Extranodal lymphoma arising within the maxillary alveolus: a case report.

OBJECTIVE: Extranodal lymphomas affecting the head and neck arise infrequently within the bones of the jaws. This is a report of a symptom-free patient whose general dentist detected a radiolucency as an incidental finding on conventional radiography.

STUDY DESIGN: The conventional radiography of lesions in the maxilla displayed "floating teeth" indicative of malignancy. This case was then imaged by cone beam computed tomography (CBCT), multidetector computed tomography (MDCT), and magnetic resonance imaging (MRI). The lymphoma grew rapidly in less than a week between the MDCT and the MRI. All the above cross-sectional modalities elicited a provisional diagnosis of a squamous cell carcinoma (SCC).

CONCLUSIONS: Evaluation of the extent of the lesion and its encroachment on adjacent structures is limited by conventional radiography. Nevertheless, conventional radiography can display features that are suggestive of malignant disease. Although cross-sectional imaging of lesions within the anatomically-complex-maxilla has generally taken the form of MDCT and MRI, CBCT has a role. In hindsight, the absence of central necrosis should have directed the inclusion of "extranodal lymphoma arising within the maxillary alveolus" in the provisional diagnosis.