Peripheral T-cell lymphoma with gingival enlargement in CLL patient
Journal name: Journal of Indian Society of Periodontology
Original article title: Peripheral T-Cell lymphoma manifested as gingival enlargement in a patient with chronic lymphocytic leukemia
The Journal of Indian Society of Periodontology (JISP) publishes original scientific articles on periodontology (the study of supporting structures of teeth) and oral implantology. It is a bimonthly open-access journal with special issues for specific occasions.
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Original source:
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Aravind Buddula, Daniel Assad
Journal of Indian Society of Periodontology:
(A bimonthly open-access journal)
Full text available for: Peripheral T-Cell lymphoma manifested as gingival enlargement in a patient with chronic lymphocytic leukemia
Year: 2011 | Doi: 10.4103/0972-124X.82272
Copyright (license): CC BY-NC-SA
Summary of article contents:
Introduction
Chronic lymphocytic leukemia (CLL) is the most prevalent form of leukemia in adults and is characterized by the accumulation of CD5+ B lymphocytes in various body compartments. While CLL increases the risk of developing concurrent malignancies, the occurrence of T-cell lymphomas in patients with CLL is rare. This case report describes an unprecedented instance of peripheral T-cell lymphoma presenting on the gingiva of a patient with a history of CLL, emphasizing the need for vigilance and collaboration among healthcare professionals in managing such complex cases.
Unforeseen Malignancy: The Case of Peripheral T-Cell Lymphoma in a CLL Patient
A 66-year-old man with a history of CLL presented with gingival swelling in the upper left posterior sextant and underwent an incisional biopsy. Histopathological evaluation revealed a proliferation of large atypical lymphoid cells, which tested positive for T-cell markers such as CD2, CD3, TIA-1, and Granzyme B, leading to a diagnosis of peripheral T-cell lymphoma. Following the diagnosis, comprehensive imaging tests disclosed extensive disease involvement, prompting the initiation of chemotherapy treatment. Remarkably, the patient responded well to the therapy, with both the T-cell lymphoma and CLL appearing to be in remission.
Conclusion
This case underlines a significant yet rare association between CLL and peripheral T-cell lymphoma, highlighting the importance of multi-disciplinary collaboration in diagnosis and treatment. The prompt recognition of suspicious oral lesions and subsequent timely interventions can significantly affect patient outcomes. Given the unique nature of this case, it contributes essential knowledge to the existing literature regarding hematologic malignancies and their manifestations in the oral cavity, advocating for a thorough approach when assessing similar presentations in patients with underlying leukemias.
FAQ section (important questions/answers):
What is the primary type of leukemia discussed in the case report?
Chronic lymphocytic leukemia (CLL) is the primary type discussed, which is the most common form of leukemia in adults, characterized by the accumulation of CD5+ B lymphocytes.
What unique condition was found in the patient with CLL?
The case report presents a unique occurrence of peripheral T-cell lymphoma on the gingiva of a patient previously diagnosed with CLL, which has not been widely reported in the literature.
What initial symptoms led to the diagnosis of T-cell lymphoma?
The patient experienced swelling in the upper left posterior sextant. An incisional biopsy revealed a proliferation of atypical cells consistent with peripheral T-cell lymphoma.
How was the T-cell lymphoma treated in this case?
The patient underwent three cycles of chemotherapy with carboplatin and etoposide, leading to a good response, with both the peripheral T-cell lymphoma and CLL appearing to be in remission.
What role did the dental professionals play in the diagnosis?
The general dentist's referral and the periodontist's decision to biopsy a suspicious lesion were crucial for early diagnosis and timely intervention, significantly reducing the patient’s morbidity.
Glossary definitions and references:
Scientific and Ayurvedic Glossary list for “Peripheral T-cell lymphoma with gingival enlargement in CLL patient”. This list explains important keywords that occur in this article and links it to the glossary for a better understanding of that concept in the context of Ayurveda and other topics.
1) Swelling:
Swelling refers to the enlargement of tissue, which in this case is significant in the oral cavity, specifically on the gingiva of a patient with chronic lymphocytic leukemia (CLL). This symptom led to further investigation and was ultimately identified as peripheral T-cell lymphoma, indicating an independent pathology distinct from CLL.
2) Blood:
Blood is a central component in understanding leukemias like chronic lymphocytic leukemia (CLL). The disease results from the abnormal proliferation of white blood cells in the blood, disrupting normal functions. Evaluating blood components such as white blood cell count is crucial for diagnosis, monitoring progression, and determining treatments for CLL and associated malignancies.
3) Chemotherapy:
Chemotherapy is a treatment modality involving medications that target rapidly dividing cells, like cancer cells. In the discussed case, chemotherapy was administered to treat peripheral T-cell lymphoma and CLL after its diagnosis. The coordinated efforts of different specialists facilitated timely chemotherapy interventions, improving the patient's prognosis.
4) Disease:
The term disease encompasses chronic lymphocytic leukemia (CLL) and the concurrent dermatological condition in this case—peripheral T-cell lymphoma. Both are hematological malignancies, with CLL being a leukemia characterized by an accumulation of abnormal B lymphocytes, while peripheral T-cell lymphoma, a type of non-Hodgkin lymphoma, arises from T-lymphocytes and presents distinct clinical challenges.
5) Beta (Bēṭa, Beṭa):
In this context, Beta refers to the Beta-F1 antigen used in immunohistochemical studies to characterize the tumor cells. The presence of this antigen, among others in the biopsy, helped establish the diagnosis of peripheral T-cell lymphoma. Identifying tumor markers is crucial for understanding tumor behavior and guiding treatment strategies.
6) Accumulation (Accumulating, Accumulate):
Accumulation in relation to chronic lymphocytic leukemia (CLL) describes the buildup of CD5+ B lymphocytes in blood, bone marrow, and lymphoid tissues. This accumulation is central to CLL pathology, as it disrupts normal blood cell function, leading to complications like cytopenias and increasing the risk of developing secondary malignancies like lymphoma.
7) Viru (Vīṟu):
The term 'viru' likely references viruses, which are among the etiological factors associated with leukemias. While no specific viral connection was documented in the case report, understanding viral impacts on immune function and their potential role in malignancy development is essential in hematopathology, considering autoimmune interactions may influence disease progression.
Other Health Sciences Concepts:
Discover the significance of concepts within the article: ‘Peripheral T-cell lymphoma with gingival enlargement in CLL patient’. Further sources in the context of Health Sciences might help you critically compare this page with similair documents:
Chemotherapy, Bone loss, Incisional Biopsy, Chronic Lymphocytic Leukemia, Positron Emission Tomography, Histologic Evaluation, Gingival enlargement, T-cell lymphoma, Soft tissue swelling, B-cell chronic lymphocytic leukemia, Autoimmune hemolytic anemia, Median survival, Peripheral T-cell lymphoma, Mayo Clinic.