Case report: extranodal T-cell lymphoma (natural killer) mimicking a dentoalveolar abscess

IF 2 3区医学 Q2 DENTISTRY, ORAL SURGERY & MEDICINE

Oral Surgery Oral Medicine Oral Pathology Oral Radiology Pub Date : 2025-03-14 DOI:10.1016/j.oooo.2025.01.076

Núbia Rafaelle Oliveira de Meneses, Luciana Munhoz, Erika Antonia dos Anjos Ramos, Alice Souza Villar Cassimiro Fonseca, Lucila Massu Yoshizaki Akinaga Moreira, Daniela Miranda Richarte de Andrade Salgado, Claudio Costa

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Abstract

T-cell lymphoma (natural killer) is a malignant neoplasm rarely developing extranodal and may mimic odontogenic alterations in the maxillofacial region. A pheoderma 41-year-old woman came to the dental service complaining of painful orofacial symptoms and fever. Clinical examination revealed intra- and extra-oral swelling on the left cheek, marked mobility, and endodontic involvement of the ipsilateral upper molars. The primary diagnostic hypothesis was an acute dentoalveolar abscess, with an initial approach of antibiotic therapy. After 2 weeks, the patients’ pain complaint was persistent, and rapid progression of the facial edema was observed. A computed tomography scan was carried out, which showed an image with soft tissue density, promoting discontinuity of the anterior and lateral walls of the left maxillary sinus. The pathological examination revealed a malignant neoplasm, whose histological type characterizes extranodal T-cell lymphoma (ENKL) in the left maxillary sinus. The proposed treatment for this condition includes radiotherapy and chemotherapy.

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T细胞淋巴瘤（自然杀伤型）是一种恶性肿瘤，很少发生在结节外，可能会在颌面部模仿牙源性改变。一名患有嗜铬细胞淋巴瘤的 41 岁女性前来牙科就诊，主诉口面部疼痛症状和发烧。临床检查发现左侧脸颊口内外肿胀，活动度明显，同侧上磨牙受牙髓病影响。主要诊断假设是急性牙槽脓肿，最初采用抗生素治疗。两周后，患者的疼痛症状持续存在，面部水肿迅速加重。患者接受了计算机断层扫描，结果显示其左侧上颌窦的前壁和侧壁出现软组织密度增高和不连续。病理检查显示左上颌窦内有恶性肿瘤，其组织学类型为结节外 T 细胞淋巴瘤（ENKL）。该病的治疗方案包括放疗和化疗。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Oral Surgery Oral Medicine Oral Pathology Oral Radiology DENTISTRY, ORAL SURGERY & MEDICINE-

CiteScore

3.80

自引率

6.90%

发文量

1217

审稿时长

2-4 weeks

期刊介绍： Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology is required reading for anyone in the fields of oral surgery, oral medicine, oral pathology, oral radiology or advanced general practice dentistry. It is the only major dental journal that provides a practical and complete overview of the medical and surgical techniques of dental practice in four areas. Topics covered include such current issues as dental implants, treatment of HIV-infected patients, and evaluation and treatment of TMJ disorders. The official publication for nine societies, the Journal is recommended for initial purchase in the Brandon Hill study, Selected List of Books and Journals for the Small Medical Library.