PMC4065453_01
Patient showing growth on right lower back region with extraoral swelling on right cheek region
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F1
On extraoral clinical examination, the swelling was located on the right mandibular region leading to facial asymmetry [Figure 1].
Ulcerative growth seen on the right buccal mucosa measuring about 5 x 6 cm in size extending anteroposteriorly from retromolar area to distal aspect of 46 region.
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F2
It was non-tender and fixed to underlying structures [Figure 2].
Increased intraoral growth after 2 months
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F3
An incisional biopsy was done along with the extraction of 46, 47 and 48 teeth under local anesthesia (2% Lignocaine with adrenalin, one in 80,000 dilution) and the specimen was submitted for histopathological evaluation [Figures 3 and 4].
Incisional biopsy specimen along with extracted 46, 47 and 48 teeth
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F4
An incisional biopsy was done along with the extraction of 46, 47 and 48 teeth under local anesthesia (2% Lignocaine with adrenalin, one in 80,000 dilution) and the specimen was submitted for histopathological evaluation [Figures 3 and 4].
Photomicrograph showing sheets of lymphoid cells (H&E stain, x400)
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F5
The connective tissue showed sheets of immature round tumor lymphoid cells of varying sizes and shapes, which were diffusely distributed in the connective tissue [Figure 5].
PMC4065453_02
Photomicrograph showing IHC positivity for CD45 with intense nuclear brown staining for cell membrane surface (IHC stain, x400)
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F6
The positivity was indicated by intense nuclear brown staining on cell membrane surface [Figure 6].
Photomicrograph showing negativity for CD20 staining (IHC stain, x400)
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F7
T-cell lineage and negative for CD20 confirming that it was not of B-cell lineage [Figures 7 and 8]. The final diagnosis was confirmed as "Extranodal Peripheral T-cell Non-Hodgkin's Lymphoma." Patient did not turn up for 2 months after the histological diagnosis.
Photomicrograph showing small cell T-lymphocytes positive for CD3 with intense nuclear brown staining for cell membrane surface (IHC stain, x400)
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F8
T-cell lineage and negative for CD20 confirming that it was not of B-cell lineage [Figures 7 and 8]. The final diagnosis was confirmed as "Extranodal Peripheral T-cell Non-Hodgkin's Lymphoma." Patient did not turn up for 2 months after the histological diagnosis.