Plasma cell mucositis with gingival enlargement and severe periodontitis

Abstract

Plasma cell mucositis (PCM) is a very rare, chronic, multifocal, idiopathic, non-neoplastic plasma cell proliferative disorder of the upper aerodigestive tract. The classic clinical presentation is an intensely erythematous mucosa with surface changes described variously as papillomatous, cobblestone, nodular or velvety. It is a very rare condition <50 cases reported in literature. A 72-year-old male patient complained of sore throat, stomatodynia, dysphagia, multiple oral ulcers, enlarged swollen bleeding gums and mobile teeth. There was chronic inflammatory enlargement of the gingiva and palate with severe periodontitis. Histopathological examination revealed a hyperplastic epithelium with a dense infiltrate of mature polyclonal plasma cells in the superficial layer of the lamina propria. PCM is a diagnosis of exclusion, to be differentiated from other infective, reactive, autoimmune, allergic and neoplastic disorders with plasma cell infiltrates. Management with surgical and immunosuppressive therapy is mostly ineffective with short remissions and frequent relapses.

An Uncommon Case of Plasma Cell Mucositis of the Tongue in a Young Man

“…Several times, PCM lesions can enter into differential diagnosis with squamous cell carcinoma (SCC) [4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20][21][22]; in literature, there are cases in which a differential diagnosis was made with oral carcinoma and there is a case report where a SCC arose from a mucosal plasmacytosis [13]. Therefore, a correct diagnosis and adequate management of the disease are essential.…”

Plasma cell mucositis of the larynx

“…Similar analogues have been reported in the nose, lower respiratory tract, and gingiva, potentially spreading from the latter to the supraglottis . Isolated plasma cell mucositis of the upper aerodigestive tract is a rarely encountered variant with <50 cases in the literature . The presence of this pathological process within the larynx was identified in only 10 cases, but these also involved other subsites.…”

“…A case presented by Tong et al believed that a toothpaste may be responsible, with the possibility of an ingredient evoking a hypersensitivity reaction. Other case reports have emphasized the presence of severe periodontitis . There is also some suggestion of an association with pre‐existing autoimmune disease, and this is particularly evident in a case report by Lee et al discussing a patient with SLE and Sjogren's syndrome.…”

“…Other case reports have emphasized the presence of severe periodontitis. 5,8 There is also some suggestion of an association with pre-existing autoimmune disease, 6 and this is particularly evident in a case report by Lee et al 9 discussing a patient with SLE and Sjogren's syndrome.…”

“…4 Isolated plasma cell mucositis of the upper aerodigestive tract is a rarely encountered variant with <50 cases in the literature. 5 The presence of this pathological process within the larynx was identified in only 10 cases, but these also involved other subsites. There was only one case of isolated laryngeal involvement.…”