Q. An 11-year-old boy is referred to the physician's office by his dental surgeon for swollen lower jaw on the left side. His mother states that his symptoms started with rapid swelling of the lower jaw and wiggly teeth for which she has taken him to the dentist. The dentist removed the loose teeth and prescribed antibiotics suspecting an abscess. But as the swelling didn’t improve, the boy was referred to the hospital. His family history shows they recently settled into the USA as refugees from Cameroon.
His temperature is 99°F (37.2°C), pulse is 90/min, blood pressure is 100/80 mmHg, and respirations are 13/min. Physical examination shows a non-tender swollen mandible on the left side with a soft mass of 1x1cm intraorally. Bilateral submandibular lymph nodes are enlarged and non-tender. Biopsy of the mass shows the presence of sheets of monomorphic medium lymphocytes with a high mitotic rate and with areas of necrosis giving a “starry-sky” appearance.
Based on these findings, which of the following monoclonal antibodies should be incorporated into the treatment regimen for a better outcome?