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A Journal on Dentistry and Maxillofacial Surgery
Minerva Stomatologica 1999 September;48(9):397-402
Non-Hodgkin's lymphoma of the upper jaw. Case report
Bonaccorso A., Tripi T. R.
Lymphomas are primitive neoplasias of the lympho-reticular system and are classified into two principal categories: Hodgkin's lymphoma (HL) and Non-Hodgkin's Lymphoma (NHL) each classified into low, medium and high grades, according to their clinical and cytological characteristics. The treatment and prognosis of such neoplasias vary according to the distribution of the illness and to the moment of initial diagnosis. In NHL, treatment depends prevalently on the histological subtype. Over the last few years it has been possible to associate to defined nosographic entities a characteristic phenotype, and to formulate a phenotypical classification of chronic lymphoproliferating illnesses. The classification of the Working Formulation subdivides lymphomas into groups of increasing malignancy. In histological sections, non-Hodgkins lymphomas are relatively homogeneous, uniformly cellular and dominated by malign lymphocytes. The symptomatology of NHL can vary according to the different location. The clinical manifestation of NHL can be in the form of swelling or ulceration. In contrast with lymphonodal lymphoma, in which the spread through blod to distant lymphonodal regions or extra lymphonodal areas is rapid, the extra lymphonodal ones show a clinical course of illness comparable with those of carcinomas. The authors present the case of a 89 year-old patient with an ulcerated, non painful swelling in the upper right alveolar maxillary region, showing slow development, soft consistency and indefinite edges; this lesion did not affected the normal physiological functions of the stomatognathic apparatus, thus explaining why the patient had noticed the appearance of the process two years prior to the visit but had not reported it. The pathological case-history shows traumas at the site of the lesions due to dentures. At the moment of the visit, the ortopathomographic examination of the upper and lower dental arch shows the presence of a lesion in the right maxillary region, radiographically opaque, with ill-defined margins and signs of continuity with the homolateral maxillary sinus.