Maxillofacial lymphomas.

Abstract

Lymphomas affecting the bones of the jaws, although less frequent than carcinomas, can both present radiologically as carcinomas in addition to the more frequent "periapical-radiolucencies-of-inflammatory-origin" (PRIOs). Certainly those lymphomas arising within the maxillary alveolus have a short period of prior awareness before presentation, denoting an aggressive process. Half are provisionally diagnosed as carcinomas and the other half as PRIOs. Failure of the latter to respond to appropriate treatment, compels prompt and appropriate investigation for a malignancy. Further distinction of the malignancy into carcinoma and lymphoma is necessary, because the treatment of carcinomas is radical, achieved mainly by resection plus radiotherapy, whereas treatment of lymphomas relies on chemotherapy and in some cases, radiotherapy. The few reported cases that have been subject to cross-sectional imaging and reporting by radiologists has only appeared relatively recently. These cases reveal roles for cone-beam computer tomography, computed tomography and magnetic resonance (MR). Ultimately the diagnosis is dependant on a biopsy from the most representative area/s and the treatment plan upon the diagnosis and extent of the disease defined by the imaging.