ORAL LYMPHOMA: A

CASE STUDY OF
MALIGNANT B CELL
LYMPHOMA (NON
HODGKIN LYMPHOMA)

Mei Syafriadi, drg, MDSc., PhD

Division of Pathology, Department of Biomedical
Sciences, Jember University
 I. INTRODUCTION
Lymphomas is a cancer of the lymph system,
which are proliferation of lymphocytes or
lymphoblast, that can be occurs in the whole part
of body including the oral cavity. Lymphomas are
two main types Hodgkin lymphomas and Non
Hodgkin Lymphomas (NHL).
There are five main types of Hodgkin Lymphoma
such as Nodular Sclerosing Hodgkin Lymphoma
(NSHL), Mixed Cellularity Hodgkin Lymphoma
(MCHL), Lymphocyte Depleted Hodgkin
Lymphoma (LDHL), Lymphocyte-rich Classic
Hodgkin Lymphoma (LRCHL), Nodular
Lymphocyte Predominant Hodgkin Lymphoma
(NLPHL).
 The Non-Hodgkin Lymphomas (NHL) are the
more common type of lymphoma. Close to
60,000 individual are affected by NHL every year
in the United States.
Non-Hodgkin Lymphomas is not a single
diseases. In fact, it is a group of related lymph
system cancers and more than twenty types such
as, Diffuse Non-Hodgkin Lymphomas (Small cell,
small cleaved cell, mixed small and large cell,
Large cell, Immunoblastic, Lymphoblastic,
undifferentiated, Burkitts tumor, Unspecified
type), Peripheral and cutaneous T-cell Non-
Hodgkin Lymphomas ( Mycosis fungoides,
Sezary diseases, T-zone lymphoma,
lymphoepitheloid lymphoma, Peripheral T-cell
lymphoma, unspecified T- cell Lymphoma types)
 The commonest symptom is enlarged lymph
nodes in the neck, armpits, groin or within the
chest.
Lymphoma may have weight loss, fever, itching
and drenching sweats at night.
To get definite diagnostic between Hodgkin
Lymphomas and Non-Hodgkin Lymphomas
needed some test such as, bone marrow test, X-
rays or CT-Scan examination and microscopic
examination (HE and Immunohistochemistry
staining) from biopsy material.
In this study we reported a case of oral lymphoma
by histopathological examination.
 II. PURPOSE OF STUDY
The purpose of this study is to distinguish
a case of tumor in oral cavity that
suspected as a Non-Hodgkin Lymphomas
(NHL) whether the case is Non-Hodgkin
Lymphomas (NHL) B-cell lymphoma or T-
Cell Lymphoma types.
 III. MATERIAL AND METODS
MATERIAL
Biopsy and Surgucal material of tumor from oral
cavity

METODS
1. HE Staining
2. Serial section 4 mikron for immunohistochemistry
Such as Bcl2, CD3 (T-Cells), CD20, CD73, and
CD79A
To differentiate Mode of lymphoid cell
proliferation
 IV. RESULT

Figure 1. HE staining showed the tumor was underlying oral mucosal (A) and the
tumor cells contain lymphoid cells proliferation with small, round in shape.
Hyperchromatic nucleus and mitotic figures (arrow) were seen (B), magnification
40x and 100x
Figure 2. Bcl2 imunostaining
 A B

Figure 3. CD3 imunostaining showed immunopositive for T-cells (A) and CD73 for
T-cell subset (B) were sporadically inside the tumor
 A B

Figure 4. expression of CD20 (A) and CD79 imunostaining showed almost the cells
were immunopositive (B)
V. Discussion and Conclusion
Lymphoma is a malignant tumor of B or T
lymphocytes usually arising and spreading
between lymphoid tissue, but in this study we
found this tumor arising in the oral cavity. The
immunostaining examination showed the tumor
cells were strongly immuno-positive to the
markers such as CD20 and CD79A, therefore
any cells immuno-positive to CD3 T-cells and
CD73 T-cells subset sporadic inside the tumor.
Conclusion: Our definite diagnose to this case
was malignant B cell lymphoma that commonly
referred as non-hodgkin lymphomas.