LYMPHOMAS WITH ORAL MANIFESTATIONS – 18 CASES IN OUR INSTITUTION AND REVIEW OF LITERATURE

Abstract

Lymphomas are the heterogeneous group of malignant diseases characterized by proliferation of malignant lymphoid cells or their precursors. Lymphomas are the ninth most common cancer worldwide and constitute 3.2% of malignant tumor. Lymphomas are generally classified to two main categories: Hodgkin s lymphomas (HL) and the non-Hodgkin lymphomas (NHL), and about 90% are NHL. Non-Hodgkin lymphoma represents 4.3% of all new cancer cases in the U.S. and the ninth most common cancer in male patient of Taiwan. Lymphomas may arise in lymph nodes or any organ with only 3% of them occurs in oral cavity. However, lymphomas represent the third most common group of malignant lesions in the oral cavity, following squamous cell carcinoma and salivary gland neoplasms. Here, we reviewed clinical features, radiologic appearance and diagnosis of 1035 cases of lymphomas with oral manifestations (18 cases in our institution and 1017 cases retrieved from literatures). We found that oral lymphomas affect patients aged 4-96 years (average, 55.1 years), occurring about 1.3 times as often in males than in females. The most common sites of involvement included tonsil, maxilla, mandible, palate, tongue, gingiva and buccal mucosa. The most frequent symptoms are swelling, pain, ulceration and paresthesia. Tooth displacement and hypermobility were also frequently seen when the alveolar bone were involved. The radiologic finding was non-specific as an osteolytic lesion. Thickening of periodontal ligament, loss of lamina dura and tooth displacement were also mentioned in some cases with invasion of jaw bones. The most common diagnosis was diffuse large B-cell lymphoma, which accounting for 30% of all cases. The oral lesions of lymphoma are often a component of more widely disseminated disease. An early detection can result in a higher cure rates and better long-term survival for the patients.