A CASE OF MALIGNANT LYMPHOMA WITH DIFFICULTY IN DIAGNOSIS AND TREATMENT

  • SATOH Chiharu
    Department of Dentistry and Oral Maxillofacial Surgery, Hokuto Hospital Oral Diagnosis and Medicine, Department of Oral Pathobiological Science, Graduate School of Dental Medicine, Hokkaido University
  • SHINDOH Masanobu
    Oral Diagnostic Pathology, Department of Oral Pathobiological Science, Graduate School of Dental Medicine, Hokkaido University
  • NOTANI Ken-ichi
    Oral Diagnosis and Medicine, Department of Oral Pathobiological Science, Graduate School of Dental Medicine, Hokkaido University
  • FUKUDA Hiroshi
    Oral Diagnosis and Medicine, Department of Oral Pathobiological Science, Graduate School of Dental Medicine, Hokkaido University

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  • 診断と治療に苦慮した悪性リンパ腫の1例

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Abstract

A 53-year-old male visited our hospital with a complaint of a painless swelling in the left cheek. Biopsies were performed twice showing chronic inflammation and no evidence of malignancy.<br>About two years later, he suffered from writing and speaking disturbances. Tumor extirpation was done due to diagnosis of intracranial middle fossa tumor, and diffuse large B-cell lymphoma was diagnosed from surgical specimen.<br>Since bilateral swelling of the cheek and trismus arose after the surgery, malignant lymphoma was suspected and biopsy was performed, however, it was not malignant. Six courses of chemotherapy with VEPA-M (VCR, CPA, PDN, ADM and MTX) were performed successfully. During the chemotherapy, an excisional biopsy of one of the enlarged left cervical lymph nodes was performed and diagnosis of B-cell small lymphocytic lymphoma was made.<br>However, tumor recurred in the left parotid region three months after the chemotherapy. Despite of salvage chemotherapy with IMVP-16 (IFX, MTX and VP), the patient died of multiple organic failure.

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