Imaging Sci Dent.  2012 Jun;42(2):111-114. 10.5624/isd.2012.42.2.111.

Imaging characteristics of diffuse large cell extra nodal non-Hodgkin's lymphoma involving the palate and maxillary sinus: a case report

• Nadendla L
• Meduri V
• Paramkusam G

• KMID: 1974418
• DOI: http://doi.org/10.5624/isd.2012.42.2.111

Abstract

Non-Hodgkin's lymphomas are a group of highly diverse malignancies and have a strong tendency to affect organs and tissues that do not ordinarily contain lymphoid cells. Primary extra nodal lymphoma of the hard palate is rare. Here, we present a case of diffuse large B cell lymphoma in a 60-year-old male patient that manifested as slightly painful ulcerated growth on the edentulous right maxillary alveolar ridge extending onto the palate, closely resembling carcinoma of the alveolar ridge. Computed tomography images showed the involvement of the maxillary sinus and right nasal cavity, along with destruction of hard palate, superiorly extending into the orbit. This case report highlights the importance of imaging to evaluate the exact extent of such large malignant lesions, which is essential for treatment planning.

Keyword

Lymphoma, Non-Hodgkin; Palate; Maxillary Sinus; Lymphoma, Large B-Cell, Diffuse

MeSH Terms

Alveolar Process
Humans
Lymphocytes
Lymphoma
Lymphoma, B-Cell
Lymphoma, Large B-Cell, Diffuse
Lymphoma, Non-Hodgkin
Male
Maxillary Sinus
Middle Aged
Nasal Cavity
Orbit
Palate
Palate, Hard
Ulcer

Figure

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  Fig. 1 Mild diffuse swelling on the right cheek and proptosis of the right eye is seen.

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  Fig. 2 Intraoral photograph shows an ulcerative growth in the right maxillary alveolar ridge extending on to the palate.

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  Fig. 3 Coronal CT image shows a large soft tissue density lesion with destruction of all walls of the right maxillary sinus, hard palate, and extension into the nasal cavity.

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  Fig. 4 Three-dimensional CT reconstruction image (bone setting) shows destruction of the maxilla, hard palate, and maxillary alveolar ridge on the right side.

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  Fig. 5 Three-dimensional CT reconstruction image (soft tissue setting) shows facial asymmetry due to the swelling and proptosis of the eye on the right side.

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  Fig. 6 Histopathological examination shows connective tissue stroma made up of predominantly large lymphocytes, few small cells, and scattered foamy macrophages (H&E stain, ×400).

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