| Popis: |
Mucosa-associated lymphoid tissue (MALT) lymphoma is a subtype of non-Hodgkin's lymphoma of B-cells from the extranodal marginal zone of mucosa-associated lymphoid tissue, with rare manifestation in the oral cavity. A 69-year-old woman with a complaint of a sessile normochromic nodule, non-ulcerated surface with telangiectasias, approximately 2 cm in size, in the lower labial mucosa on the left side, firm and well defined on palpation, painless, with an evolution time of 1 month. The patient did not present with any cutaneous or systemic changes. The diagnostic hypothesis was a reactional lesion or a benign neoplasm, so an excisional biopsy was performed. The histopathologic examination revealed numerous lymphoid follicles of various sizes, with germinal centers and monomorphic proliferation of lymphocytes, suggesting reactive lymphoid hyperplasia or non-Hodgkins lymphoma. Immunohistochemical analysis was positive for CD20, CD 43, Bcl2, Kappa, Lambda, IgM and negative for CK AE1/AE3, CD3, CD5, CD10, CD23, BCL-6, cyclin D1 and CD 138. The positive Ki-67 ratio was about 20%. These findings associated with histopathologic characteristics were consistent with a primary MALT lymphoma. The patient was referred to an oncohematology physician. Biopsy analysis confirmed the neoplastic diagnosis with negative margins, ruling out surgical intervention and treatments with chemotherapy or radiation therapy. Primary presentation of MALT lymphoma in the oral cavity is very rare, data are scarce, and the characteristics and clinical outcome of the disease remain controversial. A review of the literature was conducted and 31 manuscripts were identified between 2004 and 2024. Only case reports and case series that included primary oral MALT lymphoma were used in this comparative analysis, with a total of 78 lesions. This case report and brief review demonstrate how rare the primary occurrence of MALT lymphoma in the oral cavity is and emphasize the importance of performing biopsies and anatomopathologic studies of oral lesions. |
