Deng Xiaofei, Luo Yong, Yang Qin, Chen Bian, Peng Wei, Zheng Jincheng, Xiu Weigang
Department of Oncology, Yingshan County People's Hospital, Nanchong, Sichuan 637000, P.R. China.
Department of Head and Neck Oncology, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, P.R. China.
Oncol Lett. 2025 Mar 4;29(4):212. doi: 10.3892/ol.2025.14958. eCollection 2025 Apr.
Primary gingival diffuse large B-cell lymphoma (DLBCL) with muscle invasion is rare and accounts for ~0.5% of all reported cases of extranodal lymphoma. The present study describes the case of a 49-year-old man that initially presented at Yingshan County People's Hospital (Nanchong, China) in August 2017 with a chief complaint of tenderness and swelling of the jaw. Computed tomography revealed a mass in the gingiva, and enlarged lymph nodes in the cervical, mediastinal and gastro-hepatic ligaments. Histological examination indicated the gingival mass was a DLBCL, which was positive for CD20, BCL-6, BCL-2, C-MYC and MUM1. The patient received three lines of anti-neoplastic therapy (R-CHOP, R-CHOEP and SYHX1903) and achieved stable disease for 6 years. Subsequently, the patient experienced trauma in the left forearm due to a car accident and the subsequent color Doppler imaging led to a diagnosis of muscular hematoma; however, magnetic resonance imaging and biopsy of the forearm muscle confirmed DLBCL invasion. Due to the patient suffering from heart failure after the third line of the previous chemotherapy, palliative radiotherapy was administered to the left forearm, and the patient achieved a partial response. In conclusion, primary gingival DLBCL with muscle invasion is rare and easily misdiagnosed, and individualized treatment should be considered for these complex cases.
原发性牙龈弥漫性大B细胞淋巴瘤（DLBCL）伴肌肉浸润较为罕见，约占所有报道的结外淋巴瘤病例的0.5%。本研究描述了一名49岁男性的病例，该患者于2017年8月首次就诊于中国南充市营山县人民医院，主要症状为颌部压痛和肿胀。计算机断层扫描显示牙龈有肿块，颈部、纵隔和胃肝韧带处淋巴结肿大。组织学检查表明牙龈肿块为DLBCL，CD20、BCL-6、BCL-2、C-MYC和MUM1呈阳性。该患者接受了三线抗肿瘤治疗（R-CHOP、R-CHOEP和SYHX1903），病情稳定6年。随后，患者因车祸导致左前臂受伤，随后的彩色多普勒成像诊断为肌肉血肿；然而，前臂肌肉的磁共振成像和活检证实为DLBCL浸润。由于患者在前一线化疗的第三疗程后出现心力衰竭，因此对左前臂进行了姑息性放疗，患者获得了部分缓解。总之，原发性牙龈DLBCL伴肌肉浸润较为罕见，容易误诊，对于这些复杂病例应考虑个体化治疗。
