Soft Tissue Malignant Lymphoma Research Articles

Oral cavity malignant lymphomas are exceptionally rare, highly aggressive, and most commonly a sign of relapse—a 10-year retrospective analysis in a single institution

Background Malignant non-Hodgkin lymphoma (NHL) represents approximately 5% of all malignancies of the head and neck region and is the third most common after squamous cell carcinoma (SCC) and salivary gland tumors. NHL originates from the B or T cells of lymphatic tissue. Only 24% of NHL affect extranodal locations. The head and neck region is the second most common site of extranodal manifestation. Only 0.1% to 5% present in the oral cavity, of which the majority are diffuse large B-cell lymphomas (DLBCLs). Intraoral cases manifestations appear as part of progressive or recurrent disease after treatment failure. Primary NHLs in the oral cavity are exceptionally rare. In our study, we conducted a retrospective clinicopathologic analysis of all cases of intraoral soft tissue malignant lymphomas. Case Summary Between 2008 and 2018, there were 11 cases of intraoral soft tissue NHLs, including extremely rare cases, such as natural killer/T-cell palatal lymphoma, mantle cell lymphoma, Burkitt lymphoma that transformed into DLBCL, and mycosis fungoides (cutaneous T-cell lymphoma) of the tongue. All patients were negative for human immunodeficiency virus infection. Age range was 14 to 77 years. The presentation of lesions was diverse, ranging from swellings mimicking dental abscesses to deep ulcers mimicking SCCs and even deep fungal infections. Thus, a fast and accurate differential diagnosis was of high importance. In some of the patients, the oral cavity was the primary site of the disease, which, in part, was a sign of relapse or part of disseminated illness. The most common location was the hard palate. In greater than 90% of cases, intraoral lymphoma was the first sign of relapse. Of these patients, 55% died within 6 months of the oral manifestation of NHL; therefore, early detection of intraoral relapses is critical and highly important. Conclusions Oral mucosal manifestation of NHL is rare and, in most cases, the first sign of relapse. Many NHLs can present in oral soft tissues, and most are fatal, so clinicians should take NHL into consideration when making their differential diagnosis. NHL lesions can mimic periodontal disease, acute abscess, or even other malignancies.

Soft tissue aspiration cytopathology of malignant lymphoma and leukemia

BACKGROUND Malignant lymphoma (ML) and leukemia infrequently involve soft tissue and, to the authors' knowledge few reports exist regarding the role of fine-needle aspiration biopsy (FNAB) in their diagnosis. In the current study, the authors report their experience with FNAB in patients with soft tissue ML and leukemia. METHODS All cases of ML, leukemia, or atypical lymphoid cells from soft tissue aspirates were reviewed. Masses from lymph node-rich sites, those adjacent to enlarged lymph nodes, or those associated with cutaneous lesions were excluded. RESULTS Twenty-one patients (male:female ratio of 1:1) who ranged in age from 10 months to 87 years (mean age, 51 years) were studied. Seven patients had superficial masses and 14 patients had deep soft tissue masses. Sites included the extremities (10 patients), trunk (8 patients), and head (3 patients). Cytologic diagnoses were ML (large cell [11 patients] and Hodgkin [1 patient]), acute leukemia (lymphoblastic [3 patients] and myelogenous [2 patients]), and atypical lymphoid cells (4 patients). Eight aspirates represented the initial diagnosis of ML, three were recurrent ML, four were recurrent leukemia, one was initial leukemia, and one ML aspirate was obtained concurrently with core needle biopsy. Four aspirates were diagnosed as atypical lymphoid cells. Three subsequently were diagnosed as ML and one aspirate was diagnosed as acute leukemia. All ML were of large B-cell type. One case of atypical lymphoid cells was found to be a mantle cell lymphoma. The leukemia cases were T-cell (two cases), pre-B-cell (two cases), and myelogenous (two cases). Immunophenotyping confirmed the cytology by flow cytometry (five cases), cytospin (three cases), and cell block (four cases). Immunophenotyping of eight cases was performed on tissue samples. In one case a cytopathologic diagnosis of ML reversed a prior tissue core biopsy diagnosis of liposarcoma. The specificity and sensitivity rates for a definitive diagnosis of ML or leukemia were 100% and 82%, respectively. CONCLUSIONS In the majority of cases, it is possible to determine a specific diagnosis and subtype of soft tissue ML or leukemia using FNAB. Cancer (Cancer Cytopathol) 2001;93:35–39. © 2001 American Cancer Society.

Soft tissue aspiration cytopathology of malignant lymphoma and leukemia

Malignant lymphoma (ML) and leukemia infrequently involve soft tissue and, to the authors' knowledge few reports exist regarding the role of fine-needle aspiration biopsy (FNAB) in their diagnosis. In the current study, the authors report their experience with FNAB in patients with soft tissue ML and leukemia. All cases of ML, leukemia, or atypical lymphoid cells from soft tissue aspirates were reviewed. Masses from lymph node-rich sites, those adjacent to enlarged lymph nodes, or those associated with cutaneous lesions were excluded. Twenty-one patients (male:female ratio of 1:1) who ranged in age from 10 months to 87 years (mean age, 51 years) were studied. Seven patients had superficial masses and 14 patients had deep soft tissue masses. Sites included the extremities (10 patients), trunk (8 patients), and head (3 patients). Cytologic diagnoses were ML (large cell [11 patients] and Hodgkin [1 patient]), acute leukemia (lymphoblastic [3 patients] and myelogenous [2 patients]), and atypical lymphoid cells (4 patients). Eight aspirates represented the initial diagnosis of ML, three were recurrent ML, four were recurrent leukemia, one was initial leukemia, and one ML aspirate was obtained concurrently with core needle biopsy. Four aspirates were diagnosed as atypical lymphoid cells. Three subsequently were diagnosed as ML and one aspirate was diagnosed as acute leukemia. All ML were of large B-cell type. One case of atypical lymphoid cells was found to be a mantle cell lymphoma. The leukemia cases were T-cell (two cases), pre-B-cell (two cases), and myelogenous (two cases). Immunophenotyping confirmed the cytology by flow cytometry (five cases), cytospin (three cases), and cell block (four cases). Immunophenotyping of eight cases was performed on tissue samples. In one case a cytopathologic diagnosis of ML reversed a prior tissue core biopsy diagnosis of liposarcoma. The specificity and sensitivity rates for a definitive diagnosis of ML or leukemia were 100% and 82%, respectively. In the majority of cases, it is possible to determine a specific diagnosis and subtype of soft tissue ML or leukemia using FNAB. Cancer (Cancer Cytopathol)

Soft tissue malignant lymphoma at sites of previous surgery.

Three diffuse centroblastic lymphomas developed at the site of previous surgery. Two were preceded by atypical lymphoid infiltrates. Clinical data, microscopic features, and immunophenotypic studies were reviewed. All three patients...