Unusual presentation of extranodal diffuse large B-cell lymphoma in the head and neck: Description of a case with emphasis on radiographic features and review of the literature

A very unusual radiographic presentation of non-Hodgkin lymphoma (NHL) involving the maxilla is described. The patient was initially managed with antibiotics prescribed to treat what was thought to represent an odontogenic infection. After unsuccessful antibiotic therapy, the patient was referred to an oral surgery clinic where CBCT was performed. CBCT revealed an atypical generalized sclerosis of the affected bone rather than the usual lytic radiographic pattern associated with NHL. Destruction of the sinus floor with infiltration of the sinus was also present. This rare radio-opaque radiographic presentation is described in detail together with the clinical presentation and histopathological findings. The important radiographic features suggesting malignancy that were present in this atypical case of NHL are discussed. A differential diagnosis highlighting the differences between NHL, osteomyelitis and osteosarcoma is also provided.