Oral Ulcers Research Articles

Classifications of cutaneous lymphomas and lymphoproliferative disorders: An update from the EORTC cutaneous lymphoma histopathology group.

The classification of primary cutaneous lymphomas and lymphoproliferative disorders (LPD) is continuously evolving by integrating novel clinical, pathological and molecular data. Recently two new classifications for haematological malignancies including entities of cutaneous lymphomas were proposed: the 5th edition of the WHO classification of haematolymphoid tumours and the International Consensus Classification (ICC) of mature lymphoid neoplasms. This article provides an overview of the changes introduced in these two classifications compared to the previous WHO classification. The main changes shared by both classifications include the downgrading of CD8+ acral T-cell lymphoma to CD8+ acral T-cell LPD, and the recognition of entities that were previously categorized as provisional and have now been designated as definite types including primary cutaneous small or medium CD4+ T-cell LPD, primary cutaneous gamma/delta T-cell lymphoma, primary cutaneous CD8+ aggressive epidermotropic cytotoxic T-cell lymphoma, Epstein-Barr virus-positive mucocutaneous ulcer. Both classifications consider primary cutaneous marginal zone B-cell clonal neoplasm as an indolent disease but use a different terminology: primary cutaneous marginal zone lymphoma (WHO) and primary cutaneous marginal zone LPD (ICC). The 5th WHO classification further introduces and provides essential and desirable diagnostic criteria for each disease type and includes chapters on reactive B- or T-cell rich lymphoid proliferations formerly referred as cutaneous pseudolymphomas, as well as histiocyte and CD8 T-cell rich LPD in patients with inborn error of immunity. As already emphasized in previous lymphoma classifications, the importance of integrating clinical, histological, phenotypic and molecular features remains the crucial conceptual base for defining cutaneous (and extracutaneous) lymphomas.

An immune-related adverse event of Behcet’s-like syndrome following pembrolizumab treatment

BackgroundIn recent years, the emergence of immunotherapy has renewed therapeutic modality. Different from traditional anti-tumor therapy, immune-related adverse events of skin, gastrointestinal tract, liver, lung, endocrine glands commonly occurred. At present, only one case of immune-related adverse event of Behcet’s-like syndrome following pembrolizumab treatment was reported in USA, and no one is reported in China.Case presentationHere, we report a rare case of Behcet’s-like symptom following pembrolizumab treatment. A 43-year-old female was diagnosed as lymph node and bone metastasis of adenocarcinoma with unknown primary lesion, probably being of pulmonary origin. She was treated with pembrolizumab 200 mg every three weeks in combination with chemotherapy for 6 cycles, followed by pembrolizumab monotherapy maintenance. However, she developed Behcet’s-like syndrome with oral ulcer, genital uler, phlebitis, and vision loss after 9 cycles of pembrolizumab treatment. She was treated with prednisone 5 mg orally three times a day. Two weeks later, dose of glucocorticoid gaven to the patient gradually decreased with improved symptoms. After a treatment-free withdrawal period, the patient requested to continue pembrolizumab treatment. Unfortunately, the above symptoms recurred on the second day following pembrolizumab treatment, and glucocorticoid was taken once again. The symptoms improved and the condition was under control.ConclusionsIn view of the exponential growth of immunocheckpoint inhibitors (ICIs) in a variety of tumors, we should be alert to related adverse events, especially the rare rheumatic manifestations.

Penfhigus Vulgaris: Report Of A Clinical Case

The current article analyzes the topic of pemphigus vulgaris, which is described as an autoimmune disease affecting the skin and mucous membranes, characterized mainly by the formation of superficial blisters on the skin and oral mucosa. The objective was to present a case study of a patient with pemphigus vulgaris. A qualitative and descriptive investigation was carried out in this study. The 40-year-old male patient with pemphigus vulgaris had a complex but satisfactory evolution. Following an exacerbation in July 2023 and complications such as oral ulcers and ocular issues, he was hospitalized again. Aggressive treatment was initiated with medication adjustments, resulting in significa[1]nt improvement with remission of skin lesions, pain control, and no signs of infection. After multidisciplinary follow-up and treatment, he was discharged on November 8, 2023, showing a positive response and improved quality of life. This case highlights the importance of a comprehensive approach in pemphigus vulgaris treatment and the need for ongoing monitoring to prevent relapses and future complications.

Mechanism and Research Progress of Agarwood in Improving Recurrent Oral Aphthous Ulcer and Ulcerative Colitis

Abstract: Recurrent oral aphthous ulcer (RAU) is a common oral disease closely associated with oral flora disorders, immune dysfunction, and gastrointestinal dysfunction. Ulcerative colitis (UC) is a chronic inflammatory disease in the intestinal tract that manifests as infiltration of intestinal inflammatory cells and damage to the intestinal mucosa, often involving extraintestinal manifestations, including RAU in the UC population. The oral cavity and intestinal tract are the two major parts of the body rich in microbiota, each constituting the beginning and end of the digestive tract, and are particularly closely linked. Quercetin, a flavonoid of sedum, is a natural class of drugs with antioxidant, anti-inflammatory, antibacterial, and analgesic properties. This paper mainly reviews the interconnection between recurrent oral aphthous ulcer and ulcerative colitis and aims to investigate the mechanism of action of sedum quercetin in relieving oral and intestinal inflammation and conclude that sedum quercetin exerts anti-RAU and UC effects by regulating oral-intestinal axis flora disorder, strengthening mucosal barrier, and relieving inflammation and pain. It provides new insights for the adjuvant treatment of RAU and UC.

Topical Adipose Mesenchymal Stem cell metabolites regulate the expression of MMP-1, MMP-9, EGF, TGF-β in oral mucosa ulcer rat model

ObjectiveMatrix metalloproteinase (MMP-1 and −9), Epidermal Growth Factor (EGF), and Transforming Growth factor (TGF)-β are expressed in the oral ulcer wound-healing process. The Adipose mesenchymal stem cell metabolites (AdMSCMs) may accelerate wound-healing. This study aimed to investigate the expression of MMP-1, MMP-9, EGF, and TGF-β in the oral mucosa ulcer rat model treated with topical AdMSCMs. Materials and MethodsOral ulcer models were created in twenty healthy male Wistar rats (Rattus novergicus) divided into AdMSCMs and control groups. The oral ulcer model was treated topically using AdMSCMs oral gel three times daily for 3 and 7 days. The expression of MMP-1, MMP-9, EGF, TGF-β was evaluated through histological examination using the immunohistochemistry method. Independent t-test was used to compare the mean of expression of MMP-1, MMP-9, EGF, TGF-β between control and treatment groups (AdMSCMs), and paired t-test was used to analyze the mean between day 3 and day 7 of each group. ResultsA lower expression of MMP-1, MMP-9 in AdMSCMs group and higher expression EGF and TGF-β in AdMSCMs group compared to the control group in day 3 and day 7. Independent t-test results showed a significant difference in the expression of MMP-1, MMP-9, EGF between the control and AdMSCMs group in day 3 and day 7. Only TGF-β expression mean difference between day 3 and day 7 showed a significant difference compared to the control groups (p < 0.05) ConclusionsAdMSCMs oral gel may accelerate oral ulcer healing models by reducing the expression MMP-1, MMP-9, and increasing EGF and TGF-β expressions during the wound-healing process.

Pedunculoside promotes oral ulcer healing in mice by upregulating STAT3 and Smad3

BackgroundPedunculoside (PE) is a pentacyclic triterpenoid saponin found in the dried barks of the Ilex rotunda Thunb. In traditional Chinese medicine, the juice extracted from various Ilex species is commonly used for treating inflammatory diseases. ObjectiveThis study aims to investigate the potential of PE in promoting the healing of oral ulcers in mice and to explore its possible mechanism. Materials and MethodsA mouse model of oral ulcer was established to evaluate the healing promotion effects of PE, and an in-vitro inflammatory cell model was established by using primary fibroblasts isolated from mouse oral mucosal tissue. Gene transcription and protein expression related to cell proliferation, migration, and collagen synthesis were measured. ResultsPE showed the highest cure rate of 85.7% for oral ulcers in mice within 7-days treatment. It significantly promoted cell proliferation and collagen secretion in fibroblast in-vitro model. PE also upregulated the gene transcription of Smad3, Col1a1 and Col3a1. Furthermore, PE antagonized the inhibitory effect of WP1066 on STAT3activation, but did not affect cell migration. ConclusionThis study demonstrates that PE has potential therapeutic effects in promoting oral ulcer healing in mice. The improvement was achieved by the increasing collagen synthesis through the upregulation of STAT3 and Smad3 in mucosa fibroblasts. These results provide a preliminary pharmacological work for developing PE as a potential treatment agent for oral ulcers.

Severe Renal Impairment in a Patient with Recent Rheumatoid Arthritis Diagnosis following Methotrexate Initiation: A Case Report

ABSTRACT Rheumatoid arthritis (RA) is a chronic autoimmune disease frequently treated with immunosuppressive agents such as methotrexate (MTX). Although MTX is generally well-tolerated, it can lead to adverse effects, including renal impairment. We present a case of a patient with newly diagnosed RA who developed severe renal impairment shortly after initiating MTX therapy. A 50-year-old male with recently diagnosed RA presented with vomiting, skin itching, mouth ulcers, and a pruritic rash, all occurring shortly after starting MTX treatment. These symptoms led to acute kidney injury (AKI), necessitating hemodialysis. The patient’s symptoms and laboratory findings were indicative of ANCA-associated small-vessel vasculitis with a picture of rapidly progressive glomerulonephritis (RPGN). Treatment included discontinuation of MTX, hemodialysis, immunosuppressive therapy with corticosteroids and cyclophosphamide, and patient education. This case emphasizes the need for close monitoring of RA patients initiated on MTX therapy and prompt evaluation of renal function. Clinicians should be vigilant for signs of renal impairment and be prepared to initiate appropriate interventions, including discontinuation of MTX and consideration of immunosuppressive therapy, to optimize patient outcomes. Further research is warranted to understand better the mechanisms underlying renal complications in RA patients receiving MTX treatment.

E-cigarettes in Nigeria: A scoping review of evidence.

E-cigarettes will continue to be a public health issue in Nigeria. To curb the growing menace of the e-cigarette use in Nigeria through evidence-based approach, it is crucial to first map the empirical research landscape of e-cigarettes in Nigeria. No known study has mapped the existing empirical evidence and gaps concerning e-cigarettes in Nigeria; hence, this scoping review was conducted. This scoping review adopted the research design by Arksey and O'Malley. Four databases (PubMed, SCOPUS, CINAHL Complete, and APA PsycINFO) were searched to retrieve literature on e-cigarettes in Nigeria. With the aid of Rayyan web application, all retrieved literature were deduplicated and screened based on the review's eligibility criteria. Only those peer-reviewed journal papers meeting the inclusion criteria were included in the review. Relevant data from the included papers were charted, collated, and summarized. A total of six papers were included in this review. The reviewed papers reported a lifetime prevalence of e-cigarette use (or vaping) ranging from 5.8% to 19.8%, with a current e-cigarette use prevalence of 11.8%, among different population groups in Nigeria. The major determinants of e-cigarette use, as reported in these articles, include being a youth, having a health condition, severe anxiety, tobacco use, peer influence, and current alcohol use. Dry mouth and oral lesions (gingival inflammation and oral ulcers) were also identified to be the medical conditions associated with e-cigarette use in Nigeria. Lastly, one of the included papers identified a lack of clear regulation on e-cigarettes in Nigeria. There is an urgent need for more scientific investigations on the sociodemographic, economic, health, and regulatory landscape of e-cigarettes in Nigeria, as robust empirical evidence is needed for the effective planning, implementation, and evaluation of evidence-based policies and interventions on e-cigarettes control and regulation in Nigeria.

Drug Reaction with Eosinophilia and Systemic Symptoms Syndrome without Eosinophilia: A Complication Secondary to Aceclofenac

Abstract A 27-year-old male presented with fever, oral ulcers, and generalized lymphadenopathy 5 days following consuming aceclofenac for toothache. He had hepatosplenomegaly in ultrasonography and transaminitis on investigations. After ruling out the other causes by appropriate tests, he was diagnosed with drug reaction with eosinophilia and systemic symptoms (DRESS) due to aceclofenac and was treated with systemic steroids with good outcomes. We describe a patient with DRESS due to aceclofenac in the absence of eosinophilia which is extremely unusual. Early recognition of DRESS is essential for proper management which can reduce mortality.

Effect of β-Sitosterol on Healing of Induced Oral Traumatic Ulcer in Albino Rats

Effect of β-Sitosterol on Healing of Induced Oral Traumatic Ulcer in Albino Rats

Coexistence of ankylosing spondylitis and Behçet's disease: Successful treatment with upadacitinib.

Ankylosing spondylitis (AS) and Behçet's disease(BD) are distinct inflammatory disorders, but their coexistence is a rare clinical entity. This case sheds light on managing this complex scenario with Janus kinase (JAK) inhibitors. A 42-year-old woman presented with a decade-long history of lower back pain, nocturnal spinal discomfort, recurrent eye issues, oral and genital ulcers, hearing loss, pus formation in the left eye, and abdominal pain. Multidisciplinary consultations and diagnostic tests confirmed AS (HLA-B27 positivity and sacroiliitis) and BD (HLA-B51). Elevated acute-phase markers were observed. This case fulfills diagnostic criteria for both AS and BD, emphasizing their coexistence. Notably, treatment with upadacitinib exhibited promising efficacy, underscoring its potential as a therapeutic option in patients with contraindications for conventional treatments. Our findings illuminate the intricate management of patients presenting with these two diverse systemic conditions and advocate for further exploration of JAK inhibitors in similar cases.

Anti-inflammatory and wound healing effects of mouth gel containing kaempulchraol K from Kaempferia galanga rhizomes

Ethnopharmacological relevanceKaempferia galanga L. is one of the important medicinal plants and has been used in Thailand for treating inflammation and wound. Aim of the studyThis study aimed to investigate the efficacy of the compound from K. galanga on wound healing and anti-inflammatory activities and develop a new product in gel form to maximize the benefits of this plant. Materials and methodThe mouth gel containing kaempulchraol K (KG2) was prepared by using 1.5% carbopol 934 as a gelling agent. Formulations of mouth gel containing KG2 at 0.10%, 0.25%, and 0.50% w/w were evaluated for color, smell, pH values, viscosity, and separation. Also, the chemical and biological stabilities of mouth gel containing KG2 were evaluated by heating-cooling test. The anti-inflammatory activity was tested against RAW 264.7 cells nitric oxide (NO) production and wound healing assay was performed using human gingival fibroblasts (HGF). ResultsCompound KG2 exhibited anti-NO production with an IC50 value of 66.8 μM and the wound healing activity of compound KG2 showed cell viability in the range of 90.9–111.4%. In addition, compound KG2 at a concentration of 3 μM induced the highest proportion of cell migration on day 3 at 90.2 ± 2.4%. The mouth gel containing KG2 both before and after the heating-cooling test exhibited good consistency, with pH values in the range of 6.64–6.71 (before) and 6.63–6.68 (after). Meanwhile, the viscosity was 81,700–96,700 cP (before) and 78,300–93,300 cP (after). For the chemical stability test of the active ingredient of mouth gel, the compound showed good stability after mixing with the gel base. The mouth gel exhibited anti-inflammation with IC50 values > 1000 μg/ml both before and after accelerating conditions. The wound healing activity of mouth gel containing KG2 (0.50% w/w) showed the highest % cell viability at 128.6% (before) and 123.8% (after). For cell migration, the result suggested that the mouth gel containing KG2 at 0.10%, 0.25%, and 0.50% w/w (3 μg/ml) on day 3 enhanced cell migration higher than that of the positive controls both before (85.0–96.8%) and after (and 84.4–94.3%) the accelerating conditions. ConclusionThe present study shows that mouth gel containing 0.50% KG2 is the most appropriate with good physical, chemical, and biological stabilities and might be one of the alternative sources for treatment of mouth ulcers (oral stomatitis) derived from aphthous ulcers, chemotherapy, and radiotherapy treatments.

Assessing the knowledge and awareness of US oncologists regarding the specialty of oral medicine

ObjectivesThis cross-sectional study aimed to assess the awareness among United States (US) oncologists about oral medicine (OM) as a specialty of dentistry, and their collaboration with OM providers. MethodsAn online survey was conducted, inviting 1350 US oncologists, with data collected on demographics, practice background, comfort level with diagnosing and treating oral conditions, referral practices for oral conditions, and more. ResultsOf the invited 1350 oncologists, 192 responded (14% response rate). Among respondents, 46% were familiar with the OM specialty. Of these, 73% had previously sought consultation from OM specialists. The primary reasons for referral included dental clearance before initiating chemotherapy (38.5%), dental clearance before initiating radiotherapy (37%), and managing oral ulcers and oral potentially malignant disorders equally (32.2%). Regarding referrals to providers outside of OM, oncologists primarily referred patients with oral lesions to otolaryngologists (64.6%), followed by oral and maxillofacial surgeons (55.2%) and general dentists (45.3%). ConclusionOur study showed that over half of US oncologists were unfamiliar with the OM specialty. However, the referral rate to OM providers was high among oncologists who had prior OM knowledge. It is advisable to enhance the collaboration between OM and oncology specialists to ensure optimal care for patients with cancer.

Behçet's Disease, Pathogenesis, Clinical Features, and Treatment Approaches: A Comprehensive Review.

Behçet's disease is a systemic inflammatory disorder of unknown etiology. The disease manifests with diverse clinical symptoms, most commonly recurrent oral and genital ulcers, skin lesions, and uveitis, though it can affect multiple organ systems. Diagnosis is primarily clinical due to the lack of a definitive diagnostic test, and management involves a multidisciplinary approach to control inflammation and manage symptoms. Current treatment strategies involve corticosteroids, immunosuppressive agents, and, increasingly, biological therapies. Behçet's disease exhibits a higher prevalence along the Silk Road, suggesting a role of environmental and genetic factors. Despite significant progress in understanding its clinical characteristics and treatment approaches, gaps remain in our understanding of its pathogenesis. Future research is needed to elucidate the disease's pathophysiology and optimize treatment strategies.

Multifunctional hyaluronic acid/gelatin methacryloyl core-shell microneedle for comprehensively treating oral mucosal ulcers

Oral ulceration is the most common oral mucosal disease. Oral mucosal ulcers are extremely painful, may interfere with eating and speaking, and potentially complicate systemic symptoms in severe cases. The humid and highly dynamic environment of the oral cavity makes local drug administration for treating oral mucosal ulcers challenging. To overcome these challenges, we designed and prepared a novel dissolving microneedle (MN) patch containing multiple drugs in a core-shell to promote oral ulcer healing. The MNs contained a methacrylate gelatin shell layer of basic fibroblast growth factor (bFGF), a hyaluronic acid (HA) core loaded with dexamethasone (DXMS), and zeolite imidazoline framework-8 (ZIF-8) encapsulated in the HA-based backplane. Progressive degradation of gelatin methacryloyl (GelMA) from the tip of the MN patch in the oral mucosa resulted in sustained bFGF release at the lesion site, significantly promoting cell migration, proliferation, and angiogenesis. Moreover, the rapid release of HA and, subsequently, DXMS inhibited inflammation, and the remaining MN backing after the tip dissolved behaved as a dressing, releasing ZIF-8 for its antimicrobial effects. This novel, multifunctional, transmucosal core-shell MN patch exhibited excellent anti-inflammatory, antimicrobial, and pro-healing effects in vivo and in vitro, suggesting that it can promote oral ulcer healing.

Long-term safety, tolerability and efficacy of apomorphine sublingual film in patients with Parkinson's disease complicated by OFF episodes: a phase 3, open-label study.

Apomorphine sublingual film (SL-APO) is an on-demand treatment for OFF episodes in patients with Parkinson's disease (PD). To assess the long-term (≥ 3years) safety/tolerability and efficacy of SL-APO. Study CTH-301 ( http://www. gov NCT02542696; registered 2015-09-03) was a phase 3, multicentre, open-label study of SL-APO in PD patients with motor fluctuations, comprised of a dose-titration and long-term safety phase. All participants received SL-APO. The primary endpoint was safety/tolerability (treatment-emergent adverse events [TEAEs]) during the long-term safety phase. Efficacy assessments included the Movement Disorder Society-Unified Parkinson's Disease Rating Scale (MDS-UPDRS) part III (motor examination), assessed at weeks 24, 36 and 48 during the first year of the long-term safety phase. 496 patients were included and 120 (24.2%) completed the long-term safety phase. Mean duration of SL-APO exposure was 294.3days. TEAEs related to study drug were experienced by 65.3% of patients (most common: nausea [6.0%], stomatitis [1.8%], lip swelling [1.8%], dizziness [1.6%], oral mucosal erythema [1.6%], mouth ulceration [1.6%]). TEAEs leading to study drug withdrawal were experienced by 34.0% of patients (most common: nausea [5.4%], lip swelling [4.5%], mouth ulceration [2.6%], stomatitis [2.3%]). A clinically meaningful reduction in MDS-UPDRS part III score was observed as soon as 15min following administration of SL-APO, with peak effects observed approximately 30min post-dose and sustained up to 90min post-dose; results were consistent over 48weeks. SL-APO was generally well tolerated and efficacious over the long term as an on-demand treatment for OFF episodes in patients with PD.

Immunomodulatory melanin@Pt nanoparticle-reinforced adhesive hydrogels for healing diabetic oral ulcers

Oral ulcers may be addressed with various biomaterials infused with medications or cytokines. However, many patients derive little advantage from these substances due to inadequate adhesion, brief retention in the mouth, and diminished drug effectiveness. Here, we introduce a hydrogel patch (MPG3) consisting of a biopolymer matrix with light-activated adhesion features infused with platinum-decorated melanin nanoparticles that possess healing-promoting abilities. Initially, through straightforward local application, an adhesive hydrogel barrier forms over mucosal imperfections upon exposure to ultraviolet light. Following this, MPG3 exhibits outstanding oxygen production and reactive oxygen species elimination properties. These capabilities contribute to regulating the wound microenvironment, thereby expediting the wound's transition from the inflammatory to the proliferative stage. In rat models of oral ulcers, the MPG3 patch hastens recovery by modulating the inflammatory milieu of the damaged tissue and fostering expedited re-epithelialization and blood vessel formation. Conclusively, this light-activated adhesive hydrogel shows promise for swift wound healing and could revolutionize therapeutic approaches for treating clinical oral ulcers, especially in diabetic patients.

A Comprehensive Review on Mouth Ulcer

A Comprehensive Review on Mouth Ulcer

Bibliometric Analysis of Oral Mucositis Studies in the Nursing Field: A Descriptive Study

The research aims to conduct a bibliometric analysis of studies on oral mucositis in the field of nursing.&#x0D; Data were obtained from the Scopus database using the keywords “oral mucositis”, “stomatitis”, “aphthous stomatitis” and “oral ulcer”. A total of 16,863 studies were accessed and 344 studies that met the inclusion criteria were examined. VOSviewer 1.6.20 was used to analyze the data. The most published and cited authors on oral mucositis in the field of nursing, the most cited publications, and the distribution of these publications by journals and institutions were examined. The network map of co-author-authors, institutions, and country connections, as well as the common keyword analysis map, were also examined.&#x0D; It was discovered that publications and citations about oral mucositis in the nursing field have increased since 1990. It was determined that Laurie MacPhail was the most productive author, Chung Shan Medical University had the most publications, and the University of California had the most citations. The author with the most collaborations as a co-author was Rebecca Stone (3 co-authored articles, three clusters, 10 links, and 12 total link strength), the co-author-institution was Chung Shan Medical University (3 articles, 1 cluster, 12 links, and 12 total link strength), and the co-author- country was the United States (81 articles, 3 clusters, 15 links, and a total link strength of 19). Nutrients is the most widely published journal in this field, and the Journal of Pain and Symptom Management is the most cited. "Oral mucositis" is the most frequently used keyword in publications.&#x0D; According to study results, the most published and most cited authors and institutions in this field are in the United States. Although Turkey is one of the top three countries in terms of publications and citations, the visibility of our institutions is limited because the authors do not cooperate. There have been few studies on OM-related pain, evidence-based practice, lymphoma, multiple myeloma, and pediatric oncology patients.

Diagnostic utility of cytology in a patient with Epstein-Barr virus-positive mucocutaneous ulcer in palatine tonsils: A case report.

Epstein-Barr virus-positive mucocutaneous ulcer (EBVMCU) is a newly established immunodeficiency-related disease. Herein, we report a case of EBVMCU and focus on its cytological usefulness for diagnosis. An 82-year-old man manifested pharyngalgia, dysphagia, and oral pain. His medical history included rheumatoid arthritis that had been treated with methotrexate. Clinically, peritonsillar abscess was suspected, but since neoplastic lesions, including malignant lymphoma (ML), could not be excluded, a series of cytohistological examination was attempted. Despite some alarming findings (e.g., frequent mitoses), fine-needle aspiration and touch imprint cytology consistently revealed a heterogeneous population of lymphoid and plasmacytoid cells with mild nuclear atypia. The final diagnosis of EBVMCU was established based on the permanent histologic specimen; however, retrospectively, cytology was more representative of the benign nature of the lesion than histology, helping a great deal to differentiate it from ML. Cytology can be a useful tool for the correct diagnosis of EBVMCU.