title: Intraosseous Non-Hodgkin Lymphoma Mimicking a Periapical Lesion.
abstract: Non-Hodgkin lymphomas are a group of disorders involving malignant monoclonal proliferation of lymphoid cells, which appear at extranodal sites in approximately 40% of the cases, particularly in the gastrointestinal tract. Intraosseous lymphomas of the head and neck region are extremely rare and can mimic other diseases such as periodontitis or periapical pathologies. This report presents an additional case of intraosseous lymphoma that was previously misdiagnosed as periapical disease. In addition, a literature review was made based on PubMed, and all cases of periapical lymphoma were analyzed. After the diagnosis of lymphoma, the current patient was treated with 6 cycles of chemotherapy and showed satisfactory outcome. The literature review displayed 29 cases of lymphoma affecting the periapical region, and in 51.7% of them endodontic treatment was performed previously to the diagnosis of lymphoma. Although lymphoma is uncommon in the oral cavity, some symptoms can assist the dentist to suspect malignant conditions, mainly in cases presenting numb chin syndrome.
authors.affiliation: Oral Diagnosis Department, Piracicaba Dental School, University of Campinas, Piracicaba, Sao Paulo, Brazil.
authors.forename: Débora Lima
authors.initials: DL
authors.lastname: Pereira
authors.affiliation: Oral Diagnosis Department, Piracicaba Dental School, University of Campinas, Piracicaba, Sao Paulo, Brazil.
authors.forename: Diego Tetzner
authors.initials: DT
authors.lastname: Fernandes
authors.affiliation: Oral Diagnosis Department, Piracicaba Dental School, University of Campinas, Piracicaba, Sao Paulo, Brazil.
authors.forename: Alan Roger
authors.initials: AR
authors.lastname: Santos-Silva
authors.affiliation: Oral Diagnosis Department, Piracicaba Dental School, University of Campinas, Piracicaba, Sao Paulo, Brazil.
authors.forename: Pablo Agustin
authors.initials: PA
authors.lastname: Vargas
authors.affiliation: Oral Diagnosis Department, Piracicaba Dental School, University of Campinas, Piracicaba, Sao Paulo, Brazil.
authors.forename: Oslei Paes
authors.initials: OP
authors.lastname: de Almeida
authors.affiliation: Oral Diagnosis Department, Piracicaba Dental School, University of Campinas, Piracicaba, Sao Paulo, Brazil. Electronic address: malopes@fop.unicamp.br.
authors.forename: Márcio Ajudarte
authors.initials: MA
authors.lastname: Lopes
mesh_terms: D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D003937:Diagnosis, Differential; D006801:Humans; D008228:Lymphoma, Non-Hodgkin / Q000175:diagnosis* / Q000188:drug therapy; D008297:Male; D008339:Mandibular Neoplasms / Q000175:diagnosis* / Q000188:drug therapy; D008875:Middle Aged; D010483:Periapical Diseases / Q000175:diagnosis*
keywords: Extranodal lymphoma; non-Hodgkin lymphoma; numb chin syndrome; periapical lesion