Hematolymphoid neoplasm mimicking endodontic lesions: case series and review of the literature

Oral Surg Oral Med Oral Pathol Oral Radiol. 2025 Jan;139(1):e1-e12. doi: 10.1016/j.oooo.2024.07.011. Epub 2024 Aug 5.

Abstract

Hematolymphoid neoplasms originating in the periapical region of a tooth are rare occurrences. Their signs, symptoms, and radiographic findings can also mimic lesions of endodontic origin. History-taking and clinical examination provide clues to determine the possibility of a non-endodontic lesion, although the definitive diagnosis can only be rendered based on histologic examination. In our case series, we present four cases of hematolymphoid neoplasms that radiographically mimicked endodontic lesions. All the cases initially underwent endodontic treatment, but the lesions failed to resolve. In one case, the clinician suspected a diagnosis of lymphoma based on the patient's history. In the other cases, the clinicians' impression was that the lesions originated from endodontic issues. We present two cases of diffuse large B-cell lymphoma, a case of a plasma cell neoplasm, and a case of Langerhans cell histiocytosis, along with a literature review of three entities when found in the oral cavity as well as review of hematolymphoid neoplasm mimicking endodontic lesion previously reported in literature.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Biopsy
  • Diagnosis, Differential
  • Histiocytosis, Langerhans-Cell / diagnosis
  • Histiocytosis, Langerhans-Cell / pathology
  • Humans
  • Lymphoma, Large B-Cell, Diffuse* / diagnosis
  • Lymphoma, Large B-Cell, Diffuse* / diagnostic imaging
  • Lymphoma, Large B-Cell, Diffuse* / pathology
  • Periapical Diseases / diagnosis
  • Periapical Diseases / diagnostic imaging
  • Periapical Diseases / pathology
  • Radiography, Panoramic