ORAL LYMPHOMA: A REPORT OF TWO CONTRASTING CASES

Abstract

##Introduction: Non-Hodgkin’s lymphoma (NHL) is a broad term for malignancies of the lymphoreticular system. NHL of the oral cavity is relatively rare and can manifest in a variety of ways, which can make initial diagnosis difficult. ##Objectives: We discuss two contrasting cases of patients who initially presented with oral lesions to highlight the heterogeneity of lymphoma in the oral cavity and the importance of a thorough history and examination. ##Methods: Case note review was undertaken for Case 1 and Case 2. ##Results: Case 1 involves a 56-year-old male who was referred from his general practitioner to the oral and maxillofacial surgery (OMFS) emergency clinic with a three-week history of painful, intra-oral, ulcerated swellings in all four quadrants. He had recently developed fever, drenching night sweats and unexplained weight loss. The patient was admitted under OMFS until biopsy confirmed NK-T cell NHL. Case 2 involves a 68-year-old male who was urgently referred by his dentist, who had noticed a red patch on the left hard/soft palate junction at routine check-up. On examination, there was a 15mm erythematous, fixed submucosal lump on the left hard/soft palate junction. He was otherwise asymptomatic. Biopsy confirmed follicular B-cell NHL. Both patients were referred to haematology for ongoing care. ##Conclusions: For intra-oral lesions, lymphoma should be considered as a differential diagnosis until ruled out by biopsy. Biopsies should be performed promptly in order to prevent delays in treatment. A thorough history may help to identify the presence of ‘B symptoms’.