12 April 2026
: Case report 
Isolated Mental Nerve Neuropathy as the First Clinical Sign of Nodal Marginal Zone Lymphoma: A Diagnostic Challenge
Challenging differential diagnosis, Rare disease
Anusha Abdullah ABCDEF 1*, Philipp Poxleitner BDF 1, Ina Dewenter E 1, Paris Liokatis
E 1, Wenko Smolka DF 1, Katharina Theresa Obermeier BDE 1
DOI: 10.12659/AJCR.952353
Am J Case Rep 2026; 27:e952353
Table 1 Diagnostic timeline until the final diagnosis of nodal marginal zone lymphoma (NMZL) was confirmed.
| Time point | Event/investigation | Key findings | Interpretation |
|---|---|---|---|
| 2 Years before diagnosis | Symptom onset; initial contrast-enhanced MRI | Pain in the left mental nerve distribution; bone marrow edema in the left mandibular body | Initially suspected benign odontogenic or inflammatory cause (radiology report) |
| 6 Months before diagnosis | Symptom progression; incisional biopsy (private practice) | Limited perineural soft-tissue sample adjacent to the left mental nerve | Histopathology suggestive of neuroma |
| 5 Months before diagnosis | Repeat MRI (private practice) | Space-occupying lesion of the left mental nerve and submandibular gland, cervical lymphadenopathy | Findings suspicious for neoplastic process; referral for further evaluation |
| At diagnosis | Clinical examination; ultrasound; surgical excision | Palpable masses in the left submandibular region and near the mental foramen | Definitive histopathology confirmed NMZL |