title: Oral lymphomatoid granulomatosis, the first sign of a 'rare disease': a case report.
abstract: BACKGROUND
  Lymphomatoid granulomatosis is an uncommon Epstein-Barr virus-positive B-cell lymphoma, an angiocentric-destructive process with a predominant T-cell background. Lymphomatoid granulomatosis is listed among rare diseases. Common localization is in the lungs. Lymphomatoid granulomatosis with oral involvement is described in only two reports. In this report, we describe a third case of oral lymphomatoid granulomatosis.
  
  
  METHODS
  A 65-year-old Caucasian man with a gingival ulceration underwent a biopsy. The histological pattern was compatible with a grade III lymphomatoid granulomatosis. The staging revealed a nodular lesion in the lower lobe of his right lung. Our patient also presented with hemoptysis, an unusual and not reported clinical sign. Rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone chemotherapy was performed every three weeks for six cycles.
  
  
  CONCLUSIONS
  The pulmonary nodule and the gingival lesion disappeared. At eight-month follow-up, our patient is disease-free. We wish to emphasize that the oral manifestation described was the first sign of the disease and allowed for diagnosis. This case report adds to the medical literature for the particular clinical presentation of this rare disease.
authors.forename: Pasqualino
authors.initials: P
authors.lastname: Cargini
authors.forename: Maria
authors.initials: M
authors.lastname: Civica
authors.forename: Laura
authors.initials: L
authors.lastname: Sollima
authors.forename: Emanuela
authors.initials: E
authors.lastname: Di Cola
authors.forename: Emanuele
authors.initials: E
authors.lastname: Pontecorvi
authors.affiliation: Department of Life, Health & Environmental Sciences - Maxillofacial Surgery Operative Unit and Postgraduate School of Maxillofacial Surgery, University of L'Aquila, Via della Comunità Europea, 13, 67100 L'Aquila, Italy. tommaso.cutilli@cc.univaq.it.
authors.forename: Tommaso
authors.initials: T
authors.lastname: Cutilli
mesh_terms: D000368:Aged; D058846:Antibodies, Monoclonal, Murine-Derived / Q000008:administration & dosage; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage / Q000627:therapeutic use; D003520:Cyclophosphamide / Q000008:administration & dosage; D004317:Doxorubicin / Q000008:administration & dosage; D005887:Gingival Neoplasms / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000473:pathology*; D006801:Humans; D008175:Lung Neoplasms / Q000000981:diagnostic imaging* / Q000188:drug therapy; D008230:Lymphomatoid Granulomatosis / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000473:pathology*; D008297:Male; D011241:Prednisone / Q000008:administration & dosage; D011859:Radiography; D035583:Rare Diseases; D000069283:Rituximab; D014750:Vincristine / Q000008:administration & dosage
chemical_list: D058846:Antibodies, Monoclonal, Murine-Derived; D000069283:Rituximab; D014750:Vincristine; D004317:Doxorubicin; D003520:Cyclophosphamide; D011241:Prednisone