Focal ulcero-proliferative gingivitis: A rare presentation of mucosal tuberculosis

Abstract

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Oral and temporomandibular tuberculosis: A State-of-the-art literature review

“…Incisional, deep tissue (punch) or aspiration biopsy can also be performed and can be complemented with lymph node biopsy when there is lymphedema (100% sensitive) [25] to verify them with Ziehl-Neelsen staining (53% sensitive) [25] , where you can observe acid-fast bacilli 36 or PCR test (60% sensitive) [25] direct tissue (formalin-fixed or paraffinembedded biopsy sections) targeting the 6,110 insertion sequence of TB [37,38] or the 65 kDa heat shock protein (Hsp65) [39] . Sometimes, superficial biopsies present false negatives due to epithelial hyperplasia [40] , so multiple biopsies may be necessary {41] . In 26.8% sputum test was used, in 24.7% culture was used and in 24.7% purified protein derivative (PPD) or Mantoux test was used [23] .…”

“…Having obtained the TB vaccine (bacillus Calmette-Guerin), does not guarantee that oral TB lesions will not develop [25] . Some differential diagnoses to consider are persistent and neoformative oral ulcers such as primary gingival carcinomas, metastatic lymphoproliferative malignancies, Wegener's granulomatosis, sarcoidosis, microscopic polyangiitis, pemphigus, erosive lichen planus, mucous membrane pemphigoid, Crohn's disease, Wegner's granulomatosis, aphthous ulcer, traumatic ulcer, syphilitic ulcer, actinomycosis, deep fungal infection, drug-induced hypertrophy, leukemic infiltrate and Kaposi's sarcoma as they may present with similar morphology [4,5,40,43] .…”