Follicular lymphoma of the maxilla as initial site of presentation

Follicular lymphomas represent one of the more common B-cell lymphomas, typically involving the lymph nodes. Extranodal presentation is uncommon with intraoral sites rarely involved. We present the case of a 55-year-old female who presented for evaluation of multiple periapical radiolucencies of the maxillary dentition. These teeth had all tested vital previously. She reported a long history of left-sided nasal congestion refractory to antibiotics and steroids but was otherwise healthy. She did not report any constitutional symptoms. On examination, diffuse gingival erythema and edema of the maxilla was noted in addition to the multiple periapical radiolucencies. A biopsy of the maxillary gingiva and vestibule revealed involvement by a CD10+ B-cell lymphoma, favored to represent follicular lymphoma. Treatment is pending medical workup of other potential sites of disease.