We examined the clinical characteristics for 10 malignant lymphomas which presented the first symptom in the oral region. The mean age was 58.1 years, with a range of 23–88 years. The primary site of the tumor was the upper gingiva in 3 cases and the palate in 2. The initial symptoms were tumor mass and swelling in six cases, ulceration in two cases, and both swelling and ulceration in two cases. Five cases appeared to be in pain. The most common histopathological classification of the World Health Organization (WHO) was diffuse large B-cell lymphoma (DLBCL). According to the Ann Arbor staging classification, four cases were stage I, two were stage II, and four were stage IV. The outcome for these cases was that 8 of the 10 patients were alive after the treatment or observation.
In addition, in a review of the Japanese literature, 140 well-documented cases of malignant lymphoma in the oral region were analyzed. The common primary sites were the gingiva and palate. The initial symptom tended to be tumor mass or swelling. Because of difficulty in diagnosing malignant lymphomas of the oral region, 17.1% of the cases required multiple biopsies to make the diagnosis. In particular, the cases with ulcer or necrosis could not be definitely diagnosed. In most cases, the histopathological diagnosis was DLBCL, followed by mucosa-associated lymphoid tissue (MALT) and extranodal natural killer (NK)/T-cell lymphomas, and most of the cases were stage I (approximately 40%).