Cause Analysis of Clinical Misdiagnosis of Oral and Maxillofacial Lympho-ma

WANG Pengyi; WANG Lina; HUANG Tao; FAN Zongshang

doi:10.3969/j.issn.1002-3429.2024.19.004

Abstract：Objective To analyze the causes of clinical misdiagnosis and preventive measures of oral and maxillofa-cial lymphoma and to improve the level of clinical diagnosis and treatment.Methods From April 2023 to April 2024,the clinical data of 1 patient with oral and maxillofacial lymphoma initially misdiagnosed with oral ulcer and 1 patient initially mis-diagnosed with nasal polyps and sinusitis were retrospectively analyzed.Results One patient was admitted to hospital due to recurrent ulcer of the left hard palate for 11 months,and recurrent fever and aggravation of the left hard palate ulcer for 2 months.According to the medical history and specialist examination,recurrent oral ulcer was considered.Vitamin supplemen-tation and symptomatic treatment were given,but no improvement was found.After histopathological examination of the oral ulcer,it was confirmed as oral diffuse large B-cell lymphoma of non-germinal central origin.The misdiagnosis lasted 11 months.After treatment with CHOP chemotherapy regimen,no serious adverse reactions occurred and the disease was con-trolled.Currently,the patients was being followed up.A patient was admitted to hospital due to bilateral nasal congestion,runny nose and headache for 4 weeks.According to head and sinus CT,nasal polyps and sinusitis were considered,and mag-netic resonance imaging,pathological examination and immunohistochemical examination confirmed malignant diffuse large B-cell lymphoma of maxillary sinus.The misdiagnosis lasted 14 d.R-CHOP regimen was used for chemotherapy.Bone mar-row suppression occurred during chemotherapy,and the disease was not controlled.The patient developed new lesions and died 1 month later.Conclusion The lack of specific clinical features in the early stage of oral and maxillofacial lymphoma is likely to lead to misdiagnosis or missed diagnosis.The key to prevent misdiagnosis of oral and maxillofacial lymphoma is to perform imaging examination as soon as possible and pathological and immunohistochemical examination of suspected patients.