Lymphoproliferative disease of the hard palate: a clinicopathologic entity. A study of twenty-one cases.

Twenty-one cases of a lymphoproliferative disorder believed to represent a clinico-pathologic entity were studied. These lesions, which appeared on the hard palate, occurred in elderly men and women with an average age of 70 years. The lesions presented as soft, fluctuant swellings which were occasionally bilateral, ulcerated, or discolored. Microscopically, the lesions were classified as lymphocytic lymphomas; eight were diffuse and well differentiated, seven were nodular and well differentiated, and six were diffuse and poorly differentiated. All lesions were characterized by a tendency of the lymphocytes to show nuclear fragility. Accessory salivary gland involvement was common, this being characterized by acinar obliteration to varying degrees and by periductal hyalinization of collagen. Determinate follow-up of fourteen patients disclosed that eight died of disseminated lymphoma, three are alive with disease, and three are free of disease after treatment with radiation and/or chemotherapy. Lymphoproliferative lesions in this location are believed to be malignant or potentially malignant processes.