A Case of Follicular Lymphoma in Which Lesions Were Also Found under the Tongue during Follow-up of Palate Lesion

Abstract

Malignant lymphomas can be challenging to diagnose due to their diverse clinical manifestations. Although rare, they can develop as extranodal lymphomas in the oral cavity. Here, we report the case of a 79-year-old woman who presented to our hospital with right-sided maxillary palatal swelling. Initial examination revealed a soft, elastic lesion that appeared hyperintense on T2-weighted magnetic resonance imaging. Biopsy suggested follicular lymphoma. She consulted a hematologist, but no definitive diagnosis of follicular lymphoma was obtained. The lesion was low-risk according to the Follicular Lymphoma International Prognostic Index and did not meet the Groupe d’Etude des Lymphomes Folliculaires criteria, so we decided to follow her up. Subsequently, a tumor was discovered on the floor of her mouth. Biopsies from both lesions led to a definitive diagnosis of follicular lymphoma. Non-Hodgkin’s lymphomas such as follicular lymphoma can present as localized, diffuse soft tissue swelling and are often asymptomatic. The diagnosis of non-Hodgkin’s lymphoma can be challenging due to its wide range of clinical presentations.
There are few reports of follicular lymphoma occurring with multiple oral lesions, but there are reports of progression to intermediate-grade lymphoma, suggesting the need for ongoing examinations and active surveillance in such cases.