Proceso linfoproliferativo tipo T en lengua: a propósito de un caso

Abstract

Introduction: T-type lymphoproliferative syndromes constitute 15% of all Non-Hodgkin's Lymphomas. The most frequent extra nodal Lymphomas are located in the gastrointestinal area, followed by the cervico-facial area (34%). In the oral cavity, they are generally located in Waldeyer's ring (5-10%), with tongue lymphomas being the most infrequent, representing 3% of all Lymphomas in the cervical-facial area. Within the cutaneous forms, CD30+ lymphoproliferative disease is the second most frequent type of cutaneous T-type lymphoma. Description of the clinical case: A 78-year-old female patient referred from primary care due to a persistent lesion on the dorsum of the right side of the tongue, in addition to glossodynia and odynophagia. Physical examination revealed a grayish medallion nodular lesion that did not exceed the midline, indurated and painful on palpation. Under local anesthesia, a biopsy was taken, the same one that described the CD30+ T-cell lymphoproliferative disorder and with the result of the DNA of the sample sent to molecular biology with the presence of clonal rearrangement of T-cell receptor. With these results, a whole body PET-CT was requested, showing no suggestive foci of metabolically active lymphoproliferative infiltration. With these results, the patient was referred to the Hematology service for evaluation and subsequent pertinent treatment. Conclusions: Extranodal lymphomas located in the tongue, due to being very infrequent, represent a diagnostic challenge. Therefore, it is important to consider them while evaluating the patient in addition to an adequate clinical-pathological correlation, always supported by complementary imaging tests and of course, histology and molecular biology.