title: Inflammatory pseudotumor presenting as a facial swelling.
abstract: We present a case of inflammatory pseudotumor (IPT) presenting as a facial swelling after an accidental hit on a right side of a face. As swelling did not resolve, dental examination and teeth extraction were done by a dentist presuming the swelling was misdiagnosed with infection of dental origin. Swelling grew even bigger and patient was referred to Department of Maxillofacial Surgery. CT scan of the face and FNA of the lesion was ordered. A homogenous tumor mass in the right infraorbital region in front of anterior wall of the maxillary sinus was seen on CT The result of the FNA was reactive hyperplasia of the lymph node. Since the lesion was easily accessible surgical exploration and complete extirpation was done. Pathohistological analysis indicated a low grade B-cell Non Hodgkin lymphoma. PCR showed policlonality of B cells discarding the diagnosis of lymphoma. Pathohistological review showed diffuse intramuscular, perineural and perivascular infiltration with small lymphocytes without formation of germinative centers. Imunohistochemistry was positive for CD20 and CD3. Taking into account all features the diagnosis of IPT was established. Diagnosis of IPT is a diagnosis by exclusion, combining clinical, radiological and pathohistological characteristics. Lack of clear histologic criteria makes differential diagnosis extremely difficult. Our case is unique regarding localisation of head & neck IPT no case presenting on the face in infraorbital region has been described in the literature. Although IPT is very rare in general and especially on the face, one should be aware of it when considering differential diagnosis of facial swelling.
authors: University of Zagreb, Dubrava University Hospital, Department of Maxillofacial Surgery, Zagreb, Croatia. emildediol@yahoo.com
authors: Emil
authors: E
authors: Dediol
authors: Spomenka
authors: S
authors: Manojlović
authors: Cedna Tomasović
authors: CT
authors: Loncarić
authors: Josip
authors: J
authors: Biocić
authors: Josip
authors: J
authors: Hat
mesh_terms: D003937:Diagnosis, Differential; D004487:Edema / Q000175:diagnosis*; D005145:Face; D006104:Granuloma, Plasma Cell / Q000175:diagnosis* / Q000473:pathology / Q000532:radiotherapy; D006801:Humans; D008297:Male; D008875:Middle Aged; D016133:Polymerase Chain Reaction; D014057:Tomography, X-Ray Computed