Traumatic Ulcerative Granuloma with Stromal Eosinophilia: CD30 analysis and clonality for T cell receptor gene re-arrangement

Aizic, Asaf; Raiser, V.; Solar, Irit; Aharon, Ziva; Shlomi, Benjamin; Kaplan, Ilana

doi:10.1016/j.acthis.2019.151450

Cited by 4 publications

(4 citation statements)

References 19 publications

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“…Histologically, the inflammatory infiltrate comprised eosinophils, small lymphocytes, and large lymphoid cells. A significant number of eosinophils are seen in TUGSE compared to non-specific ulcers [14], rendering eosinophils pathognomonic in TUGSE. However, the number of eosinophils can range from mild to moderate [1] or even sparse [15].…”

Section: Discussionmentioning

confidence: 97%

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A Case Report of Traumatic Ulcerative Granuloma With Stromal Eosinophilia (TUGSE): Clinical and Histopathological Diagnostic Challenges

Mohamad,

Abdul Rahman,

Ch'ng

2023

Cureus

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Traumatic ulcerative granuloma with stromal eosinophilia is a reactive, self-limiting ulcer within the oral cavity; however, clinically, it mimics a malignant ulcer. Here, we report the case of a 13-year-old boy who presented with a painful solitary indurated ulcer at the lower lip for a week. Histopathological examination revealed an ulcerated lesion with significant infiltration of eosinophils, small lymphocytes, and large lymphoid cells. Further immunohistochemistry showed the inflammatory cells were CD3-positive T cells and CD68-positive, with a minority of the cell population showing CD30 positivity. CD1a-positive dendritic cells were also observed. We discuss the clinical and histopathological differential diagnoses of Langerhans cell histiocytosis and CD30-positive T-cell lymphoproliferative disorders and how to correlate them in formulating the final diagnosis.

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Section: Discussionmentioning

confidence: 97%

“…Some authors did suggest TUGSE might be an oral counterpart of primary CD30-positive TLPD [11,13]. However, Aizic et al found TUGSE to be reactive rather than neoplastic, even in cases with CD30-positive atypical cells [14]. In addition, Argyris et al studied a case series of CD30-positive TLPD of the gingiva.…”

Section: Discussionmentioning

confidence: 99%

A Case Report of Traumatic Ulcerative Granuloma With Stromal Eosinophilia (TUGSE): Clinical and Histopathological Diagnostic Challenges

Mohamad,

Abdul Rahman,

Ch'ng

2023

Cureus

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“…However, in the series of 17 cases reported by Aizic et al . in 2019, only seven (41.17%) were positive for CD30, and none of them were monoclonal for TCR, ruling out the possibility of a potentially malignant nature ( 4 ). In the current case, the positivity of CD3, a T cell marker, limited to typical inflammatory lymphocytes, but negativity for CD30, supports the theory that TUGSE is a benign reactive lesion rather than a potentially malignant disorder.…”

Section: Discussionmentioning

confidence: 98%

“…It can be either asymptomatic or associated with mild to severe pain, and the clinical appearance of the lesion tends to provoke fear of malignancy despite its benign nature, once it may resemble squamous cell carcinoma ( 3 ). TUGSE has an uncertain etiology, and although trauma is considered the most frequent cause, the pathological evidence of atypical CD30-positive mononuclear cells within the eosinophil-rich granulation tissue suggests a possible underlying lymphoproliferative disorder ( 4 ). Histologically, TUGSE shows a granulation tissue an eosinophil-rich inflammatory infiltrate that typically extends deep into the connective tissue and muscle, and an ulcerated surface composed of fibrin and neutrophils.…”

Section: Introductionmentioning

confidence: 99%

Traumatic ulcerative granuloma with stromal eosinophilia mimicking a squamous cell carcinoma

Bordignon,

Correia-Neto,

Gondak

et al. 2024

J Clin Exp Dent

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Traumatic ulcerative granuloma with stromal eosinophilia (TUGSE) is a rare lesion of a traumatic-reactive nature of the oral mucosa that can clinically mimic an oral carcinoma. A 59-year-old male patient presented painful ulceration with indurated margins on the base of the tongue, extending to the floor of the mouth. The use of ill-fitting denture hurting the mucosa of the region was reported by the patient. The evolution time was 45 days. The presumptive diagnoses were oral squamous cell carcinoma and chronic ulcer. An incisional biopsy revealed an ulceration associated with an eosinophil-rich inflammatory infiltrate and a bed of proliferating histiocyte-like cells in either diffuse or fasciculate arrangement. There was diffuse immunopositivity for CD3, but focal for CD68 and α-SMA, and negativity for CD30. The final diagnosis was TUGSE. The use of the ill-fitting dental prosthesis was suspended and the lesion had complete spontaneous remission three weeks later. TUGSE is an uncommon traumatic self-limiting lesion that must be included in the differential diagnosis of ulcerative lesions resembling oral cancer. The correlation of clinical and histopathological findings is pivotal for a proper diagnosis, avoiding unnecessary aggressive surgical approaches. Key words: Oral ulcer, eosinophilia, immunohistochemical, differential diagnosis.

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Top Ten Lymphoproliferative Lesions Not to Miss When Evaluating Oral Ulcer Biopsies

Hyrcza

Lindenmuth

Auerbach³

2023

Head and Neck Pathol

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Traumatic Ulcerative Granuloma with Stromal Eosinophilia: CD30 analysis and clonality for T cell receptor gene re-arrangement

Cited by 4 publications

References 19 publications

A Case Report of Traumatic Ulcerative Granuloma With Stromal Eosinophilia (TUGSE): Clinical and Histopathological Diagnostic Challenges

A Case Report of Traumatic Ulcerative Granuloma With Stromal Eosinophilia (TUGSE): Clinical and Histopathological Diagnostic Challenges

Traumatic ulcerative granuloma with stromal eosinophilia mimicking a squamous cell carcinoma

Top Ten Lymphoproliferative Lesions Not to Miss When Evaluating Oral Ulcer Biopsies

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