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Rare case report of an aggressive follicular lymphoid hyperplasia in maxilla

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Abstract

Follicular lymphoid hyperplasia is a very rare though benign reactive process of an unknown pathogenesis that may resemble a follicular lymphoma, clinically and histologically. Oral reactive follicular hyperplasia (RFH) has been described on the hard or soft palate and at the base of the tongue. We describe here the first case of RFH presenting as an aggressive tumor on the right posterior side of the maxilla in a 24-year-old male patient. The lesion had a clinical evolution of 18 months and was noticed after the surgical extraction of the right third molar, although we cannot assume a cause-effect relation with that surgical event whatsoever. His medical history was unremarkable. Following an incisional biopsy, histological examination revealed lymphoid follicles comprised by germinal centers surrounded by well-defined mantle zones. The germinal centers were positive for Bcl-6, CD10, CD20, CD21, CD23, CD79a, and Ki-67, while negative for Bcl-2, CD2, CD3, CD5, and CD138. The mantle and interfollicular zones were positive for Bcl-2, CD2, CD3, CD5, CD20, and CD138. Both areas were diffusively positive for kappa and lambda, showing polyclonality. The patient underwent a vigorous curettage of the lesion with no reoccurrences at 36 months of follow-up. This case report demonstrates that morphologic and immunohistochemical analyses are crucial to differentiate RFH from follicular lymphoma, leading to proper management.

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Authors and Affiliations

  1. Department of Clinic and Surgery, School of Dentistry, Federal University of Alfenas, Rua Gabriel Monteiro da Silva, 700, Alfenas, MG, 37130-001, Brazil

    João Adolfo Costa Hanemann, Marina Lara de Carli & Carlos Eduardo Gomes do Couto Filho

  2. Department of Head and Neck Surgery, Bom Pastor Hospital, Rua Pres. Tancredo Neves, 500, Varginha, MG, 37014-460, Brazil

    Ernesto Rabello Dendena

  3. Department of Oral Pathology, School of Dentistry, University of Sao Paulo, Av. Prof. Lineu Prestes, 2227, Sao Paulo, SP, 05508-000, Brazil

    Suzana Catanhede Orsini Machado de Sousa

  4. Department of Pathology and Parasitology, Institute of Biomedical Sciences, Federal University of Alfenas, Rua Gabriel Monteiro da Silva, 700, Alfenas, MG, 37130-001, Brazil

    Alessandro Antônio Costa Pereira & Felipe Fornias Sperandio

  5. International Center for Research at A.C. Camargo Cancer Center, R. Professor Antônio Prudente, 211, Liberdade, São Paulo, SP, 01509-010, Brazil

    Fernanda Salgueiredo Giudice

Authors
  1. João Adolfo Costa Hanemann
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  2. Marina Lara de Carli
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  6. Alessandro Antônio Costa Pereira
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Correspondence to João Adolfo Costa Hanemann.

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All procedures performed in this study involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Declaration of Helsinki and its later amendments or comparable ethical standards.

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Hanemann, J.A.C., de Carli, M.L., Dendena, E.R. et al. Rare case report of an aggressive follicular lymphoid hyperplasia in maxilla. Oral Maxillofac Surg 21, 475–481 (2017). https://doi.org/10.1007/s10006-017-0661-y

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  • DOI: https://doi.org/10.1007/s10006-017-0661-y

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