Primary extranodal malignant lymphoma affecting the periodontium.
BACKGROUND
Non-Hodgkin's lymphoma may arise in extranodal tissues within the head and neck region. These lesions may occur in the oral cavity, but rarely appear on the gingiva. Due to their malignant nature, rapid identification, diagnosis, and treatment of non-Hodgkin's lymphomas are essential to patient survival.


METHODS
An unusual case of primary extranodal non-Hodgkin's lymphoma is described. The small lesion arose on the gingiva and alveolar mucosa. Upon excision, the tissue was submitted for microscopic examination, with the expectation that the lesion would be benign and excision would constitute the entirety of treatment. However, a diagnosis of primary extranodal large B-cell lymphoma was returned.


RESULTS
In addition to excision of the lesion, the patient underwent a complete work-up to rule out other systemic lesions. Chemotherapy and radiation therapy were performed. The patient has remained healthy, without recurrence of lymphoma for 3 years.


CONCLUSIONS
This case reinforces the importance of submitting excised tissues for microscopic examination even when the lesion appears totally benign. In addition, it highlights the need for complete excision of suspected lesions, with generous borders of normal tissue. With current periodontal plastic surgical techniques, most defects remaining after soft tissue biopsy can be managed with good esthetic results.
Mealey
Brian L
BL
Department of Periodontics, Wilford Hall Medical Center, Lackland Air Force Base, TX 78236-5346, USA.
Tunder
George S
GS
Pemble
Charles W
CW
D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D001706:Biopsy; D003937:Diagnosis, Differential; D018572:Disease-Free Survival; D005500:Follow-Up Studies; D005887:Gingival Neoplasms / Q000175:diagnosis*; D006801:Humans; D016393:Lymphoma, B-Cell / Q000175:diagnosis*; D016403:Lymphoma, Large B-Cell, Diffuse / Q000175:diagnosis*; D008297:Male; D009061:Mouth Mucosa / Q000473:pathology; D009062:Mouth Neoplasms / Q000473:pathology; D018714:Radiotherapy, Adjuvant