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A rare spindle-cell variant of non-Hodgkin's lymphoma of the mandible
A 64-year-old male farmer presented with a rapidly progressive swelling of the left mandible since 6 months. The swelling was firm to hard, diffuse, nontender, obliterating the vestibule with paresthesia of lower lip. The cone beam computed tomography imaging revealed an ill-defined, moth-eaten radi...
Autores principales: | , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Medknow Publications & Media Pvt Ltd
2016
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4860914/ https://www.ncbi.nlm.nih.gov/pubmed/27194875 http://dx.doi.org/10.4103/0973-029X.180970 |
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author | Srikant, N Yinti, Shanmukha Raviteja Baliga, Mohan Kini, Hema |
author_facet | Srikant, N Yinti, Shanmukha Raviteja Baliga, Mohan Kini, Hema |
author_sort | Srikant, N |
collection | PubMed |
description | A 64-year-old male farmer presented with a rapidly progressive swelling of the left mandible since 6 months. The swelling was firm to hard, diffuse, nontender, obliterating the vestibule with paresthesia of lower lip. The cone beam computed tomography imaging revealed an ill-defined, moth-eaten radiolucency with destruction of the buccal and lingual cortical plates. The rapid growth and aggressive behavior of the lesion coupled with guidance from the patient's previous reports from the incisional biopsy and fine needle aspiration cytology warranted a mandibular resection. Microscopic examination showed an encapsulated lesion situated in the connective tissue containing a mixture of proliferating spindle-shaped cells arranged in fascicles and round cells infiltrating into the connective tissue stroma and bone. The neoplastic cells exhibited atypical features such as pleomorphism, hyperchromatism and increased mitotic figures with noncleaved nuclei. A working diagnosis of a spindle-cell sarcoma was arrived at with various differentials provided such as fibrosarcoma, rhabdomyosarcoma, leiomyosarcoma, malignant peripheral nerve sheath tumor, Langerhans cell histiocytosis and lymphoma and stating the need for immunohistochemistry to subtype the tumor. The neoplastic cells were negative for Van Gieson's stain and Masson's trichrome. Immunohistochemical analysis performed using desmin, smooth muscle actin, S-100 and CD1a in a bid to determine the phenotype of the tumor and rule out the previously stated differentials were all negative for the lesion. Lymphoid markers such as leukocyte common antigen and CD20 (cluster differentiation marker for B-cells) showed positivity in spindle-shaped cells as well as round cells indicating the tumor to be a lymphoproliferative lesion of B-cell type. A final diagnosis of “spindle-cell variant of non-Hodgkin's lymphoma” was rendered based on the immunohistochemical profile. |
format | Online Article Text |
id | pubmed-4860914 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2016 |
publisher | Medknow Publications & Media Pvt Ltd |
record_format | MEDLINE/PubMed |
spelling | pubmed-48609142016-05-18 A rare spindle-cell variant of non-Hodgkin's lymphoma of the mandible Srikant, N Yinti, Shanmukha Raviteja Baliga, Mohan Kini, Hema J Oral Maxillofac Pathol Case Report A 64-year-old male farmer presented with a rapidly progressive swelling of the left mandible since 6 months. The swelling was firm to hard, diffuse, nontender, obliterating the vestibule with paresthesia of lower lip. The cone beam computed tomography imaging revealed an ill-defined, moth-eaten radiolucency with destruction of the buccal and lingual cortical plates. The rapid growth and aggressive behavior of the lesion coupled with guidance from the patient's previous reports from the incisional biopsy and fine needle aspiration cytology warranted a mandibular resection. Microscopic examination showed an encapsulated lesion situated in the connective tissue containing a mixture of proliferating spindle-shaped cells arranged in fascicles and round cells infiltrating into the connective tissue stroma and bone. The neoplastic cells exhibited atypical features such as pleomorphism, hyperchromatism and increased mitotic figures with noncleaved nuclei. A working diagnosis of a spindle-cell sarcoma was arrived at with various differentials provided such as fibrosarcoma, rhabdomyosarcoma, leiomyosarcoma, malignant peripheral nerve sheath tumor, Langerhans cell histiocytosis and lymphoma and stating the need for immunohistochemistry to subtype the tumor. The neoplastic cells were negative for Van Gieson's stain and Masson's trichrome. Immunohistochemical analysis performed using desmin, smooth muscle actin, S-100 and CD1a in a bid to determine the phenotype of the tumor and rule out the previously stated differentials were all negative for the lesion. Lymphoid markers such as leukocyte common antigen and CD20 (cluster differentiation marker for B-cells) showed positivity in spindle-shaped cells as well as round cells indicating the tumor to be a lymphoproliferative lesion of B-cell type. A final diagnosis of “spindle-cell variant of non-Hodgkin's lymphoma” was rendered based on the immunohistochemical profile. Medknow Publications & Media Pvt Ltd 2016 /pmc/articles/PMC4860914/ /pubmed/27194875 http://dx.doi.org/10.4103/0973-029X.180970 Text en Copyright: © 2016 Journal of Oral and Maxillofacial Pathology http://creativecommons.org/licenses/by-nc-sa/3.0 This is an open access article distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 3.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as the author is credited and the new creations are licensed under the identical terms. |
spellingShingle | Case Report Srikant, N Yinti, Shanmukha Raviteja Baliga, Mohan Kini, Hema A rare spindle-cell variant of non-Hodgkin's lymphoma of the mandible |
title | A rare spindle-cell variant of non-Hodgkin's lymphoma of the mandible |
title_full | A rare spindle-cell variant of non-Hodgkin's lymphoma of the mandible |
title_fullStr | A rare spindle-cell variant of non-Hodgkin's lymphoma of the mandible |
title_full_unstemmed | A rare spindle-cell variant of non-Hodgkin's lymphoma of the mandible |
title_short | A rare spindle-cell variant of non-Hodgkin's lymphoma of the mandible |
title_sort | rare spindle-cell variant of non-hodgkin's lymphoma of the mandible |
topic | Case Report |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4860914/ https://www.ncbi.nlm.nih.gov/pubmed/27194875 http://dx.doi.org/10.4103/0973-029X.180970 |
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