Maxillofacial Plastic and Reconstructive Surgery

Korean Association of Maxillofacial Plastic and Reconstructive Surgeons (대한악안면성형재건외과학회)
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Progressive Transformation of Germinal Centers in Submandibular Area: Case Report

악하부에 발생한 Progressive Transformation of Germinal Centers: 증례보고

  • Park, Su-Won (Department of Oral and Maxillofacial Surgery, Ulsan University Hospital, College of Medicine, University of Ulsan) ;
  • Jang, Soo-Mi (Department of Oral and Maxillofacial Surgery, Ulsan University Hospital, College of Medicine, University of Ulsan) ;
  • Kim, Dong-Yul (Department of Oral and Maxillofacial Surgery, Ulsan University Hospital, College of Medicine, University of Ulsan) ;
  • Son, Jang-Ho (Department of Oral and Maxillofacial Surgery, Ulsan University Hospital, College of Medicine, University of Ulsan) ;
  • Cho, Yeong-Cheol (Department of Oral and Maxillofacial Surgery, Ulsan University Hospital, College of Medicine, University of Ulsan) ;
  • Sung, Iel-Yong (Department of Oral and Maxillofacial Surgery, Ulsan University Hospital, College of Medicine, University of Ulsan)
  • 박수원 (울산대학교 의과대학 울산대학교병원 구강악안면외과학교실) ;
  • 장수미 (울산대학교 의과대학 울산대학교병원 구강악안면외과학교실) ;
  • 김동율 (울산대학교 의과대학 울산대학교병원 구강악안면외과학교실) ;
  • 손장호 (울산대학교 의과대학 울산대학교병원 구강악안면외과학교실) ;
  • 조영철 (울산대학교 의과대학 울산대학교병원 구강악안면외과학교실) ;
  • 성일용 (울산대학교 의과대학 울산대학교병원 구강악안면외과학교실)
  • Received : 2011.03.29
  • Accepted : 2011.06.08
  • Published : 2011.07.31
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Abstract

Progressive transformation of germinal centers (PTGC) is mostly a disease of young adults and it presents as unexplained, asymptomatic, localized or generalized lymphadenopathy that is usually persistent or recurrent over a period of many years. PTGCs are larger than regular germinal centers and they contain a variable proportion of small mantle zone lymphocytes and so they become progressively transformed and they may result in the loss of clear demarcation between them and the mantle zone. PTGC may resemble the nodules of nodular lymphocyte predominant Hodgkin's disease (NLPHD) and it may be mistaken for NLPHD. Histological and immunohistochemical studies are helpful in differentiating these diseases. Because of the relatively frequent recurrences of PTGC, follow-up and repeat biopsy are indicated. Although PTGC is not considered to be a premalignant condition, PTGC may occur prior to, concurrent with or following NLPHD. This emphasizes the need for ongoing follow-up and repeat biopsy. Although PTGC is reported in 3.5% to 10% of the cases of chronic nonspecific lymphadenopathy, oral & maxillofacial surgeons are not widely aware of this condition and its clinical implications. Herein, we present a case of PTGC. A 24-year-old male without any history of immunodeficiency or autoimmune disease was admitted to the Department of Oral & Maxillofacial surgery at Ulsan University Hospital for evaluation of a right submandibular swelling. He had another mass on the right thigh that was noticed about 1 year ago. The submandibular lesion was completely resected and biopsied. The histological findings and immunohistochemical stains (CD3, CD15, CD20, CD30, CD57, BCL-2, EMA) were consistent with PTGC. He was followed up without any other complaints for 9 months.

Keywords

References

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