A study was made of a series of 302 consecutive cases of localized hyperplastic lesions of the gingiva (epulides). The lesions were classified into five groups: pyogenic granuloma, calcifying fibroblastic granuloma, fibrous hyperplasia, peripheral giant cell granuloma and denture hyperplasia. The study indicates that there are some differences in age and sex distribution as well as in location between the different histological groups. Pyogenic granuloma was found to be the most common lesion on the gingiva. Pyogenic granuloma and calcifying fibroblastic granuloma occur in younger patients more often than fibrous hyperplasia, and thus may represent a stage in the development of fibrous hyperplasia. Denture hyperplasia occurs predominantly in females and it is suggested that its formation may be affected by hormonal alterations in the menopause.
Kaposi's sarcoma of the gingiva and skin developed in an HIV-negative renal transplant patient while he was receiving cyclosporine therapy. The Kaposi's sarcoma developed shortly after the patient had an acute infection with cytomegalovirus (CMV). Electron microscopy of the tumor's established cell line showed two types of virus-like particles. CMV DNA was identifiable in the cell line whereas infectious CMV could be isolated only after repeated passages (only after 3 months of culture). The other virus could not be identified, but did not appear to be either HIV or papilloma virus. The patient's tumor regressed after the discontinuation of cyclosporine therapy and the recovery from the acute CMV infection.
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