A case of diffuse large B cell lymphoma (DLBCL) with lower lip paralysis as the first manifestation

  • DANJO Atsushi
    Department of Oral and Maxillofacial Surgery, Faculty of Medicine, Saga University
  • YAMASHITA Yoshio
    Department of Oral and Maxillofacial Surgery, Faculty of Medicine, Saga University
  • SHIMOHIRA Daiji
    Department of Oral and Maxillofacial Surgery, Faculty of Medicine, Saga University
  • SHINDO Takero
    Division of Hematology, Respiratory Medicine and Oncology, Saga University
  • UCHIHASHI Kazuyoshi
    Department of Pathology and Microbiology, Faculty of Medicine, Saga University
  • GOTO Masaaki
    Department of Oral and Maxillofacial Surgery, Faculty of Medicine, Saga University

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Other Title
  • Numb chin症候群として発症したびまん性大細胞型B細胞性リンパ腫 (DLBCL) の1例
  • Numb chin ショウコウグン ト シテ ハッショウ シタ ビマンセイ ダイ サイボウガタ B サイボウセイ リンパシュ(DLBCL)ノ 1レイ

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Case reports on malignant lymphoma in the oral and maxillofacial region are rare, and most describe extranodal lymphomas. We report a case of diffuse large B-cell lymphoma (DLBCL) that invaded into the right mental nerve of a 78-year-old woman, who initially presented with right lower lip palsy and pain. We diagnosed severe marginal periodontitis of the right lower first premolar, and planned to extract the tooth in 3 months because she had been taking bisphosphonates for more than 3 years. Two months after the first visit, her palsy and pain became more severe. The right lower lip was red and swollen, and a bead-like mass had developed around the mental foramen. Biopsy of the swollen mental nerve showed DLBCL. Systemic screening results showed that the stage was Ⅳ A. The patient was given chemotherapy with rituximab, tetrahydropyranyl adriamycin, and cyclophosphamide (R-THP-COP) combined with radiotherapy to the left cervical lesion. The redness, swelling, and paralysis of the right lower lip disappeared, and there have been no signs of recurrence in the 13 months after treatment.

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