Frontiers in surgery · 2026
Fibrous dysplasia of the jaw and diffuse large B-cell lymphoma coexistence, diagnosis and treatment experience and analysis: a case report.
Клинический случайСтатьяНазвание и аннотация: Перевод пока не подготовлен
Обработка статьи · этапы, ошибки и управление
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Ошибки и ограничения
История · было → стало
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Hong Qing, Zhang Chaowei, Yao Weiyi, Han Yuxuan, Zhu Yanan, Tang Xinyu, Chen Na
Аннотация
BACKGROUND: Fibrous dysplasia (FD) is a rare benign fibro-osseous bone lesion, while diffuse large B-cell lymphoma (DLBCL) is the most common aggressive non-Hodgkin lymphoma. Their clinical and imaging manifestations overlap substantially, which complicates diagnosis, particularly when DLBCL manifests as extranodal bone lesions without peripheral lymphadenopathy. The coexistence of jaw FD and DLBCL is extremely rare, and relevant clinical experience is insufficient.
CASE DESCRIPTION: This report presents a 46-year-old female with a 40-year history of jaw FD who presented with progressive right mandibular swelling and pain for 2 months. Laboratory tests showed elevated alkaline phosphatase. Imaging revealed right mandibular bone destruction, and pathological examination confirmed non-germinal center B-cell-like (non-GCB) DLBCL limited to the skeletal system, with double-expressor lymphoma features. The patient was staged as IIIA with an intermediate-low International Prognostic Index (IPI) and intermediate-high National Comprehensive Cancer Network International Prognostic Index(NCCN-IPI) risk. She received 8 cycles of polatuzumab vedotin, rituximab, cyclophosphamide, doxorubicin hydrochloride and prednisone (Pola-R-CHP) chemotherapy, achieving partial relief of symptoms and reduced mandibular mass, but residual lesions remained. Subsequently, second-line dexamethasone, high-dose cytarabine and cisplatin (DHAP) salvage therapy was initiated due to persistent disease activity.
CONCLUSIONS: The coexistence of FD and DLBCL is easily misdiagnosed as FD progression. For FD patients with new-onset bone destruction and mass formation, timely pathological biopsy is essential to confirm malignancy. Accurate imaging, pathological evaluation, and risk stratification guide treatment selection. First-line chemoimmunotherapy may achieve partial remission in refractory cases, and second-line intensive salvage regimens are needed for persistent disease. This case provides a reference for the diagnosis and treatment of similar rare complex cases.
CASE DESCRIPTION: This report presents a 46-year-old female with a 40-year history of jaw FD who presented with progressive right mandibular swelling and pain for 2 months. Laboratory tests showed elevated alkaline phosphatase. Imaging revealed right mandibular bone destruction, and pathological examination confirmed non-germinal center B-cell-like (non-GCB) DLBCL limited to the skeletal system, with double-expressor lymphoma features. The patient was staged as IIIA with an intermediate-low International Prognostic Index (IPI) and intermediate-high National Comprehensive Cancer Network International Prognostic Index(NCCN-IPI) risk. She received 8 cycles of polatuzumab vedotin, rituximab, cyclophosphamide, doxorubicin hydrochloride and prednisone (Pola-R-CHP) chemotherapy, achieving partial relief of symptoms and reduced mandibular mass, but residual lesions remained. Subsequently, second-line dexamethasone, high-dose cytarabine and cisplatin (DHAP) salvage therapy was initiated due to persistent disease activity.
CONCLUSIONS: The coexistence of FD and DLBCL is easily misdiagnosed as FD progression. For FD patients with new-onset bone destruction and mass formation, timely pathological biopsy is essential to confirm malignancy. Accurate imaging, pathological evaluation, and risk stratification guide treatment selection. First-line chemoimmunotherapy may achieve partial remission in refractory cases, and second-line intensive salvage regimens are needed for persistent disease. This case provides a reference for the diagnosis and treatment of similar rare complex cases.