title: Gingival Anaplastic Large-Cell Lymphoma Mimicking Hyperplastic Benignancy as the First Clinical Manifestation of AIDS: A Case Report and Review of the Literature.
abstract: This paper presents an unusual case of gingival ALCL, which mimicked a benign hyperplastic lesion that occurred in a 57-year-old white man representing the first clinical manifestation of acquired immunodeficiency syndrome (AIDS). The patient was referred to the Dental Clinic of PUCPR complaining of a lobulated nodule on the gingiva of his upper central incisors. The presence of advanced chronic periodontitis and dental plaque raised suspicion for a benignancy. An excisional biopsy was performed, and large pleomorphic cells with an abundant cytoplasm, sometimes containing prominent nucleoli and "Hallmark" cells, were observed through hematoxylin and eosin staining. The tumor cells showed strong CD30 expression, EMA, Ki-67, and LCA, and negative stain for p80(NPM/ALK), CKAE1/AE3, CD20, CD3, CD56, and CD15. The final diagnosis was ALCL (ALK-negative). Further laboratory tests revealed positivity for human immunodeficiency virus (HIV). The patient was submitted to chemotherapy, but four months after diagnosis, the patient died due to pneumonia and respiratory failure. Oral anaplastic large-cell lymphoma (ALCL) is a rare disorder. Only 5 cases involving the gingiva have been reported, and to our knowledge, this is the first case reported of the ALCL, which mimicked a hyperplastic benignancy as the first clinical manifestation of AIDS.
authors.affiliation: Department of Stomatology, Faculty of Dentistry, School of Health and Biosciences, Pontifical Catholic University of Paraná, Imaculada Conceição, 1155 Prado Velho, 80-215-901 Curitiba, PR, Brazil.
authors.forename: Rafaela Elvira
authors.initials: RE
authors.lastname: Rozza-de-Menezes
authors.forename: Stefânia
authors.initials: S
authors.lastname: Jeronimo Ferreira
authors.forename: Diogo
authors.initials: D
authors.lastname: Lenzi Capella
authors.forename: Stephan
authors.initials: S
authors.lastname: Schwartz
authors.forename: Ana Helena
authors.initials: AH
authors.lastname: Willrich
authors.forename: Lúcia
authors.initials: L
authors.lastname: de Noronha
authors.forename: Aline Cristina
authors.initials: AC
authors.lastname: Batista Rodrigues Johann
authors.forename: Paulo Henrique
authors.initials: PH
authors.lastname: Couto Souza