I got called down to the emergency clinic to take a look at "cancer". The patient was a 57-year-old male with mass on his posterior mandibular gingiva. It had been present for a "while". There was a recent history of rapid enlargement. No pain was associated with the lesion prior to the ulceration.
The patient appeared to be in good health otherwise. There was no history of tobacco usage.
The student taking care of the patient had put squamous cell carcinoma as the provisional diagnosis.
Intra-oral examination revealed an ulcerated mass approximately 30 x 12 mm in size on the right mandibular gingiva.
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| Plasmablastic lymphoma in a 57-year-old HIV positive male |
I agreed with the student, the mass did look scary. The patient was sent for a biopsy to the surgery clinics the same day. They performed an incisional biopsy.
The specimen exhibited features consistent with lymphoma. The case was discussed with the hematopathology people who rendered the final diagnosis of plasmablastic lymphoma (a type of non-Hodgkin's lymphoma) following immunohistochemical studies. That put the patient's HIV status into question (plasmablastic lymphoma is usually seen in patients with HIV). The patient was referred to an oncologist who ordered HIV tests, he tested positive!
He was put on chemotherapy and that's the last information I have on him.
He was put on chemotherapy and that's the last information I have on him.
Lymphoma:
Lymphoma is a malignancy that arises from lymphocytes. It is classified into two major types, Hodgkin's lymphoma and non-Hodgkin's lymphoma. Both types are seen over a wide age range. Hodgkin's lymphoma predominantly involved the lymph nodes. Non-Hodgkin's lymphoma most commonly involves extra-nodal structures, it rarely ever involves lymph nodes.
The prognosis varies with the type of lymphoma. Treatment options include chemotherapy and rarely radiotherapy.
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