Oral manifestations and clinical progression of a rare double-hit B-cell lymphoma: a case report and review of the literature.

Abstract

Double-hit (DH) lymphoma is a rare subtype of B-cell lymphoma characterized by the chromosomal rearrangement of c-Myc and Bcl-2, and/or Bcl-6. c-Myc is an oncogene that keeps cells proliferative. Bcl-2 and Bcl-6 grant cells antiapoptotic features. The concurrent expression of these genes and their synergistic effect make DH lymphoma refractory to traditional chemotherapy, with an extremely poor prognosis. Here, we present a case of DH lymphoma in the oral cavity, including its rapid clinical course, extensive involvement of multiple sites and organs, and response to aggressive chemotherapy. It is important for dental providers to be familiar with lymphoma's oral manifestations and consider the disease in the differential diagnosis for expansile palatal lesions. The early detection and accurate diagnosis of lymphoma by dental practitioners can help expedite proper multidisciplinary care and lead to significant reductions in patient morbidity and mortality.