examination provide clues to determine the possibility of a non-endodontic lesion, although the definitive diagnosis can only be rendered based on histologic examination. In our case series, we present four cases of hematolymphoid neoplasms that radiographically mimicked endodontic lesions. All the cases initially underwent endodontic treatment, but the lesions failed to resolve. In one case, the clinician suspected a diagnosis of lymphoma based on the patient's history. In the other cases, the clinicians' impression was that the lesions originated from endodontic issues. We present two cases of diffuse large B-cell lymphoma, a case of a plasma cell neoplasm, and a case of Langerhans cell histiocytosis, along with a literature review of three entities when found in the oral cavity as well as review of hematolymphoid neoplasm mimicking endodontic lesion previously reported in literature.
起源于牙齿根尖周区域的血液淋巴系统肿瘤较为罕见。其体征、症状及影像学表现也可能与牙髓源性病变相似。尽管最终诊断只能基于组织学检查，但病史采集和临床检查可为判断非牙髓性病变的可能性提供线索。在我们的病例系列中，我们呈现了4例影像学表现类似牙髓病变的血液淋巴系统肿瘤病例。所有病例最初均接受了牙髓治疗，但病变未愈。其中1例，临床医生根据患者病史怀疑为淋巴瘤。在其他病例中，临床医生认为病变源于牙髓问题。我们呈现了2例弥漫性大B细胞淋巴瘤、1例浆细胞肿瘤及1例朗格汉斯细胞组织细胞增多症病例，并对这三种实体在口腔中出现的情况进行了文献综述，同时也回顾了既往文献中报道的类似牙髓病变的血液淋巴系统肿瘤。
