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Lymphomas in the head and neck region (HNR) can be a diagnostic challenge owing to their indistinctive oral manifestations that frequently mimic other pathologies. This case report highlights a young male who experienced spontaneous paraesthesia of his lower lip with an accompanied localized dull ache. Initial clinical examination and investigations were inconclusive. A definitive diagnosis of extranodal low-grade B-cell non-Hodgkin lymphoma (NHL) was only confirmed after the second incisional biopsy, which was 15 months after onset of symptoms. This report offers insight of NHL in the HNR and its clinical presentation. It aims to improve awareness amongst dental practitioners to aid early diagnosis.
CPD/Clinical Relevance: The reader should consider lymphomas as a differential diagnosis for unexplained symptoms, including paraesthesia, mucosal ulceration and soft tissue swelling.
Article
Lymphomas are malignant neoplastic proliferations of the lymphatic system.1 They can be divided into two entities: Hodgkin lymphoma (HL) and non-Hodgkin lymphoma (NHL), depending on the presence or absence of Reed-Sternberg cells, respectively. NHL comprises 90% of all cases, with over 20 different subtypes described in the World Health Organization (WHO) 2016 classification, according to the type of lymphoid cell involved.1,2,34 The majority of NHLs are derived from B-lymphocytes (85–90%), with the remaining arising from T-lymphocytes or natural killer (NK) cells.3 This large group of B-, T- or NK-cell neoplasms can also be subclassified according to their predicted clinical behaviour (Figure 1).5,6,7,8
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