Non-Hodgkin's Lymphoma of the Tongue Presenting as an Ulcerative Lesion

♦Corresponding Author: Negar Azarpira, MD Transplant Research Center, Pathology Department, Shiraz University of Medical Sciences, Shiraz, Iran Tel/fax:+98-711-6474331 Email:[email protected] Introduction The most common malignancy in the oral cavity is squamous cell carcinoma; however, malignant lymphoma may occur in the lymphoid tissue of Waldeyer's ring, the gingival area, buccal mucosa or palate. The typical clinical presentation is that of a soft, bulky mass covered by normal or ulcerated mucosa. Microscopically, most cases are diffuse large B-cell lymphomas. Some have tropism to the overlying epithelium, which suggests that malignant lymphomas of this region share some of the characteristics of socalled mucosa-associated lymphoid tissue (MALT) lymphoma.1-3 Most head and neck non-Hodgkin’s lymphomas (NHL), including oral lesions, are of B cell origin; diffuse large cell is the most common type. An increasing number of AIDSrelated malignant lymphoma of the oral cavity of both B and T cell types have been reported, the former predominant.4,5 In contrast to lymphomas of the nasal/ nasopharyngeal region those of tonsil and tongue are nearly always negative for Epstein-Barr virus.6,7 The prognosis of NHL depends on the stage of the tumor, the Abstract Malignant lymphoma may occur in the oral cavity and oropharynx, but is most commonly located in Waldeyer's ring, particularly in the palatine and lingual tonsil. The occurrence of malignant lymphoma in the tongue is very rare. Clinical features are nonspecific ulcerative lesions that do not heal. In the literature, the majority of cases are non-Hodgkin’s lymphoma, diffuse large B cell type; however T-cell phenotype also may occur. We describe a 60-year-old man who presented with an ulcerative mass in the left lateral aspect of his tongue, unresponsive to medical therapy. After tissue biopsy, histopathological and immunohistochemical analyses confirmed a diagnosis of non-Hodgkin’s lymphoma, diffuse large B cell type..