Ulceration of the Palate: A case report of a rapidly increasing, painful ulceration of the palate, proven to be a B-call Lymphoma

Morrison, A., Lopes, V. and Mather, C. (2012) Ulceration of the Palate: A case report of a rapidly increasing, painful ulceration of the palate, proven to be a B-call Lymphoma. xxi Congress of the European Association for Cranio–Maxillo–Facial Surgery, Dubrovnik, Croatia, 11−15 September 2012.

Abstract

A case of a 37 year old Caucasian female referred to an Oral Surgery Department regarding a 5mm diameter ulcerated swelling in the hard palate located in the midline is reported. Following an inconclusive biopsy report the swelling rapidly increased in size so that it extended to the soft palate and had become painful. The patient then developed night sweats, was struggling to maintain an oral intake and had palpable lymphadenopathy on the right side. An urgent CT scan of the head, neck and thorax was ordered and the patient was admitted for further biopsies under general anaesthetic. The results of the biopsy were reported as a high grade large, diffuse B-cell Lymphoma and fluorescent in-situ hybridization confirmed the presence of EBV-encoded nuclear RNAs within the lymphoblasts. The CT scan showed a 2x1.5x1cm lesion over the right hard palate which extended into the nasal cavity. The patient‘s condition deteriorated and was readmitted for an emergency laparotomy following acute left sided abdominal pain, fever and increasing weight loss. This revealed a perforation of the splenic flexure of the large colon and on biopsy the presence of diffuse large B-cell lymphoma, with similar characteristics to the oral lesion was diagnosed. Diffuse large B-cell lymphoma is highly aggressive and should be considered in the differential diagnosis of the hard palate as it can cause systemic symptoms which will result in a poor prognosis.

• Item Type: Conference or Workshop Item
• Status: Published
• Refereed: Yes
• Glasgow Author(s) Enlighten ID: Mather, Mr Craig
• Authors: Morrison, A., Lopes, V., and Mather, C.
• College/School: College of Medical Veterinary and Life Sciences > School of Medicine, Dentistry & Nursing > Dental School