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一例罕见的T细胞淋巴母细胞淋巴瘤:诊断困境

A Rare Case of T-cell Lymphoblastic Lymphoma: A Diagnostic Predicament.

作者信息

Shil Malabika, Srinivasan Vaishnavi, Vincent Anjali A, Gaikwad Trupti, Thomas Delphia

机构信息

Oral Medicine and Radiology, Mithila Minority Dental College and Hospital, Darbhanga, IND.

Oral Medicine, Government Dental College and Hospital, Hyderabad, IND.

出版信息

Cureus. 2024 Aug 2;16(8):e65994. doi: 10.7759/cureus.65994. eCollection 2024 Aug.

DOI:10.7759/cureus.65994
PMID:39221387
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11366176/
Abstract

Lymphomas are the malignant neoplasms of lymphocytes and their precursor cells. Their diagnosis can sometimes be difficult due to their similarity to various other entities. A 10-year-old female reported swelling on the right side of the upper jaw for a month which was associated with mild continuous pain. On examination, a mild diffused swelling was noted on the right middle third of the face region which was firm in consistency and slightly tender. Intraorally, a firm tender swelling was noted on the right side of the hard palate. A proximal caries was noted with 55. A provisional diagnosis of dentoalveolar abscess with 55 was made. A panoramic radiograph showed loss of lamina dura concerning 11, 12, 53, 14, and 55, and loss of floor of the maxillary sinus. Cone-beam computed tomography and computed tomography-paranasal sinus revealed an ill-defined, hypodense osteolytic lesion with irregular borders extending from the 11 to 15 tooth region. Radiographic evaluation was suggestive of an infectious or neoplastic lesion. An incisional biopsy was performed and sent for histopathological and immunohistochemical analysis. A diagnosis of T-cell lymphoblastic lymphoma was made based on the features seen. The patient was sent for chemotherapy and radiotherapy. The reduction in the size of the lesion was noted on follow-up. Lymphoblastic lymphoma is a neoplasm of lymphocytes that is rarely seen in the oral cavity. Early diagnosis and prompt treatment are necessary to prevent further complications.

摘要

淋巴瘤是淋巴细胞及其前体细胞的恶性肿瘤。由于它们与其他各种病变相似,有时诊断会很困难。一名10岁女性报告上颌右侧肿胀一个月,伴有轻度持续性疼痛。检查时,面部右侧中三分之一处有轻度弥漫性肿胀,质地坚硬,稍有压痛。口腔内,硬腭右侧有一个坚硬压痛的肿胀。发现55号牙有近中龋。初步诊断为55号牙的牙槽脓肿。全景片显示11、12、53、14和55号牙的硬骨板缺失,上颌窦底骨质缺失。锥形束计算机断层扫描和鼻窦计算机断层扫描显示,从11号牙到15号牙区域有一个边界不清、低密度的溶骨性病变,边界不规则。影像学评估提示为感染性或肿瘤性病变。进行了切开活检并送去做组织病理学和免疫组织化学分析。根据所见特征诊断为T细胞淋巴母细胞淋巴瘤。患者被送去进行化疗和放疗。随访时发现病变大小缩小。淋巴母细胞淋巴瘤是一种淋巴细胞肿瘤,在口腔中很少见。早期诊断和及时治疗对于预防进一步并发症是必要的。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3d92/11366176/0d44bc17db24/cureus-0016-00000065994-i08.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3d92/11366176/97f1d1daa2c1/cureus-0016-00000065994-i01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3d92/11366176/e7be7f44d696/cureus-0016-00000065994-i02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3d92/11366176/4fba8d8ada98/cureus-0016-00000065994-i03.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3d92/11366176/4683eb0af49f/cureus-0016-00000065994-i04.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3d92/11366176/1d2a41450ea7/cureus-0016-00000065994-i05.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3d92/11366176/02ebd8647e3b/cureus-0016-00000065994-i06.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3d92/11366176/25e91f014ce8/cureus-0016-00000065994-i07.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3d92/11366176/0d44bc17db24/cureus-0016-00000065994-i08.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3d92/11366176/97f1d1daa2c1/cureus-0016-00000065994-i01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3d92/11366176/e7be7f44d696/cureus-0016-00000065994-i02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3d92/11366176/4fba8d8ada98/cureus-0016-00000065994-i03.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3d92/11366176/4683eb0af49f/cureus-0016-00000065994-i04.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3d92/11366176/1d2a41450ea7/cureus-0016-00000065994-i05.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3d92/11366176/02ebd8647e3b/cureus-0016-00000065994-i06.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3d92/11366176/25e91f014ce8/cureus-0016-00000065994-i07.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3d92/11366176/0d44bc17db24/cureus-0016-00000065994-i08.jpg

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本文引用的文献

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B-cell Lymphoblastic Lymphoma of the Paranasal Sinuses: A Case Study of a Rare Clinical Entity.鼻窦B细胞淋巴母细胞淋巴瘤:一种罕见临床实体的病例研究
Cureus. 2022 Nov 16;14(11):e31565. doi: 10.7759/cureus.31565. eCollection 2022 Nov.
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Peripheral T-cell lymphoma of the oral cavity: A case report.口腔周围 T 细胞淋巴瘤:一例报告。
Cancer Rep (Hoboken). 2023 Jan;6(1):e1751. doi: 10.1002/cnr2.1751. Epub 2022 Oct 28.
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Update on Lymphoblastic Leukemia/Lymphoma.淋巴母细胞白血病/淋巴瘤最新进展
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Oral and oropharyngeal lymphomas: A multi-institutional collaborative study.口腔和口咽淋巴瘤:一项多机构合作研究。
J Oral Pathol Med. 2021 Jul;50(6):603-612. doi: 10.1111/jop.13211. Epub 2021 Jun 30.
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Epidemiology of Non-Hodgkin's Lymphoma.非霍奇金淋巴瘤的流行病学。
Med Sci (Basel). 2021 Jan 30;9(1):5. doi: 10.3390/medsci9010005.
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T-cell lymphoblastic lymphoma and leukemia: different diseases from a common premalignant progenitor?T 细胞淋巴母细胞淋巴瘤和白血病:来自共同前恶性前体细胞的不同疾病?
Blood Adv. 2020 Jul 28;4(14):3466-3473. doi: 10.1182/bloodadvances.2020001822.
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A case of systemic precursor T-cell lymphoblastic lymphoma presenting with single tooth mobility.一例以单颗牙齿松动为表现的系统性前体T细胞淋巴母细胞淋巴瘤。
SAGE Open Med Case Rep. 2020 Jun 3;8:2050313X20927961. doi: 10.1177/2050313X20927961. eCollection 2020.
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Acute lymphoblastic leukemia/lymphoma of the oral and maxillofacial region.口腔颌面部急性淋巴细胞白血病/淋巴瘤
Oral Surg Oral Med Oral Pathol Oral Radiol. 2018 Aug;126(2):152-164. doi: 10.1016/j.oooo.2018.01.010. Epub 2018 Jan 31.
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Crit Rev Oncol Hematol. 2017 May;113:304-317. doi: 10.1016/j.critrevonc.2017.03.020. Epub 2017 Mar 18.
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Oral manifestations of lymphoma: a systematic review.淋巴瘤的口腔表现:一项系统评价。
Ecancermedicalscience. 2016 Aug 17;10:665. doi: 10.3332/ecancer.2016.665. eCollection 2016.