A Case Of Spontaneous Regression Of Lymphoma In The Mandibular Gingiva After Biopsy
Nobuyuki Kaibuchi, Toshihiro Okamoto, Toshiyuki Kataoka, Akira Kumasaka, Tomohiro Ando, A case of spontaneous regression of lymphoma in the mandibular gingiva after biopsy, Oral and Maxillofacial Surgery Cases, Volume 1, Issue 3, 2015, Pages 33-37, ISSN 2214-5419, https://doi.org/10.1016/j.omsc.2015.06.002.
View Original Source →Abstract
We report a case of lymphoma that developed on the mandibular gingiva and spontaneously regressed after biopsy was performed. The patient was an 87-year-old man who visited our hospital with a complaint of gingival swelling in the left mandibular molar region. We observed an elastic, soft, well-demarcated, granuloma-like mass measuring 30 × 25 mm in size and comprising partially white pseudomembranous areas. We conducted a biopsy, which confirmed a pathologic diagnosis of a diffuse large B-cell lymphoma. Because of age constraints, the patient was monitored without being administered aggressive therapy, and the mass disappeared 20 days after biopsy. We then performed a follow-up biopsy, which revealed the absence of tumor cells. There was no recurrence of lymphoma during the 2.5-year follow-up period.
Case Details
Disease Location
Left mandibular gingiva
Personal Characteristics
87 -year-old male he was under treatment for old cerebral infarction and premature ventricular contraction he was on ticlopidine, spironolactone, furosemide, and mecobalamin no sign of suppressed immunity and not on immunosuppressant meds the patient eventually died from other disease
Clinical Characteristics
Presented with a complaint of gingival swelling in the left mandibular molar region initial exam took place january 2007 at presentation, the patient was 153cm and 61kg and a body temp of 35.7c. A 30x25mm mass with well-defined borders was identified in the left molar region of the mandibular gingiva, it was elastic, granuloma-like and had a partially wite pseudomembrane the remains of a wisdom tooth root were found in the left mandible CT showed a non-uniform contrasted mass near the left lower wisdom tooth t2 images revealed non-uniform low signals with some high signals. T1 revealed uniform medium signal intensity. Dynamic MRI revealed an increased trend over time for non-uniform contrast of the mass soon after its detection. (lymphoma is a non-uniform mass without rim enhancement) fdg-PET noted accumulation in the left mandible cancer on the left mandibular gingiva was diagnosed the patient was hospitalized from mid-january for more testing and treatment, partial tissue samples from anterior and posterior sides of the tumor were collected. Pathological diagnosis was dlbcl. Azithromycin was administered to prevent infection histopathologic findings included observed proliferation of hyperchromatic atypical cells with high nucleus to cell ratios, accompanied by necrosis ihc showed samples to be CD45+ and some cells partially positive for cd79a. There were also tissues positive for CD10. Mib-1 index was greater than 95% these findings suggested dlbcl
Remission Characteristics
20 days after the biopsy, the tumor was found to have disappeared the lower left wisdom tooth was extracted and another biopsy was performed; results from that biopsy found no malignancy hematoxylin and eosin staining revealed disappearance of the follicular structure and diffuse proliferation of large cells the patient was followed up for 2 years and 6 months until he was transferred, no relapse was observed
Treatment & Mechanisms
Proposed Remission Mechanisms
Stimulation caused by the biopsy procedure
Clinical Treatment
He was on ticlopidine, spironolactone, furosemide, and mecobalamin azithromycin
Non-Clinical Treatment
None reported