Oral pyogenic granuloma: An 18‐year retrospective clinicopathological and immunohistochemical study

Abstract

Background Pyogenic granuloma (PG) is a lesion characterized by the proliferation of blood vessels, commonly affecting the skin and the mouth. We aimed to compare clinical, microscopic, and immunohistochemical features of the two types of oral PG: lobular capillary hemangioma (LCH) and non‐LCH (NLCH). Methods Epidemiological and clinical data from 2000 to 2018 were collected from the archives of our institution, and histopathological sections of PG were reviewed. Immunohistochemical analyses (CD34, D2‐40, SMA, mast cell, and Ki‐67) were performed in 34 cases. Results Sixty‐two LCH and 107 non‐LCH samples were included. The mean (±SD) age of the patients was 38.59 ± 16.96 years; 55.62% were female; 39.64% of cases occurred in the gingiva, 44% of the nodules were pedunculated, and 13.02% of patients reported a history of trauma. NLCH was more prevalent among older patients than LCH. The most prevalent site of LCH was the lips, while NLCH occurred more in the gingiva (P < 0.05). Epithelial atrophy, microvessels, SMA‐positive areas, and Ki‐67‐positive nuclei were more prevalent in LCH (P < 0.05). Conclusions PG accounted for 2.25% of lesions archived in the pathology service and most cases were NLCH. LCH and NLCH exhibited clinicopathological differences in terms of age, site, epithelial atrophy, vascularization, and proliferation rate.

Large Lobular Capillary Hemangioma Associated with Ingrown Toenail: Histopathological Features and Case Report

“…LCH-PG presents specific pathological and immune-histochemical characteristics, characterized by the proliferation of newly formed small vessels, oedema, mixed cell infiltrate, and fibrous septa and collarettes of the adnexal epithelium that partially surround the lesion. As in the case presented here, this distinctive pattern becomes more evident when the epidermis regenerates and when a fibrosis surrounds the capillary tufts [ 1 , 13 , 14 ]. In the present case, immuno-histochemistry was not performed since the endothelial cells could be observed and a definitive diagnosis could be made with only Masson’s trichrome staining.…”

Diagnosis and management of exuberant palatal pyogenic granuloma in a systemically compromised patient – Case report

“…Pyogenic granuloma is clinically characterized as a small nodule or papule that arises as a result of an inflammatory reaction, such as local irritation and trauma, which stimulates the development of a highly vascularized granulation reaction. [6][7][8] Previously, it was thought to result from pus-producing microorganisms, leading to the term 'pyogenic'. 9 In the oral cavity, this condition was also responsible for 28% and 50.3% of reactive lesions diagnosed in surveys from Brazil and India, respectively.…”

“…4,5 The etiopathogenesis of oral pyogenic granulomas is linked to chronic low-intensity stimuli (such as local irritation and trauma) and, therefore, this lesion is commonly found in individuals with dental calculus and periodontal disease. 6,8 Thus, it is likely that hormonal factors, such as diabetes mellitus, which alter the host's immune response and directly affect periodontal health 3,5 , may interfere with the appearance of more exuberant oral pyogenic granulomas.…”

Overview of Oral Pyogenic Granuloma

“…This variance suggests that there are two distinct histological types of PG. According to Toida et al [41], some pathogenic factors may have an impact on the development of blood vessels with different luminal sizes in the central region of non-LCH PG and the lobular region of LCH PG.…”