Hodgkin and non-Hodgkin lymphoma of the head and neck: clinical, pathologic, and imaging evaluation.

Epstein-Barr virus (EBV) is ubiquitous: over 90% of the adult population is infected with this virus. EBV is capable of infecting both B lymphocytes and epithelial cells throughout the body including the head and neck region. Transmission occurs mainly by exchange of saliva. The infection is asymptomatic or mild in children but, in adolescents and young adults, it causes infectious mononucleosis, a self-limiting disease characterized by lethargy, sore throat, fever and lymphadenopathy. Once established, the virus often remains latent and people become lifelong carriers without experiencing disease. However, in some people, the latent virus is capable of causing malignant tumours, such as nasopharyngeal carcinoma and various B- and T-cell lymphomas, at sites including the head, neck and oropharyngeal region. As lymphoma is the second-most common malignant disease of the head, neck and oral region after squamous cell carcinoma, oral health care workers including dentists and specialists have a responsibility to carry out a thorough clinical examination of this anatomical region with a view to identifying and diagnosing lesions that may represent lymphomas. Early detection allows early treatment resulting in better prognosis. The focus of this review is on the morphology, transmission and carcinogenic properties of EBV and clinical and diagnostic aspects of a range of EBV-associated malignancies occurring in the head, neck and oral region. As carcinogenic agents, viruses contribute to a significant proportion of the global cancer burden: approximately 15% of all human cancers, worldwide, are attributable to viruses.1,2 Serologic and epidemiologic studies are providing mounting evidence of an etiologic association between viruses and head and neck malignancies.3 To update oral and maxillofacial surgeons and oral medicine specialists and raise awareness of this association, we recently reviewed the evidence of the etiologic role of human papillomavirus in oral disease.4 In this paper, we review the current state of knowledge of the association of Epstein-Barr virus (EBV) with malignant diseases in the head and neck region.

Evidence of epstein-barr virus association with head and neck cancers: a review.

Non-Hodgkin's lymphomas are a group of neoplasms that originate from the cells of the lymphoreticular system. Forty percent of non-Hodgkin's lymphomas arise from extra nodal sites. Non-Hodgkin's lymphomas detected primarily in the bone are quite rare, but among jaw lesions, they are more frequently present in the maxilla than in the mandible. There are no classical characteristic clinical features of lymphomas involving the jaw bones. Swelling, ulcer or discomfort may be present in the region of the lymphoma, or it may mimic a periapical pathology or a benign condition. Though non-Hodgkin's lymphomas have been reported in all age groups, they generally affect the elderly, particularly males. Primary non-Hodgkin's lymphomas of the bone can be effectively managed by chemotherapy, with or without radiotherapy. We report a case of a large B-cell lymphoma of the mandible, in which the patient presented with a diffuse swelling on the right body of the mandible. A subsequent biopsy and immunohistochemistry were instrumental in this diagnosis. After finding no metastasis to other sites, the patient was treated with chemotherapy. The swelling regressed completely following the chemotherapy regimen, with no sign of recurrence observed over the last eighteen months.

/pdf/diffuse-large-b-cell-lymphoma-of-mandible-a-case-report-5erhlur3s0.pdf

Diffuse large B-cell lymphoma of mandible: a case report.

https://www.neuroimaging.theclinics.com/article/S1052-5149(03)00042-X/pdf

Malignant tumors of the mandible and maxilla

Primary non-Hodgkins's lymphoma is a very uncommon lesion, accounting for 0.6% in jaws. As the lesions frequently resemble other disease such as chronic osteomyelitis, odontogenic or any secondary neoplasms, further evaluation and histopathologic examination allow early identification for appropriate treatment. The purpose of this case report is to describe a rare case of non-Hodgkin's lymphoma of the mandible, explore the diagnosis and workup based on immunohistochemistry.

Primary non-Hodgkin's lymphoma of the mandible.

An analysis of management of 546 cases of solitary thyroid nodules in an endemic area is presented. None of the evaluating procedures could effectively isolate benign from malignant disease. Of 508 cases considered clinically to be benign, 42 harboured malignancy on histological examination whereas of the 38 cases suspected clinically to be malignant, 21 were histologically benign. 131I-Thyroid scanning also lacked sensitivity in identifying malignant nodules since the prevalence of malignancy in cases which were 9cold9 (44/316) was not significantly different from that amongst the 9uniform9 cases (15/142). Fine-needle aspiration cytology, although the most sensitive and specific evaluating modality, did not decrease the number of operations for solitary thyroid nodules nor did it increase the incidence of malignancy amongst the operated cases, because of its limitations in differentiating benign from malignant follicular neoplasms. The conditions under which surgery was advocated are described.

https://pmj.bmj.com/content/postgradmedj/73/863/560.full.pdf

Management options for solitary thyroid nodules in an endemic goitrous area.

A case of an amebic liver abscess with unusual clinical manifestations is presented. A middle-aged male with an abscess in both lobes of the liver presented with obstructive jaundice due to pressure on the porta hepatis with stasis of the bile in the intrahepatic biliary radicals. The patient did not respond to repeated needle aspirations and thus required open drainage. Subsequently, the patient developed a biliary leak through the drainage sites, and an injection of contrast dye into the cavity revealed a communication between the abscess cavities and the biliary tree. The biliary leak stopped spontaneously, and the large cavities also closed completely during the followup period.

Amebic liver abscess with jaundice

A case report of isolated involvement of the mandible by non-Hodgkin lymphoma is presented The patient presented with a non-healing ulcer following a tooth extraction Biopsy revealed an undifferentiated cancer Investigations failed to reveal any involvement of the organs A hemimandibulectomy was performed followed by radiotherapy on receipt of the histopathological diagnosis of non-Hodgkin lymphoma The patient is asymptomatic two and a half years after treatment

Isolated involvement of the mandible by non-Hodgkin's lymphoma.

A rare case of papillary carcinoma of the thyroid producing hyperthyroidism is presented. A young patients presented seven years after a thyroid operation with metastatic disease in the cervical lymph nodes and a history of deteriorating vision in the left eye. He also had a lesion in the base of the skull which could not be established to be metastasis from the thyroid cancer. There was clinical and biochemical evidence of hyperthyroidism. Radionuclide scan revealed uptake in the residual thyroid tissue and patchy uptake by the cervical lymph nodes. The patient underwent a complete thyroidectomy and radical neck dissection of the left side and 'berry-picking' of the lymph nodes on the right side. Although the patient became euthyroid post-operatively, his general condition deteriorated and he rapidly lost vision in both eyes before any ablative therapy could be instituted for the tumour in the base of the skull. The patient was lost to follow-up.

Hyperthyroidism due to papillary carcinoma of the thyroid--a case report.

A prospective randomized double blind study to evaluate the effect of infusion of amino acid enriched solution on changes in surface and core temperature under general anaesthesia

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