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Oral follicular lymphoma: a clinicopathologic and molecular study

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Abstract

Follicular lymphoma is a hematolymphoid neoplasm that originates from germinal center B cells. It is made up of a combination of small cleaved centrocytes and a varying quantity of larger non-cleaved centroblasts to describe the clinical, microscopic, immunohistochemical, and molecular features of oral follicular lymphomas. Follicular lymphomas affecting the oral cavity were retrieved from pathology files. Immunohistochemistry was performed to confirm the diagnosis, and fluorescence in situ hybridization (FISH) was employed to detect rearrangements in BCL2, BCL6, and MYC genes. Clinical and follow-up data were obtained from the patient’s medical and pathology files. Twenty cases were obtained. There was an equal sex distribution (10 males: 10 females) and a mean age of 60.9 years (range: 10–83 years-old). Lesions presented as asymptomatic swellings, usually in the palate (10 cases) and the buccal mucosa (7 cases). Five patients presented with concomitant nodal involvement. Microscopic evaluation depicted the follicular growth pattern with diffuse areas in six cases. Grades 1 and 2 follicular lymphomas represented 12 cases, while grade 3A neoplasms accounted for other 8 cases. Two cases showed rearrangements in MYC, BCL2, and BCL6 genes, while single BCL2 translocation was found in eight cases. Two cases had no translocation. Three patients deceased and the 2-year overall survival achieved 88%. Follicular lymphoma affecting the oral cavity is uncommon, usually affects the palate as a non-ulcerated swelling and the presence of a systemic disease most always be ruled out.

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Data availability

The data that support the findings of this study are available from the corresponding author upon request.

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Funding

This study was supported by the São Paulo State Research Foundation (FAPESP #22/03123-5), the Minas Gerais State Research Foundation (FAPEMIG), the Rio de Janeiro State Research Foundation (FAPERJ), the National Council for Scientific and Technological Development (CNPq), and the Coordination for the Improvement of Higher Education Personnel (CAPES, 001).

Author information

Authors and Affiliations

  1. Oral Diagnosis Department, Piracicaba Dental School, University of Campinas, Piracicaba, Brazil

    Lucas Lacerda de Souza, Paulo Victor Mendes Penafort, Alan Roger Santos-Silva, Márcio Ajudarte Lopes & Pablo Agustin Vargas

  2. Department of Oral Surgery and Pathology, School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil

    Cinthia Veronica Bardález López de Cáceres, Maria Sissa Pereira Sant’Ana, Wagner Henriques de Castro, Ricardo Alves Mesquita, Silvia Ferreira de Sousa & Felipe Paiva Fonseca

  3. Department of Oral Diagnosis and Pathology, School of Dentistry, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil

    Bruno Augusto Benevenuto de Andrade

  4. Service of Oral Pathology, João de Barros Barreto University Hospital, Federal University of Pará, Belém, Brazil

    Hélder Antônio Rebelo Pontes

  5. Pathology Institute of Araçatuba and School of Medicine, Centro Universitário Católico Unisalesiano Auxilium, Araçatuba, Brazil

    José Cândido Caldeira Xavier-Júnior

  6. Getúlio Sales Diagnósticos, Natal, Brasil

    Ciro Dantas Soares

  7. Department of Oral and Maxillofacial Pathology, School of Dentistry, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa

    Liam Robinson & Willie F. P. van Heerden

  8. Laboratory of Molecular Biology, Ophir Loyola Hospital, Belém, Brazil

    Rommel Mario Rodríguez Burbano

  9. Multipat Anatomic Pathology and Molecular Pathology Laboratory, Campinas, Brazil

    Guilherme Rossi Assis-Mendonça & José Vassallo

  10. Collaborating Researcher Program, Department of Structural and Functional Biology, Institute of Biology, University of Campinas, Campinas, Brazil

    Guilherme Rossi Assis-Mendonça

Authors
  1. Lucas Lacerda de Souza
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  2. Cinthia Veronica Bardález López de Cáceres
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  3. Maria Sissa Pereira Sant’Ana
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  4. Paulo Victor Mendes Penafort
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  5. Bruno Augusto Benevenuto de Andrade
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  6. Hélder Antônio Rebelo Pontes
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  7. Wagner Henriques de Castro
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  8. Ricardo Alves Mesquita
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  9. José Cândido Caldeira Xavier-Júnior
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  10. Alan Roger Santos-Silva
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  11. Márcio Ajudarte Lopes
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  12. Ciro Dantas Soares
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  13. Liam Robinson
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  14. Willie F. P. van Heerden
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  15. Rommel Mario Rodríguez Burbano
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  16. Guilherme Rossi Assis-Mendonça
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  17. José Vassallo
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  18. Silvia Ferreira de Sousa
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  19. Pablo Agustin Vargas
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  20. Felipe Paiva Fonseca
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Contributions

Study concept and design: FPF. Data acquisition: LLS, CVBLC, MSPS, CDS, BABA, JCCXJ, LR, PAV, FPF. Data analysis and interpretation: LLS, CVBLC, MSPS, BABA, HARP, RAM, LR, WvH, RMRB, PAV, GRAM, FPF. Statistical analysis: LLS. Manuscript preparation: LLS, CVBLC, GRAM, FPF. Manuscript editing: all authors. Manuscript review: all authors.

Corresponding author

Correspondence to Felipe Paiva Fonseca.

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Ethical approval

The study was approved by the Ethics Committee of the Piracicaba Dental School, University of Campinas, Piracicaba, Brazil (protocol no. 67128417.4.0000.5418) and the Ethics Committee of the Federal University of Minas Gerais, Belo Horizonte, Brazil (protocol no. 10723019.0.1001.514).

Consent for publication

Consent for publication was obtained for every individual person’s data included in the study.

Informed Consent

This work is covered by protocol approved by the Ethics Committee of the Piracicaba Dental School, University of Campinas, Piracicaba, Brazil (protocol no. 67128417.4.0000.5418) and the Ethics Committee of the Federal University of Minas Gerais, Belo Horizonte, Brazil (protocol no. 10723019.0.1001.514) and it does not require informed consent due to the retrospective nature of the work and the lack of data that could potentially identify the patient.

Conflict of interest

The authors declare no competing interests.

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Souza, L.L., Cáceres, C.V.B.L., Sant’Ana, M.S.P. et al. Oral follicular lymphoma: a clinicopathologic and molecular study. J Hematopathol 16, 199–208 (2023). https://doi.org/10.1007/s12308-023-00563-6

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  • DOI: https://doi.org/10.1007/s12308-023-00563-6

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