Abstract
A 52-year-old man was admitted to the oral diagnoses department for evaluation of a painless facial swelling for 4 months. A physical examination revealed dysphagia and facial asymmetry in the left jaw. In an intraoral exam, an expansive and necrotic lesion limiting stomatognathic function was observed. The radiographic aspect confirmed a primary soft tissue lesion with osteolytic capacity. Incisional biopsy and the microscopy showed diffuse small cell proliferation, with nuclear hyperchromatism, high mitotic activity, and clear perinuclear space, associated with large cells, with clear cytoplasm resembling macrophages, in a connective tissue stroma, resembling a “starry sky”. Immunohistochemical analysis revealed positivity for CD38, CD138, weak for CD20, and negative for CD79, CD19, CD10, CD3, CAM5.2, CK (LMH), PAX, TDT, and AE1AE3. With diagnosis of diffuse large B-cell lymphoma with plasmablastic differentiation, the patient was evaluated for human immunodeficiency virus, with negative results. The patient died after the first chemotherapy cycle.
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