Complete Spontaneous Remission Of An Aggressive Non-hodgkin's Lymphoma With Primary Manifestation In The Oral Cavity
HEIBEL, H., KNÖDGEN, R., BREDENFELD, H., WICKENHAUSER, C., SCHEER, M., & ZÖLLER, J. E. (2004). Complete spontaneous Remission of an Aggressive Non-Hodgkin’s Lymphoma with Primary Manifestation in the Oral Cavity. Leukemia & Lymphoma, 45(1), 171–174. https://doi.org/10.1080/1042819031000139747
View Original Source →Abstract
A well-documented case of complete spontaneous remission of a histopathologically supported highly malignant B-cell Non-Hodgkin's lymphoma with primary manifestation in the oral cavity is presented. This regression, which has showed no signs of recurrence for more than 18 months, occurred following a diagnostic biopsy and without any therapeutic intervention. This report is followed by a short review on the literature upon spontaneous remission on Non-Hodgkin's-Lymphoma.
Case Details
Disease Location
Oral cavity
Personal Characteristics
70 -year-old male history of arterial hypertension and diabete mellitus type 2 had teeth 37 and 38 extracted due to mobility grade 3 in august 2000
Clinical Characteristics
Pronounced periapical osteolysis was discernible on the dental x-rays at the beginning of september 2000, the patient returned to the dentist because the extraction site hadn't healed properly, the dentist performed an orthopantomogram (opg) and referred the patient to surgery. The first examination revealed an ulcerous-tumorous mucosal lesion in region 037-038 and was approx 3x2cm in diameter the opg showed an irregular and indistinctly circumscribed lucency in region 036-038 and a non-homogenous peripheral shaded zone under local anesthesia, excisional biopsies were performed and samples sent for histopathological investigation histological exam at two different locations yielded malignant nhl b-cell lymphoma the squamous epithelium was intact and under it was a diffuse large cell infiltration with many mitoses, these cells were strongly positive for CD20 while squamous epithelium showed no reaction. This was defined as diffuse large b-cell lymphoma clinical staging revealed no other lymphomas, bone scan showed nothing abnormal except for the lower-jaw, bone marrow aspiration was normal. Diagnosis of stage 1, a, e of a diffuse large cell nhl, and the patient refused radio and chemotherapy
Remission Characteristics
In october 2000, the lower-jaw finding remissed without any treatment by february 2001, the mucous membrane in the previously affected zone showed no inflammation deep excisional biopsy were performed again and there were no histological or immunohistochemical findings that indicated presense or recurrence of b-cell nhl, only a moderate fibrosis of the subepithelial stroma could be detected in june 2001, complete remission was confirmed, clinical exam, blood and ultrasound found nothing abnormal october 2001, another exam found no mucosal inflammation and a opg showed a complete remineralization of the osteolytic process with no detectable loss of bone substance exam in may 2002 was normal
Treatment & Mechanisms
Proposed Remission Mechanisms
The possible induction of an immune response by the trauma of operative sampling
Clinical Treatment
None reported
Non-Clinical Treatment
None reported