Unusual gingival presentation of post-transplantation lymphoproliferative disorder: A case report and review of the literature

• Published in: Oral surgery, oral medicine, oral pathology, oral radiology and endodontics Vol. 90; no. 4; pp. 436 - 441
• Main Authors: Raut, Alexandra, Huryn, Joseph, Pollack, Alan, Zlotolow, Ian
• Format: Journal Article
• Language: English
• Published: St. Louis, MO Mosby, Inc 01.10.2000; Elsevier
• Subjects: Adult; Antibodies, Monoclonal - therapeutic use; Antibodies, Monoclonal, Murine-Derived; Antineoplastic Agents - therapeutic use; Biological and medical sciences; Bone Marrow Transplantation - adverse effects; Burkitt Lymphoma - etiology; Burkitt Lymphoma - pathology; Burkitt Lymphoma - therapy; Dentistry; Diagnosis, Differential; Facial bones, jaws, teeth, parodontium: diseases, semeiology; Gingival Neoplasms - etiology; Gingival Neoplasms - pathology; Gingival Neoplasms - therapy; Graft vs Host Disease - complications; Graft vs Host Disease - etiology; Humans; Immunosuppression - adverse effects; Lymphoma, Large B-Cell, Diffuse - etiology; Lymphoma, Large B-Cell, Diffuse - pathology; Lymphoma, Large B-Cell, Diffuse - therapy; Male; Medical sciences; Miscellaneous; Neoplasm Staging; Otorhinolaryngology. Stomatology; Rituximab; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Tumors; Human; Immunopathology; Stomatology; Male; Malignant hemopathy; Transplantation; Immune deficiency; Case study; Periodontal disease; Treatment; Surgery; Lymphoproliferative syndrome; Bone marrow; Adult; Complication; Graft; Gingiva; Bibliographic review; Organ
• ISSN: 1079-2104; 1528-395X
• DOI: 10.1067/moe.2000.107446

Post-transplantation lymphoproliferative disorder is a well-documented complication of solid organ or bone marrow transplantation. Histologically, it is characterized by an abnormal proliferation of lymphocytes, which can range from benign B-cell hyperplasia to malignant lymphoma. Non-Hodgkin’s lymphoma (NHL) is associated with several risk factors, such as congenital or acquired immunodeficiency states, autoimmune disorders, and infectious agents (eg, Epstein-Barr virus). Primary sites of presentation in the head and neck are Waldeyer’s ring, paranasal sinuses, salivary glands, the oral cavity, and the larynx. Clinical appearance of gingival NHL varies but is usually found to be an asymptomatic gingival enlargement or mass resembling a pyogenic granuloma. We present a patient with a gingival ulceration that was subsequently diagnosed as Epstein-Barr virus malignant lymphoma resulting from the immunosuppression needed to prevent graft-versus-host disease after bone marrow transplantation. (Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2000;90:436-41)