Hematolymphoid neoplasm mimicking an endodontic lesion: series of 4 cases

Introduction

Hematolymphoid neoplasms originating in the periapical region of a tooth are a rare occurrence. Signs, symptoms, and radiographic findings can mimic lesions of endodontic origin. History-taking and clinical examination might provide some clues to define the possibility of a non-endodontic lesion, although the definitive diagnosis can only be rendered based on histologic examination.

Description

We present four cases of hematolymphoid neoplasms that radiographically mimic endodontic lesions. All of the cases initially underwent endodontic treatment, but the lesions failed to resolve. In one case, the clinician suspected a diagnosis of lymphoma based on the patient's history. In the other cases, the clinicians' impression was that the lesions originated from endodontic issues. We present two cases of diffuse B-cell lymphoma, a case of plasma cell neoplasm, and a case of Langerhans cell histiocytosis, along with a literature review of all three entities when found in the oral cavity.

Conclusion

Hematolymphoid neoplasms can manifest in the periapical region of teeth. The definitive diagnosis can only be established through histopathologic examination, making an accurate diagnosis crucial. Consequently, the patient will undergo further appropriate investigation and management.