Follicular lymphoid hyperplasia of the posterior maxillary site presenting as uncommon entity: a case report and review of the literature.
Differential diagnosis
Follicular lymphoid hyperplasia
Immunohistochemistry
Lymphoma
Maxilla
Journal
BMC oral health
ISSN: 1472-6831
Titre abrégé: BMC Oral Health
Pays: England
ID NLM: 101088684
Informations de publication
Date de publication:
11 11 2019
11 11 2019
Historique:
received:
28
02
2018
accepted:
22
10
2019
entrez:
13
11
2019
pubmed:
13
11
2019
medline:
11
2
2020
Statut:
epublish
Résumé
Follicular lymphoid hyperplasia (FLH) is characterized by an increased number and size of lymphoid follicles. In some cases, the etiology of FLH is unclear. FLH in the oral and maxillofacial region is an uncommon benign entity which may resemble malignant lymphoma clinically and histologically. We report the case of a 51-year-old woman who presented with an asymptomatic firm mass in the left posterior maxillary site. Computed tomography scan of her head and neck showed a clear circumscribed solid mass measuring 28 × 23 mm in size. There was no evidence of bone involvement. Incisional biopsy demonstrated benign lymphoid tissue. The patient underwent complete surgical resection. Histologically, the resected specimen showed scattered lymphoid follicles with germinal centers and predominant small lymphocytes in the interfollicular areas. Immunohistochemically, the lymphoid follicles were positive for CD20, CD79a, CD10, CD21, and Bcl6. The germinal centers were negative for Bcl2. Based on these findings, a diagnosis of benign FLH was made. There was no recurrence at 1 year postoperatively. We diagnosed an extremely rare case of FLH arising from an unusual site and whose onset of entity is unknown. Careful clinical and histopathological evaluations are essential in making a differential diagnosis from a neoplastic lymphoid proliferation with a nodular growth pattern.
Sections du résumé
BACKGROUND
Follicular lymphoid hyperplasia (FLH) is characterized by an increased number and size of lymphoid follicles. In some cases, the etiology of FLH is unclear. FLH in the oral and maxillofacial region is an uncommon benign entity which may resemble malignant lymphoma clinically and histologically.
CASE PRESENTATION
We report the case of a 51-year-old woman who presented with an asymptomatic firm mass in the left posterior maxillary site. Computed tomography scan of her head and neck showed a clear circumscribed solid mass measuring 28 × 23 mm in size. There was no evidence of bone involvement. Incisional biopsy demonstrated benign lymphoid tissue. The patient underwent complete surgical resection. Histologically, the resected specimen showed scattered lymphoid follicles with germinal centers and predominant small lymphocytes in the interfollicular areas. Immunohistochemically, the lymphoid follicles were positive for CD20, CD79a, CD10, CD21, and Bcl6. The germinal centers were negative for Bcl2. Based on these findings, a diagnosis of benign FLH was made. There was no recurrence at 1 year postoperatively.
CONCLUSIONS
We diagnosed an extremely rare case of FLH arising from an unusual site and whose onset of entity is unknown. Careful clinical and histopathological evaluations are essential in making a differential diagnosis from a neoplastic lymphoid proliferation with a nodular growth pattern.
Identifiants
pubmed: 31711493
doi: 10.1186/s12903-019-0936-9
pii: 10.1186/s12903-019-0936-9
pmc: PMC6849200
doi:
Types de publication
Case Reports
Journal Article
Review
Langues
eng
Sous-ensembles de citation
IM
Pagination
243Références
Arch Pathol Lab Med. 1998 Jun;122(6):539-44
pubmed: 9625422
Clin Res Hepatol Gastroenterol. 2012 Aug;36(4):e71-80
pubmed: 22230217
J Oral Maxillofac Surg. 1988 Dec;46(12):1103-5
pubmed: 3193287
Quintessence Int. 2010 Sep;41(8):661-3
pubmed: 20657855
Appl Immunohistochem Mol Morphol. 2000 Dec;8(4):263-6
pubmed: 11127917
J Oral Maxillofac Surg. 1992 May;50(5):538-40
pubmed: 1573495
J Craniomaxillofac Surg. 2009 Mar;37(2):79-82
pubmed: 19138528
Haematologica. 1997 Mar-Apr;82(2):205-10
pubmed: 9175328
J Craniomaxillofac Surg. 2008 Oct;36(7):410-4
pubmed: 18562205
Otolaryngol Head Neck Surg. 1980 Jul-Aug;88(4):349-56
pubmed: 6821414
APMIS. 2005 Mar;113(3):221-4
pubmed: 15799767
Am J Gastroenterol. 1999 Jun;94(6):1669-73
pubmed: 10364042
Histopathology. 2001 Oct;39(4):353-8
pubmed: 11683934
J Contemp Dent Pract. 2005 Aug 15;6(3):111-9
pubmed: 16127479
J Oral Maxillofac Surg. 2013 Jul;71(7):1202-8
pubmed: 23522767
Aust Dent J. 1973 Feb;18(1):38-40
pubmed: 4513352
J Craniomaxillofac Surg. 2007 Jan;35(1):39-47
pubmed: 17267230
Oral Maxillofac Surg. 2017 Dec;21(4):475-481
pubmed: 29067544
Oral Surg Oral Med Oral Pathol. 1983 Feb;55(2):162-8
pubmed: 6572867
Diagn Mol Pathol. 1993 Mar;2(1):57-60
pubmed: 8287227
J Oral Pathol. 1987 Jan;16(1):18-26
pubmed: 3104564
Am J Pathol. 1999 Jan;154(1):77-82
pubmed: 9916921
Histopathology. 2004 Mar;44(3):268-76
pubmed: 14987231
J Oral Pathol Med. 1990 May;19(5):221-5
pubmed: 1694245
Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2003 Aug;96(2):172-5
pubmed: 12931089