Abstract
Follicular lymphoid hyperplasia of the hard palate is a reactive lymphoid proliferation which closely simulates the palatal lymphomas, both clinically and histologically. It is therefore imperative that the pathologist be familiar with the features that separate these two conditions. It reported a case of FLH in a 70-year-old white woman, showing a nodular lesion in right posterior soft palate, reddish, soft, asymptomatic. Histopathological analysis revealed lymphoid aggregates with discrete lobular appearance in the lamina propria of connective tissue showing numerous lymphocytes in the periphery with scanty cytoplasm and homogeneously basophilic nuclei and central areas of germinal centers showing tingible-body macrophages and occasional mitotic figures. In order to distinguish Follicular Lymphoma (FL) from Follicular Hyperplasia (FH), immunohistochemical staining method for bcl-2 was used showing positivity in the mantle zone and absence of immunostaining in the cellular elements within the follicle centres.
Highlights
Follicular Lymphoid Hyperplasia (FLH) of the palate is a poorly understood and very rare non-neoplastic lymphoproliferative disease in the oral mucosa, which may be confused clinically and histologically with malignant lymphoma [1,2,3,4,5,6,7]
Seven cases (31.8%) of FLH occurred in patients with other diseases, while three patients (13.6%) had associated lymphadenopathy, one had undergone a total thyroidectomy, one had rheumatoid arthritis and serologic changes consistent with autoimmune disease systemic disorder, one had non-Hodgkin’s lymphoma and one had associated hypertension and osteoporosis, accounting for 4.5%, respectively
The clinicopathological features of lymphoid hyperplasia in the oral mucosa were initially reported by Adkins in 1973 [1]
Summary
Follicular Lymphoid Hyperplasia (FLH) of the palate is a poorly understood and very rare non-neoplastic lymphoproliferative disease in the oral mucosa, which may be confused clinically and histologically with malignant lymphoma [1,2,3,4,5,6,7]. The oral cavity may be involved, usually occurs as a painless, slow growing nonulcerated mass in the posterior hard palate. It is often unilateral but occasionally it may be bilateral or involve a large area of the hard palate [8]. A small number of patients have developed recurrences after local excision but have not shown any evidence of malignization after long-term follow-up [8]
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