Metastatic anaplastic large cell lymphoma of the oral cavity
A 32-year-old man was referred to the Department of Oral Surgery, Dental School of Isfahan in 2010. Patient's chief complaint was swelling and scarring of the posterior hard palate about three weeks before visiting and after the extraction of maxillary left second and third molars.\nOn physical examination, the patient had scar with raised edges and a yellow - white membrane in posterior of the hard palate []. The patient declared a history of lymphoma from 1.5 years ago in the neck lymph nodes which diagnosis was Anaplastic larg cell lymphoma, that had been receiving chemotherapy.\nSevere alveolar ridge resorption with irregular border were found in left maxilla by an X-ray examination [].\nThe clinical signs and symptoms of patient raised probability of diagnosis of ulcers caused by chemotherapy and tumor's metastasis. After that, incisional biopsy was done and was sent to Oral and Maxillofacial Pathology Department after embedding in 10% formalin fixative.\nMicroscopically, the proliferation of large and bizarre form neoplastic cells with hyperchromatic and angular nuclei, and numerous bizarre tumor giant cells with atypical mitotic figures which had been located between necrotic tissue and degenerated minor salivary glands as seperated foci was seen. Surface of this lesion had been covered with the fibrinoleukocyter membrane [].\nThe histologic findings suggested an ALCL, and differential diagnoses included metastasis of lymphoma, poorly differentiated carcinoma and malignant melanoma.\nImmunohistochemical staining was carried out on formalin-fixed paraffin-embedded tissues. The antibodies used to determine the definitive diagnosis were included: LCA, CK, CD20, CD30 and CD3. The following results were obtained []:\nCK = −\nLCA = 4+\nCD3 = 4+\nCD20 = 1+\nCD30 = 3+\nBased on the immunohistochemical findings, the lesion was diagnosed as an Metastatic ALCL.\nThe patient was transfered to Omid's hospital of Isfahan. Despite consecutive follow-up, unfortunately the patient didn’t corporate about presenting treatment plan and refused from referring to oral pathology department.