Retrospective analysis of the histopathologic features of 288 cases of reactional lesions in gingiva and alveolar ridge

Appl Immunohistochem Mol Morphol. 2014 Aug;22(7):505-10. doi: 10.1097/PAI.0b013e31829ea1c5.

Abstract

Introduction: The aim of this study was to perform a retrospective study of histopathologic features of a series of cases of pyogenic granuloma (PG), peripheral giant cell lesion (PGCL), and peripheral ossifying fibromas (POF) that constitutes the group called reactional lesions, located in gingiva and alveolar ridge.

Study design: Cases of PG, PGCL, and POF were selected for this study. The morphological analysis of the lesions constituted the following: intensity of inflammatory infiltrate (IF), presence of vascular proliferation (VP), fibroblastic proliferation (FP), areas of ulceration (AU), bacterial colony (BC), presence of mineralization (PM), multinucleated giant cells (MGC), hemosiderin deposition (HD), hemorrhage area (HA).

Results: Of the 288 cases analyzed, 162 (56.3%) were PG, 72 (25%) were PGCL, and 54 (18.8%) were POF. The IF, VP, AU, and BC were more prominent in PG (85.8%, 98.8%, 91.4%, and 46.9%, respectively) and PM in POFs (98.1%). FP was more frequent in POF (98.1%) and PGCL (100%) and MGC in PGCL (100%), although some cases of POF (7.4%) and PG (0.6%) exhibited MGC. HD was more frequent in PGCL (40.3%) and HA in PG (53.1%).

Conclusions: This study demonstrated that IF, VP, AU, BC, and HA are the common features in PG, MGC, FP, and HD are the most common in PGCL, and PM associated with FP are the most common in POF, which can help in the histopathologic differential diagnosis between these lesions. In addition, it may suggest a possible development and maturation of the PG in POF with reduction in the inflammatory component and increase in the fibrous component.

MeSH terms

  • Alveolar Process* / metabolism
  • Alveolar Process* / pathology
  • Cell Proliferation
  • Female
  • Fibroblasts / metabolism
  • Fibroblasts / pathology
  • Fibroma, Ossifying* / metabolism
  • Fibroma, Ossifying* / pathology
  • Giant Cells / metabolism
  • Giant Cells / pathology
  • Gingiva* / metabolism
  • Gingiva* / pathology
  • Granuloma, Pyogenic* / metabolism
  • Granuloma, Pyogenic* / pathology
  • Humans
  • Inflammation / metabolism
  • Inflammation / pathology
  • Jaw Neoplasms* / metabolism
  • Jaw Neoplasms* / pathology
  • Male
  • Retrospective Studies