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Delayed diagnosis of oral lymphoma: a case series

British Dental Journal volume 234, pages 151–154 (2023)Cite this article

A Correction to this article was published on 10 March 2023

This article has been updated

Abstract

Lymphomas are the second most common neoplasm in the head and neck. The clinical and radiographic presentation of non-Hodgkin lymphoma in the oral cavity is non-specific and can be hard to differentiate from other common infectious or inflammatory conditions. We report four cases of lymphoma of the head and neck, which presented as odontogenic infection, osteomyelitis, or cutaneous infection, and subsequently led to a delay in provision of appropriate treatment. Correlation between clinical, radiographic and histological findings is essential in reaching an accurate diagnosis. It is important for clinicians to consider malignant lesions, such as lymphoma, in the differential diagnosis of pain, swelling, tooth mobility or radiographic radiolucencies. Clinicians should maintain a high level of suspicion for malignancy when inflammatory lesions fail to respond to normal modes of treatment.

Key points

  • Oral lymphomas are the second most common neoplasm in the head and neck after squamous cell carcinoma.

  • Clinical presentation of non-Hodgkin lymphoma is variable and difficult to differentiate from odontogenic infections.

  • Delayed diagnosis of oral lymphoma can adversely affect patients' prognosis.

  • Clinicians should maintain a high level of suspicion for malignancy when inflammatory lesions fail to respond to normal modes of treatment.

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Acknowledgements

To the Oral and Maxillofacial Surgery Departments of Norfolk and Norwich University Hospital and James Paget University Hospital.

The authors declare no conflicts of interest.

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Authors and Affiliations

  1. Norfolk and Norwich University Hospitals NHS Foundation Trust, Colney Lane, Norwich, NR4 7UY, United Kingdom

    Sophie Mills, Richard Sisson & Sharon Prince

  2. James Paget University Hospitals NHS Foundation Trust, Lowestoft Road, Gorleston-on-Sea, Great Yarmouth, NR31 6LA, United Kingdom

    Evaldas Lukosevicius

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  1. Sophie Mills
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  2. Evaldas Lukosevicius
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Contributions

Sophie Mills, Evaldas Lukosevicius, Richard Sisson and Sharon Prince contributed equally to the manuscript, with Sophie Mills writing the first draft and all authors participating in the editing process and approving the final version.

Corresponding author

Correspondence to Sophie Mills.

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Written consent to publish was obtained from all four participants for inclusion of their radiographic/clinical images and personal information.

Additional information

The original online version of this article was revised.

When this article was originally published, the caption for Figure 1 incorrectly referenced the lower left second molar/third molar instead of the lower right second molar/third molar. The correct figure caption is included below:

Fig. 1 An OPG radiograph showing diffuse radiolucency around the roots of the lower right second molar with loss of the lamina dura and widening of the periodontal ligament space. The extraction socket is visible following removal of the lower right third molar, initially thought to be the cause of the symptoms.

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Mills, S., Lukosevicius, E., Sisson, R. et al. Delayed diagnosis of oral lymphoma: a case series. Br Dent J 234, 151–154 (2023). https://doi.org/10.1038/s41415-023-5462-0

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