Oral Hodgkin lymphoma: a wolf in wolf's clothing

Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2007 Nov;104(5):e45-51. doi: 10.1016/j.tripleo.2007.06.002.

Abstract

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.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Aged
  • Diagnosis, Differential
  • Female
  • Herpesvirus 4, Human / isolation & purification
  • Hodgkin Disease / pathology*
  • Hodgkin Disease / radiotherapy
  • Hodgkin Disease / virology
  • Humans
  • Mouth Mucosa / pathology*
  • Mouth Mucosa / radiation effects
  • Mouth Mucosa / virology
  • Palatal Neoplasms / pathology*
  • Palatal Neoplasms / surgery
  • Palatal Neoplasms / virology
  • Palate / pathology*
  • Palate / radiation effects
  • Palate / virology
  • Treatment Outcome