PRIMARY DIFFUSE LARGE B-CELL LYMPHOMA OF THE MANDIBLE: A RARE CASE REPORT

Abstract

Diffuse large B-cell lymphoma is a malignant neoplasm of the lymphoid system and represents the majority cases of non-Hodgkin lymphomas. Nevertheless, it is a low-rate event in the head and neck region, especially as a primary occurrence. This is a case report of a primary extranodal diffuse large B-cell lymphoma in the mandible of a 52-year-old male patient who had no previous neoplasm history. Clinical examination and image examinations evidenced an asymptomatic singular intraosseous lesion in the mandibular bone measuring 5 cm, presenting one-and-a-half-year evolution. Odontogenic myxoma was clinical diagnostic hypothesis, and an incisional biopsy was performed. Microscopy was compatible with malignant neoplasm and immunohistochemical analysis was positive for CD20, PAX5, CD3, CD4, and CD10 markers, concluding the diagnosis of diffuse large B-cell lymphoma. The patient was treated with 4 cycles of rituximab plus cyclophosphamide, doxorubicin (hydroxydaunorubicin), vincristine (Oncovin), and prednisone chemotherapy protocol. He responded very positively to the treatment and is still under follow-up. Diffuse large B-cell lymphoma is a malignant neoplasm of the lymphoid system and represents the majority cases of non-Hodgkin lymphomas. Nevertheless, it is a low-rate event in the head and neck region, especially as a primary occurrence. This is a case report of a primary extranodal diffuse large B-cell lymphoma in the mandible of a 52-year-old male patient who had no previous neoplasm history. Clinical examination and image examinations evidenced an asymptomatic singular intraosseous lesion in the mandibular bone measuring 5 cm, presenting one-and-a-half-year evolution. Odontogenic myxoma was clinical diagnostic hypothesis, and an incisional biopsy was performed. Microscopy was compatible with malignant neoplasm and immunohistochemical analysis was positive for CD20, PAX5, CD3, CD4, and CD10 markers, concluding the diagnosis of diffuse large B-cell lymphoma. The patient was treated with 4 cycles of rituximab plus cyclophosphamide, doxorubicin (hydroxydaunorubicin), vincristine (Oncovin), and prednisone chemotherapy protocol. He responded very positively to the treatment and is still under follow-up.