Oral Hodgkin lymphoma: a wolf in wolf's clothing.
Hodgkin lymphoma typically presents as a nodal lesion and infrequently involves extranodal sites. The English language literature contains only 7 reports of primary Hodgkin lymphoma arising in the oral mucosa in the absence of nodal disease. We report a case of primary, extranodal Hodgkin lymphoma in the palatal mucosa of a 79-year-old white female. An incisional biopsy revealed a diffuse, mixed cellular infiltrate, consisting of benign lymphocytes, plasma cells, histiocytes, and foci rich in eosinophils. Within this background was a scattering of large, atypical cells, including Reed-Sternberg forms that exhibited immunoreactivity for CD30 and CD20 and nonreactivity for CD15 and CD45RO, supporting a diagnosis of classical Hodgkin lymphoma. Positron emission tomography exhibited a single focal area of abnormal hypermetabolic activity involving the left palate area, without involvement of any other site. The clinical stage was Ann Arbor I-A. The primary tumor and submandibular and upper neck lymph nodes were treated with a 6-MV photon beam to a total dose of 4000 cGy. There was no evidence of disease at 15-month follow-up.
Whitt
Joseph C
JC
School of Dentistry, University of Missouri School of Dentistry, Kansas City, MO 64108-6489, USA. whittj@umkc.edu
Dunlap
Charles L
CL
Martin
Kurt F
KF
D000368:Aged; D003937:Diagnosis, Differential; D005260:Female; D004854:Herpesvirus 4, Human / Q000302:isolation & purification; D006689:Hodgkin Disease / Q000473:pathology* / Q000532:radiotherapy / Q000821:virology; D006801:Humans; D009061:Mouth Mucosa / Q000473:pathology* / Q000528:radiation effects / Q000821:virology; D010157:Palatal Neoplasms / Q000473:pathology* / Q000601:surgery / Q000821:virology; D010159:Palate / Q000473:pathology* / Q000528:radiation effects / Q000821:virology; D016896:Treatment Outcome