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一名年轻男孩的原发性牙龈间变性淋巴瘤激酶(ALK)阳性间变性大细胞淋巴瘤

Primary Gingival Anaplastic Lymphoma Kinase (ALK)-Positive Anaplastic Large Cell Lymphoma in a Young Boy.

作者信息

Lutz Claire M, Bruneau Julie, Molina Thierry J, Ejeil Anne-Laure

机构信息

Department of Odontology, Oral Medicine and Oral Surgery, Bretonneau Hospital, Assistance Publique-Hôpitaux de Paris (AP-HP) Université Paris Cité, Paris, FRA.

Department of Pathology, Robert Debré and Necker-Enfants Malades University Hospitals, Assistance Publique-Hôpitaux de Paris (AP‑HP) Université Paris Cité, Paris, FRA.

出版信息

Cureus. 2025 Aug 1;17(8):e89217. doi: 10.7759/cureus.89217. eCollection 2025 Aug.

Abstract

Anaplastic large cell lymphoma (ALCL) is a rare non-Hodgkin lymphoma derived from natural killer (NK) or T-cells. It mainly affects lymph nodes, and less frequently, extranodal sites such as the skin, bone, or oral cavity. Lack of awareness of these extranodal manifestations can lead to delayed diagnosis, sometimes with dramatic consequences. Here, we report the case of a young boy referred to our oral pathology consultation with persistent intraoral and cervical swellings that had lasted for three months, despite multiple dental and medical appointments and treatments. He was previously misdiagnosed repeatedly with infectious cellulitis of dental origin. Considering the clinical features, we suspected a malignant process and referred the patient to a pediatric oncohematology department. Anatomopathological analyses revealed an anaplastic lymphoma kinase (ALK)-positive ALCL, and appropriate treatment could be initiated. Extranodal manifestations, particularly oral, are little-known forms of lymphoma, especially in children. In most cases of extranodal ALCL, the first diagnosis considered is a benign tumor, which delays the correct diagnosis. It is therefore essential to raise awareness among practitioners about the detection of extranodal, particularly oral, manifestations of these rare lymphomas.

摘要

间变性大细胞淋巴瘤(ALCL)是一种罕见的非霍奇金淋巴瘤,起源于自然杀伤(NK)细胞或T细胞。它主要累及淋巴结,较少累及结外部位,如皮肤、骨骼或口腔。对这些结外表现缺乏认识可能导致诊断延迟,有时会产生严重后果。在此,我们报告一例年轻男孩的病例,他因口腔内和颈部持续肿胀三个月前来我们的口腔病理会诊,尽管此前多次进行牙科和医学检查及治疗。他之前曾多次被误诊为牙源性感染性蜂窝织炎。考虑到临床特征,我们怀疑是恶性病变,并将患者转诊至儿科肿瘤血液科。解剖病理学分析显示为间变性淋巴瘤激酶(ALK)阳性的ALCL,随后启动了适当的治疗。结外表现,尤其是口腔表现,是鲜为人知的淋巴瘤形式,在儿童中尤为如此。在大多数结外ALCL病例中,最初考虑的诊断是良性肿瘤,这会延误正确诊断。因此,提高从业者对这些罕见淋巴瘤结外表现,尤其是口腔表现的认识至关重要。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/eb99/12399289/38dd9a657b41/cureus-0017-00000089217-i01.jpg

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