Mirza M Shakir.
Non-Hodgkins Lymphoma affecting the upper lip.
J Pak Dent Assoc Jan ;14(3):174-6.

A 60 years old male presented with the complaint, of the swelling of the upper lip and face, Figure 1. According to patient initially the swelling was increasing in size very slowly but in the last week it increased in size at a very rapid pace and became very painful. The examination revealed that the swelling of the upper lips had extended from the midline to the left side and the left nostril was lifted Figure 3. On palpation the swelling was soft and nonfluctuant but tender. It has extended diffusely backwards; therefore measurement of the lesion couldn`t be assessed correctly. There was no past history of any significant medical problem. General physical examination was reasonably satisfactory. All biochemical and hematological investigations were in normal limits. An incisional biopsy from the mucosal surface of the upper lip was performed and submitted for histo-pathology and immuno-histological chemistry. The sections were stained with a panel of monoclonal antibodies using envision system. The large atypical cells were positive for LCA, Pan B (CD20 and CD79a) but were negative for Pan T (UCHLI) and cytokeratin MNF. A diagnosis of diffuse large cell non-Hodgkin`s lymphoma of B-Cell phenotype was established which is a very rare site for non-Hodgkin`s lymphoma of head and neck. The patient was kept on chemotherapy. He responded well with complete disappearance of the swelling Figure 4.

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