Mantle cell lymphoma involving the oral and maxillofacial region: a study of 20 cases

Marcus Vinícius Ribeiro Carvalho; Carla Isabelly Rodrigues-Fernandes; Cinthia Veronica Bardález López de Cáceres; Ricardo Alves Mesquita; Manoela Domingues Martins; Elena María José Román Tager; Roman Carlos; Fábio Ramôa Pires; Liam Robinson; Willie F P van Heerden; Vitor Bonetti Valente; José Cândido Caldeira Xavier-Júnior; Daniel Galera Bernabé; Hélder Antônio Rebelo Pontes; Ciro Dantas Soares; Mauro Henrique Melo da Costa; Pablo Agustin Vargas; Felipe Paiva Fonseca

doi:10.1016/j.oooo.2022.08.018

Mantle cell lymphoma involving the oral and maxillofacial region: a study of 20 cases

Oral Surg Oral Med Oral Pathol Oral Radiol. 2023 Jan;135(1):101-109. doi: 10.1016/j.oooo.2022.08.018. Epub 2022 Sep 7.

Authors

Marcus Vinícius Ribeiro Carvalho¹, Carla Isabelly Rodrigues-Fernandes¹, Cinthia Veronica Bardález López de Cáceres¹, Ricardo Alves Mesquita², Manoela Domingues Martins³, Elena María José Román Tager⁴, Roman Carlos⁵, Fábio Ramôa Pires⁶, Liam Robinson⁷, Willie F P van Heerden⁷, Vitor Bonetti Valente⁸, José Cândido Caldeira Xavier-Júnior⁹, Daniel Galera Bernabé⁸, Hélder Antônio Rebelo Pontes¹⁰, Ciro Dantas Soares¹¹, Mauro Henrique Melo da Costa¹², Pablo Agustin Vargas¹³, Felipe Paiva Fonseca¹⁴

Affiliations

¹ Department of Oral Diagnosis, Piracicaba Dental School, University of Campinas, Piracicaba, Brazil.
² Department of Oral Surgery and Pathology, School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil.
³ Department of Oral Pathology, School of Dentistry, Federal University of Rio Grande do Sul, Porto Alegre, Brazil.
⁴ Department of Oral Diagnosis, Piracicaba Dental School, University of Campinas, Piracicaba, Brazil; Pathology Section, Centro Clínico de Cabeza y Cuello/Hospital Herrera Llerandi, Guatemala City, Guatemala.
⁵ Pathology Section, Centro Clínico de Cabeza y Cuello/Hospital Herrera Llerandi, Guatemala City, Guatemala.
⁶ Oral Pathology, Dental School, Rio de Janeiro State University, Rio de Janeiro, Brazil.
⁷ Department of Oral Pathology and Oral Biology, School of Dentistry, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa.
⁸ Oral Oncology Center, São Paulo State University (UNESP), School of Dentistry, Araçatuba, Brazil.
⁹ Pathology Institute of Araçatuba and School of Medicine, Centro Universitário Católico Unisalesiano Auxilium, Araçatuba, Brazil.
¹⁰ Oral Pathology Service, João de Barros Barreto University Hospital, Federal University of Pará, Belém, Brazil.
¹¹ Getúlio Sales Diagnósticos, Natal, Brazil.
¹² Private practice, Campinas, Brazil.
¹³ Department of Oral Diagnosis, Piracicaba Dental School, University of Campinas, Piracicaba, Brazil; Department of Oral Pathology and Oral Biology, School of Dentistry, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa.
¹⁴ Department of Oral Diagnosis, Piracicaba Dental School, University of Campinas, Piracicaba, Brazil; Department of Oral Surgery and Pathology, School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil; Department of Oral Pathology and Oral Biology, School of Dentistry, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa. Electronic address: Felipepfonseca@hotmail.com.

PMID: 36396588
DOI: 10.1016/j.oooo.2022.08.018

Abstract

Objective: To investigate the clinicopathologic features of mantle cell lymphoma (MCL) involving the oral and maxillofacial region.

Methods: The MCL cases were retrieved from the pathosis database of 6 pathology laboratories. Original hematoxylin and eosin slides and immunohistochemical reactions were reviewed for confirmation of the initial diagnosis. Clinical data of the cases were obtained from the patients' pathosis and/or medical charts.

Results: Twenty cases were included in the study, showing a male predominance and a mean age of 66 years. The oral cavity (12 cases) and the oropharynx (5 cases) were the most commonly involved subsites. Most cases presented as asymptomatic swellings, with 2 cases showing bilateral involvement of the palate. The classic histologic variant predominated (12/20 cases). All cases expressed CD20 with nuclear cyclin D1 positivity. SOX11 was seen in 9/13 cases, CD5 in 6/16 cases, Bcl2 in 16/19 cases, CD10 in 2/20 cases, and Bcl6 in 4/16 cases. Ki67 showed a mean proliferation index of 40.6%. The Epstein-Barr virus (EBV) was negative in all cases investigated. Follow-up data was available for 7 patients, with 5 currently alive and 2 deceased.

Conclusion: Mantle cell lymphoma, albeit rare, may manifest in the oral and maxillofacial region. Its histologic heterogeneity demands a high degree of diagnostic skill from pathologists.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Adult
Aged
Cyclin D1
Epstein-Barr Virus Infections*
Female
Herpesvirus 4, Human
Humans
Lymphoma, Mantle-Cell* / diagnosis
Lymphoma, Mantle-Cell* / pathology
Male

Substances

Cyclin D1