case_images: PMC11292186_01
case_images: Clinical photo of the patient showing swelling on the posterolateral portion of the soft palate.
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case_images: PMC11292186_01_f1000research-12-169876-g0000.jpg
case_images: f1
case_images: Intraorally, a single ulceroproliferative lesion present over the anterior faucial pillar was observed ( Figure 1, marked with a red circle).
case_images: Punch biopsy specimen (2 x 1.7 cm).
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case_images: f2
case_images: This was followed by a punch biopsy from the same site ( Figure 2) in January 2023, with histopathological features suggestive of a lymphoproliferative lesion.
case_images: A: Non-enhancing necrotic areas noted in the left tonsillar fossa; B: Anteromedial extension abutting to the base of the tongue.
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case_images: f3
case_images: A contrast-enhanced computerized tomography (CECT) presented evidence of a soft tissue density lesion with few non-enhancing necrotic areas noted in the left tonsillar fossa measuring 2.2 x 2 x 2.7 cm ( Figure 3A, marked with a red circle) with the following extensions: a. Anteromedially extending into the oropharynx causing partial obstruction with non-visualization of uvula suggestive of involvement abutting the base of the tongue and vallecula ( Figure 3B, marked with a red circle). b.
case_images: A: Diffuse infiltration of large lymphocytes (marked by red arrow); B: CD45 positive.
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case_images: f4
case_images: The nucleus was double the size of the nucleus of a normal lymphocyte, vesicular chromatin, and prominent nucleoli ( Figure 4A, marked with red arrows). Immunohistochemical features with cytokeratin staining were negative, CD45 was strongly positive with an intensity score of 3, proportionate scores of 4 ( Figure 4B), and CD20 positive.