NUMERO: #20230485

Título: Intraoral syphilis mimicking lymphoproliferative disorder

Nome do Apresentador: Gabriela Fonseca Rocha

Categoria do Trabalho: Painel de caso clínico (PCC)

Área Temática: Patologia Oral

Resumo: Syphilis microscopically mimicking lymphoproliferative disorder (LPD) is rare. To date, 12 cases of secondary syphilis, all but one in extraoral location, have been reported. A 22-year-old male was referred for evaluation of a painful lingual ulcer 1 month ago, suggesting infectious disease. Incisional biopsy revealed an exuberant lymphoid proliferation with follicular architecture, permeated by sheets of plasma cells in fibrovascular stroma. Moreover, some lymphoid nodules evidenced germinal centers. These findings suggested LPD, notably MALT lymphoma and low-grade follicular lymphoma. Immunohistochemical analysis showed positivity for CD20 CD79a, Bcl-2, with Bcl-6 highlighting germinal centers. Polyclonal plasma cells were positive for MUM1/IRF4, CD79a and CD138. At this point, mainly considering the presence of numerous polyclonal plasma cells, FTA-ABS serum test was requested, which was positive. Thus, a diagnosis of primary syphilis was made. After penicillin therapy, complete resolution of the lingual lesion was evidenced.

Autor 1:  Gabriela Fonseca Rocha

E-mail 1:  [email protected]

Autor 2:   Larissa Doalla de Almeida e Silva

E-mail 2:  [email protected]

Autor 3 :  Herberth Campos Silva

E-mail 3:  [email protected]

Autor 4:  Evânio Vilela Silva

E-mail 4:  [email protected]

Autor 5:  Heitor Albergoni Silveira

E-mail 5:  [email protected]

Autor 6:  Jorge Esquiche León

E-mail 6:  [email protected]

Autor 7:  Ana Terezinha Marques Mesquita

E-mail 7:  [email protected]