PMC6320604_01
Clinical aspects. Lip swelling and healing blister upon presentation
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Fig1
A 71-year old, female patient with a previous history of non-Hodgkin lymphoma and transient ischemic attack came to the emergency room of our University Hospital for sudden onset of right hemifacial paraesthesia, edema of the lower lip (Fig. 1) and accentuation of an already present tinnitus.
Lower lip biopsy
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Fig2
Thus, the patient was referred to the Dental Clinic, where a mucosal biopsy of the affected lower lip was performed (Fig. 2).
Histological aspects. a Lip biopsy showed the inflammatory infiltrate in the submucosa associated with numerous granulomas (H&E staining, magnification x25). b, c Higher magnification of the granulomas in the deep submucosa, showing giant cells and lymphoplasma cells, without non-caseating necrosis (H&E staining, magnification x80). d Giant cells of macrophage origin as confirmed by an antimacrophage antibody staining, CD68 (magnification x80)
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Fig3
The two aggregates of non-caseating granulomatous inflammation consisted of lymphocytes and epithelioid histiocytes, and few multinucleated giant cells, clustered around scattered vessels (Fig. 3).