模仿牙髓治疗导致的根尖周病变的白血病和淋巴瘤：系统综述。

IF 3.5 2区医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE

Journal of endodontics Pub Date : 2025-02-01 DOI:10.1016/j.joen.2024.11.005

Isis Samara de Melo Queiroga DDS , Victor Zanetti Drumond DDS , Lucas Guimarães Abreu DDS, MSc, PhD , Lauren Frenzel Schuch DDS, MSc, PhD , Ricardo Alves Mesquita DDS, MSc, PhD , Erick Miranda Souza DDS, MSc, PhD , Bruno Augusto Benevenuto de Andrade DDS, MSc, PhD , José Alcides Almeida de Arruda DDS, MSc, PhD , Gerhilde Callou Sampaio DDS, MSc, PhD

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引用次数: 0

摘要

导言：白血病和淋巴瘤模仿根尖周病症可导致重大诊断误区。牙髓病学家在处理此类病例时几乎没有任何指导。本系统综述旨在总结模仿根尖周病变并导致牙髓治疗的白血病/淋巴瘤的临床病理学、影像学和管理方面的内容：方法：在 PubMed、Embase、Scopus、Web of Science 和 LILACS 中进行检索，并辅以人工仔细检查和灰色文献。其中包括病例报告和/或系列病例。使用乔安娜-布里格斯研究所（Joanna Briggs Institute）的工具对研究进行了严格评估：在已确定的 3,617 条记录中，共纳入了 32 项研究，涉及 37 名患者（平均年龄 43.6 岁；男女比例 1.2:1）。21人（56.8%）被诊断为弥漫大B细胞淋巴瘤。上颌骨前部和下颌骨后部是最常受影响的部位（各占 29.7%）。从X光片上看，97.3%的病变在根尖周围区域有放射线。94.6%的病例在确诊白血病/淋巴瘤之前接受了牙髓治疗，5.4%的病例接受了再治疗。最终确诊的平均时间为 4.9 个月：结论：白血病和淋巴瘤可能会被误诊为根尖周炎，从而导致不恰当的牙髓治疗和延误诊断。牙髓病学家应该熟悉这些罕见但可能危及生命的血淋巴样恶性肿瘤的广泛临床放射谱。

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Leukemia and Lymphoma Mimicking Periapical Conditions Resulting in Endodontic Treatment: A Systematic Review

Introduction

Leukemia and lymphoma mimicking periapical conditions can lead to significant diagnostic pitfalls. Guidance for endodontists in managing such cases is barely explored. This systematic review aimed to summarize the clinicopathologic, imaging, and management aspects of leukemia/lymphoma that mimicked periapical conditions and resulted in endodontic treatment.

Methods

Searches were conducted in PubMed, Embase, Scopus, Web of Science, and LILACS, supplemented by manual scrutiny and gray literature. Case reports and/or case series were included. Critical appraisal of the studies was performed using the Joanna Briggs Institute tool.

Results

Among 3,617 identified records, 32 studies involving 37 individuals (mean age 43.6 years; male-to-female ratio 1.2:1) were included. Diffuse large B-cell lymphoma was diagnosed in 21 (56.8%) individuals. The anterior maxilla and posterior mandible were the most frequently affected sites (29.7% each). Radiographically, 97.3% of the lesions exhibited radiolucency in the periapical region. Endodontic treatment preceded the diagnosis of leukemia/lymphoma in 94.6% of cases, while retreatment occurred in 5.4%. The mean time to final diagnosis was 4.9 months.

Conclusion

Leukemia and lymphoma can be misdiagnosed as periapical conditions, leading to inappropriate endodontic treatments and delayed diagnoses. Endodontists should become familiar with the broad clinicoradiographic spectrum of these rare, but potentially life-threatening hematolymphoid malignancies.

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来源期刊

Journal of endodontics 医学-牙科与口腔外科

CiteScore

8.80

自引率

9.50%

发文量

224

审稿时长

42 days

期刊介绍： The Journal of Endodontics, the official journal of the American Association of Endodontists, publishes scientific articles, case reports and comparison studies evaluating materials and methods of pulp conservation and endodontic treatment. Endodontists and general dentists can learn about new concepts in root canal treatment and the latest advances in techniques and instrumentation in the one journal that helps them keep pace with rapid changes in this field.