Follicular lymphoid hyperplasia of the hard palate and oral mucosa: report of three cases and a review of the literature.
OBJECTIVE
To bring to wider attention this uncommon, poorly understood entity which may closely resemble, clinically and morphologically, follicular lymphoma.


RESULTS
We report three cases of follicular lymphoid hyperplasia of the hard palate and oral mucosa which caused diagnostic difficulties for the referring pathologists. The clinicopathological features are described and integrated into a review of the 16 previously recorded cases. The condition most commonly presents as a slowly growing mass situated in the posterior hard palate but may present with multicentric oral lesions and lymphadenopathy. Morphologically, it is characterized by a dense follicular lymphoid infiltrate within the lamina propria which may show the classical features of benign reactive hyperplasia, but not uncommonly, indistinct germinal centres, ill-defined mantles and a lack of tingible-body macrophages are features which may lead to an erroneous diagnosis of follicular lymphoma.


CONCLUSIONS
Follicular lymphoid hyperplasia of the palate is a poorly recognized entity which is frequently confused with follicular lymphoma. Awareness of the entity combined with the use of immunohistochemistry for immunoglobulin light chains and bcl-2 protein allows a correct diagnosis to be made avoiding extensive investigation and aggressive treatment to the patient.
Menasce
L P
LP
Department of Histopathology, Christie Hospital NHS Trust, Manchester, UK.
Shanks
J H
JH
Banerjee
S S
SS
Harris
M
M
D000368:Aged; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D006965:Hyperplasia; D007145:Immunoglobulin kappa-Chains / Q000032:analysis; D007146:Immunoglobulin lambda-Chains / Q000032:analysis; D007150:Immunohistochemistry; D008221:Lymphoid Tissue / Q000737:chemistry / Q000473:pathology*; D008224:Lymphoma, Follicular / Q000473:pathology; D008297:Male; D008875:Middle Aged; D009061:Mouth Mucosa / Q000737:chemistry / Q000473:pathology*; D010159:Palate / Q000737:chemistry / Q000473:pathology*; D019253:Proto-Oncogene Proteins c-bcl-2 / Q000032:analysis
D007145:Immunoglobulin kappa-Chains; D007146:Immunoglobulin lambda-Chains; D019253:Proto-Oncogene Proteins c-bcl-2