PMC7757333_01
extraoral presence of a palpable right submandibular lymphadenopathy (A,B) and intraoral ulcerated and budding right gingivo-mandibular lesion extending throughout the mandibular crest and evolving for 1 month (C,D)
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F1
The extra oral clinical examination revealed the presence of one palpable right submandibular lymph node greater than 1 cm and having a firm consistency (Figure 1, A,B). This lesion extended throughout the right mandibular crest and had been evolving for 1 month, according to the patient (Figure 1, C,D).
craniofacial CT-scan: axial sections, narrow window
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F2
The neurological examination revealed a unilateral labial-chin hypoaesthesia suggestive of malignancy. The craniofacial CT scan examination revealed an infiltration of the right lateral mandibular soft tissues associated with a poorly-limited osteolytic lesion affecting the mandibular crest in relation to the floating tooth 45 (Figure 2).
histological and immunohistochemical examinations leading to the diagnosis of large B-cell lymphoma; presence of large tumour cells having clear and abundant cytoplasm with nuclei showing several marked atypias (A,B). The mitoses and the apoptotic bodies were quite numerous; the tumour was the site of important necrotic changes, the tumour cells strongly expressed CD20 (C); they did not express CD3 (D) and CK (E)
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F3
They did not express CD3 and CK (Figure 3).
PMC7757333_02
extraoral slight swelling on the left cheek + left palpable cervical lymphadenopathy with sensation of hypoaesthesia along the path of the left inferior alveolar nerve (A,B) and intraoral extended gingival mass ranging from the 34 to 38 with terminal dental mobility (C)
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F4
The extraoral clinical examination revealed the presence of palpable left cervical lymphadenopathy with normal mouth opening (Figure 4, A,B). The intraoral examination showed an extensive gingival mass ranging from teeth 34 to 37 with terminal dental mobilities evolving for 3 weeks (Figure 4C).
panoramic X-ray invasion of the teeth furcation and bone lysis in the left molar region (B) and abdominal CT-scan (B,C): axial sections, narrow window: tumour mass of the ileocecal junction associated with peritoneal carcinomatosis, presence of multiple mediastinal lymphadenopathies
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F5
The radiological examination revealed the presence of a bone destruction involving teeth furcation in the left molar region (Figure 5A). The abdominal CT scan evoked a tumoural mass of the ileocecal junction associated with a peritoneal carcinomatosis as well as multiple mediastinal lymph nodes, the largest of which measured 31*21mm (Figure 5,B,C).
oral biopsy: left mandibular attached gingiva in the swelling next to the premolars (A,B); histological and immunohistochemical examinations leading to the diagnosis of Burkitt s lymphoma (C,D,E,F,G); presence of a lymphomatous proliferation of diffuse architecture consisting of small to medium lymphocytes, with basophilic cytoplasm with too many mitoses (A,B); the lymphocytes were of phenotype B expressing markers CD20 (+) (E) and heterogeneous Bcl6 (F); the tumour proliferation index Ki67 was 100% (G)
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F6
A biopsy of the oral lesion was performed (Figure 6, A,B) and the patient was surgically operated for his abdominal tumour in the general surgery department. The tumour proliferation index Ki67 was 100% (Figure 6 C,D,E,F,G).