ArticleSpecial care in dentistry : official publication of the American Association of Hospital Dentists, the Academy of Dentistry for the Handicapped, and the American Society for Geriatric Dentistry
Intraosseous Non-Hodgkin Lymphoma Mimicking a Periapical Lesion.
Article in Special care in dentistry : official publication of the American Association of Hospital Dentists, the Academy of Dentistry for the Handicapped, and the American Society for Geriatric Dentistry. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
introductionPeriapical radiolucent lesions are commonly of endodontic origin; however, some persistent cases may indicate non-endodontic pathologies, including malignancies. Diffuse large B-cell lymphoma (DLBCL) is the most prevalent subtype of lymphoma affecting the oral and maxillofacial region, yet its primary occurrence in the jaws is rare. This case report highlights the diagnostic challenges in differentiating endodontic lesions from periapical lymphomas and includes a literature review of documented cases. CASE REPORT: A 44-year-old male presented with a persistent periapical lesion in the anterior maxilla, unresponsive to endodontic and periodontal treatments. Clinical examination revealed facial asymmetry, gingival edema, palatal swelling, and dental mobility. Imaging showed an ill-defined hypodense lesion extending beyond the periapical region. Fine needle aspiration and incisional biopsy confirmed DLBCL through histopathology and immunohistochemistry. The patient underwent six cycles of R-CHOP chemotherapy.
resultsAfter treatment, intraoral examination revealed mucosal integrity, absence of swelling, and stabilization of dental mobility. Cone-beam computed tomography demonstrated bone regeneration, and PET/CT imaging confirmed complete remission.
conclusionThis case underscores the importance of considering malignancies in the differential diagnosis of persistent periapical lesions. Accurate clinicoradiographic assessment, histopathological confirmation, and interdisciplinary collaboration are essential for timely diagnosis and improved patient outcomes.
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