Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, and Endodontology
Oral and maxillofacial pathologyOnline only articleOral Hodgkin lymphoma: a wolf in wolf’s clothing
Section snippets
Case Report
A 79-year-old edentulous Caucasian female presented with an asymptomatic enlargement of her left palate that had been increasing in size over the preceding 3 months. Clinical intraoral examination revealed a 3.0 × 2.0–cm sessile swelling of the soft palate. The lesion exhibited a central calderalike crater with irregular, rolled borders (Fig. 1). She was afebrile and exhibited no cervical lymphadenopathy. Her medical history was significant for penicillin allergy and prior hospitalization for
Review of the Literature
Table II summarizes the clinical and histologic features of the 7 previously reported cases and the present case of primary intraoral extranodal Hodgkin lymphoma. The average age was 69 years with a range of 24 to 81 years. There was an equal gender incidence. Race was provided for only 4 of the cases, all Caucasians. The clinical lesions involved a variety of locations, including palate, tonsil, tongue, floor of mouth, buccal alveolar mucosa, buccal vestibule, and mandibular bone, with no one
Discussion
Both CHL and NLPHL are derived from germinal center (GC) B cells, with rare exceptions (see following). In a normal germinal center, activated B cells proliferate and undergo somatic hypermutation of variable region genes. Only B cells that produce high-affinity antibody to the immunizing antigen are selected to survive. Those cells that do not acquire favorable high-affinity mutations or that lose their ability to produce antibody are eliminated by apoptosis. Both CHL and NLPHL exhibit
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