下顎骨骨髄から発生したと考えられた巨大な悪性リンパ腫の１例

Malignant lymphoma

北海道歯学会

北海道歯学雑誌

Malignant lymphoma arising in the mandible is extremely rare. In this study we report on a case of malignant lymphoma arising in the bone marrow of the mandible. The patient was a 59-year-old man. In September 2014, he noticed a swelling in the right parotid masseteric region. The swelling was getting bigger, and thereafter he visited an oral surgeon’s hospital in October, 2014. In the hospital, antibiotics were administered and he had the diagnosis of an odontogenic inflammation from clinical and imaging findings. The swelling was improved temporarily, but the symptom recurred soon. Other diseases, including lesions, were suspected. He was then referred to our hospital. At the first visit, an extra-oral examination showed facial asymmetry caused by the swelling and hypoesthesia of the right mental region and lower lip. An intraoral examination showed a mass under the right normal buccal mucosa. Contrast enhanced CT and an MRI showed irregular and punctate bone resorption in the cortical bone of the right mandible and uniformly enhanced soft tissue. PET-CT revealed an abnormal uptake in the right mandible region (SUV max : 22.5). In blood tests there were no apparent abnormalities. Biopsy of the tissue showed diffuse large B-cell lymphoma. He received chemotherapy with R-CHOP and irradiation at the department of hematology. He has remained in remission six months after treatment.