AIMS: To bring to wider attention this uncommon, poorly understood entity which may closely resemble, clinically and morphologically, follicular lymphoma. METHODS AND RESULTS: We report three cases of follicular lymphoid hyperplasia of the hard palate and oral mucosa which caused diagnostic difficulties for the referring pathologists. The clinicopathological features are described and integrated into a review of the 16 previously recorded cases. The condition most commonly presents as a slowly growing mass situated in the posterior hard palate but may present with multicentric oral lesions and lymphadenopathy. Morphologically, it is characterized by a dense follicular lymphoid infiltrate within the lamina propria which may show the classical features of benign reactive hyperplasia, but not uncommonly, indistinct germinal centres, ill-defined mantles and a lack of tingible-body macrophages are features which may lead to an erroneous diagnosis of follicular lymphoma. CONCLUSIONS: Follicular lymphoid hyperplasia of the palate is a poorly recognized entity which is frequently confused with follicular lymphoma. Awareness of the entity combined with the use of immunohistochemistry for immunoglobulin light chains and bcl-2 protein allows a correct diagnosis to be made avoiding extensive investigation and aggressive treatment to the patient.
AIMS: To bring to wider attention this uncommon, poorly understood entity which may closely resemble, clinically and morphologically, follicular lymphoma. METHODS AND RESULTS: We report three cases of follicular lymphoid hyperplasia of the hard palate and oral mucosa which caused diagnostic difficulties for the referring pathologists. The clinicopathological features are described and integrated into a review of the 16 previously recorded cases. The condition most commonly presents as a slowly growing mass situated in the posterior hard palate but may present with multicentric oral lesions and lymphadenopathy. Morphologically, it is characterized by a dense follicular lymphoid infiltrate within the lamina propria which may show the classical features of benign reactive hyperplasia, but not uncommonly, indistinct germinal centres, ill-defined mantles and a lack of tingible-body macrophages are features which may lead to an erroneous diagnosis of follicular lymphoma. CONCLUSIONS:Follicular lymphoid hyperplasia of the palate is a poorly recognized entity which is frequently confused with follicular lymphoma. Awareness of the entity combined with the use of immunohistochemistry for immunoglobulin light chains and bcl-2 protein allows a correct diagnosis to be made avoiding extensive investigation and aggressive treatment to the patient.
Authors: João Adolfo Costa Hanemann; Marina Lara de Carli; Ernesto Rabello Dendena; Carlos Eduardo Gomes do Couto Filho; Suzana Catanhede Orsini Machado de Sousa; Alessandro Antônio Costa Pereira; Fernanda Salgueiredo Giudice; Felipe Fornias Sperandio Journal: Oral Maxillofac Surg Date: 2017-10-25