Journal of General Practice

Background: Plasmablastic Lymphoma (PBL) is a rare aggressive subtype of B cell Lymphoma commonly associated with HIV infection. However, PBL is also seen in other immunodeficient and immunocompetent individuals. Because of its rarity and lack of expression of markers used in establishing an initial hematopoietic lineage, it poses a diagnostic challenge to pathologists.

Aim and Objective: To study cases of PBL at a Tertiary Care Oncology Institute, Hyderabad. To summarize the current knowledge on clinical and pathological characteristics, differential diagnosis, therapeutic and prognostic factors.

Observations and Results: Twenty cases of Plasmablastic Lymphoma were studied. Inaddition to Hematoxylin and Eosin staining, Immunohistochemistry was done for further diagnosis. Most of the cases were diagnosed as Poorly differentiated neoplasm on H&E, followed up with IHC, which was positive for CD138 and Ki67.

Conclusion: To increase awareness towards PBL and to avoid misdiagnosis.

Objectives: To compare the symptomatology of patients with maxillary sinusitis of dental origin (MSDO) with sinusitis due to upper respiratory tract infection (URTI) with a special focus on time to correct diagnosis. To define the accuracy of cone beam computed tomography (CBCT) in detecting the dental origin of the sinusitis.
Methods: Retrospective review of the otolaryngology specialist care, primary health care and dental health care medical records of patients with maxillary sinusitis who has been referred for radiology. All patients were examined by CBCT, which has a better resolution regarding bony structures than low-dose computed tomography. To the best of our knowledge there is no previous study on this topic based on CBCT as diagnostic method.
Results: Sixty-one patients were included in the study; of these, 25 had MSDO and 36 had URTI sinusitis. The MSDO patients more frequently reported foul odour and foul taste than patients with URTI sinusitis. The URTI sinusitis patients more frequently reported symptoms such as facial pain, facial congestion and cold-related symptoms. Both the time from the onset of symptoms to the first medical visit and the subsequent time to a correct diagnosis were significantly longer in the MSDO group. The accuracy of CBCT for detecting dental pathology as the underlying cause of sinusitis was 97%.
Conclusion: The present study verifies that maxillary sinusitis of dental origin differs from viral-induced rhinosinusitis concerning symptomatology and clinical findings. Certain findings and symptoms could serve as valuable indicators of an underlying dental pathology, because although MSDO is well known, the present study shows that these patients are often misdiagnosed and the correct diagnose and treatment is often delayed several months. Consequently, better assessment is important. The suspicion of MSDO should be raised for patients with unilateral sinusitis presenting little pain, foul odour or foul taste and a long time course. These patients should be referred for radiology, preferably CBCT, to rule out odontogenic cause. CBCT is easy to perform for sinusitis examinations and has advances to common CT, especially regarding detection of pathology in bony structures as the periapical area. Because of this CBCT is a reliable tool in order to detect maxillary sinusitis of dental origin.