PMC7155859_01
Intra-oral view. Clinical views of the lesion with (a) and without (b) the removable prosthesis. These views show a nodulary sessile mass on soft palate with inflammatory aspect on the surface and related to the prosthetic edge.
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F1
An 81-year-old female patient was referred by her dentist for teeth extractions and evaluation of a palatal swelling (Fig. 1). This hyperplasia consisted of a sessile lesion with an overlying mucosa devoid of any ulceration or inflammation (Fig. 1).
Microscopical views. Slides 2a (hematoxylin-eosin staining (HE), x 4) and 2b (HE, x 40) showing proliferation of lymphoid cells of small sizes (centrocytes) and of 10 to 15 of big sizes cells (centroblast) by field of view organized in follicular architecture and without tangible body macrophages; oral mucosa is covered by a normal malpighian epithelium; slide 2c (immunochemistry, x 4) shows a strong positivity to CD20 antibody compatible with B cells infiltration.
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F2
This lymphoid proliferation was represented by small-sized lymphoid cells (centrocytes) combined with some bigger cells (10 - 15 centroblasts by field of view with x 40 magnification) (Fig. 2a, b). Immunostaining was positive for cluster designation 20 (CD20), therefore confirming the B nature of this tumoral proliferation (Fig. 2c).
The 18-FDG PET-scanner of case 1. In cephalic region, we note a focal hyperfixation into the right palate which can correspond to a post-operative inflammation. In the thoraco-abdomino-pelvic region, there are two clavicular, one mesenteric and one right inguinal nodes.
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F3
PMC7155859_02
Clinical and radiological presentation of case 2. No dental infection in relation to buccal swelling (b) is observed on panoramic X-ray (a).
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F4
Her dentist initially suspected a dental infection leading to the endodontic treatment of the first left lower molar (Fig. 4a). The overlying mucosa had a healthy appearance and palpation revealed a submucosal mass of elongated shape and firm consistency (Fig. 4b).
Facial magnetic resonance imaging (MRI) of case 2. Axial slice through mandibular body showing an elongated and well limited mass (*) slightly enhanced by gadolinium in T1 weighted image and laying in the buccal corridor against the buccal cortex.
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F5
Microscopical views of case 2. (a) Lymphoid proliferation clustered into identifiable nodules (HE, x 4). (b) Centroblast cells are mainly observed in the field of view with many mitoses (HE, x 40).
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F6
Histopathological examination revealed a grade 3B follicular lymphoma (Fig. 6).