Periorbital non-Hodgkin's lymphoma after blunt trauma

The head and neck region is the second most common site for the development of extranodal lymphomas. Richter′s syndrome (RS) involves the transformation of B-cell chronic lymphocytic leukemia (B-CLL) to an aggressive lymphoma, most commonly, diffuse large B-cell lymphoma (DLBCL). We report the case...

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Published in:Oral surgery, oral medicine, oral pathology, oral radiology and endodontics oral medicine, oral pathology, oral radiology and endodontics, 2010-06, Vol.109 (6), p.e56-e59
Main Authors: Kriwalsky, Marcus Stephan, MD, DDS, Schroers, Roland, MD, PhD, Stricker, Ingo, MD, Hollstein, Stefan, Kunkel, Martin, MD, DDS, PhD
Format: Article
Language:English
Subjects:
Antibodies, Monoclonal - administration & dosage
Antibodies, Monoclonal, Murine-Derived
Antineoplastic Combined Chemotherapy Protocols
Cell Transformation, Neoplastic - pathology
Cyclophosphamide
Dentistry
Doxorubicin
Facial Injuries - pathology
Head and Neck Neoplasms - drug therapy
Head and Neck Neoplasms - pathology
Humans
Leukemia, Lymphocytic, Chronic, B-Cell - drug therapy
Leukemia, Lymphocytic, Chronic, B-Cell - pathology
Lymphoma, Large B-Cell, Diffuse - drug therapy
Lymphoma, Large B-Cell, Diffuse - pathology
Lymphoma, Non-Hodgkin - drug therapy
Lymphoma, Non-Hodgkin - pathology
Male
Middle Aged
Orbit - injuries
Prednisone
Rituximab
Surgery
Treatment Outcome
Vincristine
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Summary:The head and neck region is the second most common site for the development of extranodal lymphomas. Richter′s syndrome (RS) involves the transformation of B-cell chronic lymphocytic leukemia (B-CLL) to an aggressive lymphoma, most commonly, diffuse large B-cell lymphoma (DLBCL). We report the case of a 62-year-old man who developed DLBCL in the periorbital region 2 months after blunt trauma to the site. The patient lacked other physical symptoms at the time of presentation. Bone marrow biopsy and immunophenotypic analysis revealed a Richter transformation of unknown B-CLL. RS frequently arises in lymph nodes or bone marrow and rarely presents with extranodal involvement. Chemotherapy resulted in total remission of the lymphoma and no relapse was observed in the 6-month follow-up period. This case demonstrates that the clinician must recognize that unresolved soft tissue swelling after a trauma may be caused by NHL.
ISSN:1079-2104
1528-395X
DOI:10.1016/j.tripleo.2010.02.015