Home Dental Radiology Ill-defined lytic mandibular lesion – The Journal of the American Dental Association

Ill-defined lytic mandibular lesion – The Journal of the American Dental Association

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Figure 1

Intraoral radiographs show ill-defined osteolytic lesion.

Figure 2

Axial computed tomographic image shows permeative bone destruction (arrows).

Figure 3

Hematoxylin-eosin stain (magnification ×600) shows a diffuse infiltrate of large lymphoid cells with large nuclei, vesicular chromatin pattern, and prominent nucleoli. Numerous atypical mitotic figures are also identified.

Figure 4

Photomicrograph (immunohistochemical stain, original magnification ×600) shows the cytoplasm of the atypical lymphocytes. There is diffuse cluster differentiation 20 immunoreactivity, indicating a B-cell lineage.

An otherwise healthy 69-year-old woman was referred to an oral medicine and facial pain clinic for evaluation of persistent right mandibular infection and pain that had begun 5 months previously. She correlated the onset to an extraction of the mandibular right first molar (tooth no. 30) due to gross caries. She had recurring episodes of facial swelling, tongue paresthesia, and dysgeusia. She reported that her symptoms did not improve despite multiple antibiotic treatments. Clinical examination revealed mobility and tenderness on palpation of the mandibular right anterior teeth and premolars.



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