Non-Hodgkin's lymphoma and periodontitis. A case report

Background: We describe an unusual case of extranodal non-Hodgkin's lymphom a that developed in the maxillae associated with localized severe periodont itis in a 64-year-old Caucasian male. The lymphoma was diagnosed less than 2 years following routine periodontal surgery and 8 weeks after the extract ion of hopeless teeth in the associated area. Methods: Two months following the extractions, the patient experienced pain and swelling in the maxillary right edentulous area mimicking an abscess, and reported for emergency care. An expansile lesion measuring 2.0 x 2.5 cm in diameter was noted on radiographic examination to extend into the right maxillary sinus. A definitive biopsy diagnosis of high grade, small, non-c leaved, diffuse non-Hodgkin's lymphoma of the right posterior maxillae was established. The patient was subsequently treated by a combination of radia tion, chemotherapy, and bone marrow transplantation. Results: The maxillary tissues healed uneventfully, and the patient has bee n closely observed for approximately 5 years without symptoms or recurrence of the lymphoma. Conclusions: This case highlights the need for careful debridement of extra ction sockets associated with severe periodontitis and argues for the routi ne submission of extracted teeth with adjacent soft tissue for microscopic analysis, to assist in the early diagnosis of potentially life-threatening malignancies.