Abstract

Cutaneous T-cell lymphomas (CTCL) comprise a heterogeneous group of diseases characterized by malignant proliferations of T-lymphocytes primarily involving the skin. While CTCL can involve internal organs and lymph nodes, oral involvement is uncommon and has historically been associated with advanced disease and poor prognosis. We present three cases of oral involvement in the setting of cutaneous T-cell lymphoma, including two cases of mycosis fungoides and one case of gamma-delta T-cell lymphoma (GDTCL). Sites of involvement included mandibular gingiva, palate, and nasopharynx. In two of three cases, the histopathologic features were subtle. In case 1, only after immunohistochemical staining did the atypical and epithelioltropic T-cell infiltrate become apparent. In case 2, there was a moderately dense inflammatory infiltrate without significant cytologic atypia but given the gamma-delta phenotype and patient’s history, a diagnosis of involvement by the patient’s known GDTCL was rendered. In our experience, the timing of oral involvement varied dramatically, ranging from intra-oral presentation within five months of initial diagnosis to nine years after diagnosis. The average age at presentation of oral disease in our experience was 67 years, similar to previously published reports in the literature. Essential to diagnosis is careful clinicopathologic correlation, diligent use of immunohistochemistry, and knowledge of the patient’s underlying neoplasm. Importantly, a heightened clinical and pathologic suspicion for involvement by the patient’s underlying lymphoma is necessary for a timely and appropriate diagnosis.

Financial Disclosure:
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