case_images: PMC3891080_01
case_images: Gross findings in a patient with gingival hyperplasia. Compared with cyclosporine-induced gingival hyperplasia, the gingival lesion in this patient was characterized by a focal, irregular surface and ulceration.
case_images: kjim-20-330-g001.jpg
case_images: PMC3891080_01_kjim-20-330-g001.jpg
case_images: F1
case_images: A male, 41 years old, visited the clinic in April 2002 after experiencing bleeding, pus discharge, edema, and pain of the gingivae over the previous three months (Figure 1A, 1B).
case_images: Serum cyclosporine levels in this patient decreased simultaneously with a reduction in the dose of cyclosporine from January 2002 onwards, but gingival hyperplasia was not alleviated despite this.
case_images: kjim-20-330-g002.jpg
case_images: PMC3891080_01_kjim-20-330-g002.jpg
case_images: F2
case_images: Serum cyclosporine levels were low (Figure 2).
case_images: Microscopic image of a gingival biopsy showing atypical lymphocytes. These findings are indicative of the presence of leukemic cell infiltration and a malignant lymphoma or histiocytic tumor (x400, H-E stain).
case_images: kjim-20-330-g003.jpg
case_images: PMC3891080_01_kjim-20-330-g003.jpg
case_images: F3
case_images: The biopsy established the presence of leukemic cell infiltration including a malignant lymphoma or histiocytic tumor (Figure 3).
case_images: An immunohistochemical image of a tissue section showing positive reactions to LCA (A) and L26 (B) and negative reactions to UCHL-1 and CD68. This is indicative of a diffuse large B cell type malignant lymphoma (x400).
case_images: kjim-20-330-g004.jpg
case_images: PMC3891080_01_kjim-20-330-g004.jpg
case_images: F4
case_images: Muramidase and immunohistochemical stains specific for LCA (Figure 4A), L26 (Figure 4B), UCHL1, and CD68 revealed a large diffuse B cell type of malignant lymphoma.
case_images: An immunohistochemical stain showing a positive reaction to EBV (LMP) (x400).
case_images: kjim-20-330-g005.jpg
case_images: PMC3891080_01_kjim-20-330-g005.jpg
case_images: F5
case_images: The latent membrane protein for the Epstein-Barr virus (EBV-LMP) immunohistochemical stain was positive (Figure 5).