Follicular lymphoid hyperplasia of the hard palate and oral mucosa: report of three cases and a review of the literature

Histopathology. 2001 Oct;39(4):353-8. doi: 10.1046/j.1365-2559.2001.01210.x.

Abstract

Aims: To bring to wider attention this uncommon, poorly understood entity which may closely resemble, clinically and morphologically, follicular lymphoma.

Methods and results: We report three cases of follicular lymphoid hyperplasia of the hard palate and oral mucosa which caused diagnostic difficulties for the referring pathologists. The clinicopathological features are described and integrated into a review of the 16 previously recorded cases. The condition most commonly presents as a slowly growing mass situated in the posterior hard palate but may present with multicentric oral lesions and lymphadenopathy. Morphologically, it is characterized by a dense follicular lymphoid infiltrate within the lamina propria which may show the classical features of benign reactive hyperplasia, but not uncommonly, indistinct germinal centres, ill-defined mantles and a lack of tingible-body macrophages are features which may lead to an erroneous diagnosis of follicular lymphoma.

Conclusions: Follicular lymphoid hyperplasia of the palate is a poorly recognized entity which is frequently confused with follicular lymphoma. Awareness of the entity combined with the use of immunohistochemistry for immunoglobulin light chains and bcl-2 protein allows a correct diagnosis to be made avoiding extensive investigation and aggressive treatment to the patient.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Aged
  • Diagnosis, Differential
  • Female
  • Humans
  • Hyperplasia
  • Immunoglobulin kappa-Chains / analysis
  • Immunoglobulin lambda-Chains / analysis
  • Immunohistochemistry
  • Lymphoid Tissue / chemistry
  • Lymphoid Tissue / pathology*
  • Lymphoma, Follicular / pathology
  • Male
  • Middle Aged
  • Mouth Mucosa / chemistry
  • Mouth Mucosa / pathology*
  • Palate / chemistry
  • Palate / pathology*
  • Proto-Oncogene Proteins c-bcl-2 / analysis

Substances

  • Immunoglobulin kappa-Chains
  • Immunoglobulin lambda-Chains
  • Proto-Oncogene Proteins c-bcl-2