A case of primary extranodal malignant lymphoma was reported, which manifested on the gingiva of left maxilla and arose on the gingiva of the mandible after seven years as another histological type.
A 59-year-old man visited the Department of Maxillofacial and Oral Surgery, Nagasaki University, Hospital of Medicine with the chief complaint of ulcer involving from the gingiva of left maxilla to left soft palate on 12 Sep.1975.
A biopsy confirmed malignant lymphoma, medium-sized cell type (L.S.G. classification), of the gingiva of left maxilla. Chemotherapy and irradiation (Tele 60Co) were performed, and significant improvement of the lesion was observed.
Following up for five years after the therapy, clinical investigation revealed complete remission of the lesion because of no recurrence and metastasis.
On 20 Dec.1982 the patient visited the Department of Maxillofacial and Oral Surgery, Nagasaki University, Hospital of Dentistry complaining of ulcer of the anterior mandibular gingiva. As malignat lymphoma was intensely suspected, a gingival biopsy was performed.
Histological diagnosis was malignant lymphoma, pleomorphic type (L.S.G. classification), of the gingiva. Chemotherapy and irradiation (Linac X-ray) were carried out, which caused disappearance of the gingival ulcer. Further chemotherapy was continued after transfer to the Department of Hematology, Atomic Disease Institute, Nagasaki University, Hospital of Medicine.
On 30 Mar.1983 malgnant lymphoma was found in the stomach, and the patient died of the advanced lymphoma on 23 May 1983.
Autopsy showed invasion of malignant lymphoma into bilateral lungs, stomach, spleen, pancreas, and lymph nodes of the lungs and abdomen. Lymphoma cell in pleural effusion had 67% of E-rosette forming cells, which suggested T-cell type malignant lymphoma.
