Abstract
A 32-year-old white woman was referred for evaluation of palate lesion with 3 months’ duration. Medical history included recent investigation for tuberculosis due to the presence of nodules detected on chest radiograph and previous treatment for syphilis. The patient exam revealed nasal obstruction, cough, secretion drainage, and weight loss. Extraoral examination showed erythema and edema in the face. Moreover, erosive lesions, crusts and purulent drainage were observed in the nasal area. Intraorally, an extensive necrotic lesion with bone destruction and exposure, midline palatal perforation was detected. Differential diagnosis included tertiary syphilis, leishmaniosis, tuberculosis, deep mycosis, Wegener granulomatosis, maxillary sinus carcinoma, and T-cell/natural killer (T/NK) lymphoma. Hematologic tests were negative for infectious diseases. Incisional biopsy followed by histopathologic examination revealed an unspecified malignant neoplasm. Epstein-Barr virus (EBV) was positive in the sample. T/NK lymphoma diagnosis was supported by morphologic aspects and immunohistochemical profile. Treatment comprised radiotherapy, and a partial remission was observed. The patient remains under follow-up care. A 32-year-old white woman was referred for evaluation of palate lesion with 3 months’ duration. Medical history included recent investigation for tuberculosis due to the presence of nodules detected on chest radiograph and previous treatment for syphilis. The patient exam revealed nasal obstruction, cough, secretion drainage, and weight loss. Extraoral examination showed erythema and edema in the face. Moreover, erosive lesions, crusts and purulent drainage were observed in the nasal area. Intraorally, an extensive necrotic lesion with bone destruction and exposure, midline palatal perforation was detected. Differential diagnosis included tertiary syphilis, leishmaniosis, tuberculosis, deep mycosis, Wegener granulomatosis, maxillary sinus carcinoma, and T-cell/natural killer (T/NK) lymphoma. Hematologic tests were negative for infectious diseases. Incisional biopsy followed by histopathologic examination revealed an unspecified malignant neoplasm. Epstein-Barr virus (EBV) was positive in the sample. T/NK lymphoma diagnosis was supported by morphologic aspects and immunohistochemical profile. Treatment comprised radiotherapy, and a partial remission was observed. The patient remains under follow-up care.
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