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Copyright of Meandros Medical & Dental Journal is the property of Galenos Yayinevi Tic. LTD. STI and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Introduction: Gingival overgrowth is a typical clinical manifestation of reactive lesions, which can develop from either known or unknown triggers. There is a dearth of new literature on these reactive conditions, despite the fact that they exert significant influence on the patient's aesthetics, psychology, and oral function. As a result, this report presents three cases of reactive gingival overgrowths. Case Presentation: The three cases of gingival overgrowth that are reported included two females and one male with ages 42 years, 19 years, and 39 years respectively. Traumatic 11mm x 7mm gingival overgrowth was observed in Case 1. Traumainduced sessile gingival overgrowth was 10mm x 8mm in Case 2. Case-3 had 12mm x 9mm pedunculated gingival overgrowth. None of the overgrowths showed any radiographic bone loss or clinical attachment loss. In each of the three cases, the dental hygiene was excellent. Conclusion: Taking into account and comparing the clinical characteristics of these overgrowths with the existing literature, they are identified as reactive pyogenic granuloma. The reported cases shed light on diagnostic steps for this pathology and serve as a reminder for upcoming dental clinicians and researchers. [ABSTRACT FROM AUTHOR]

Soft-tissue lesions in the oral cavity, one of the most common sites for tumors and tumor-like lesions, can be challenging to diagnose and treat due to the wide spectrum from benign indolent to invasive malignant lesions. We report an abnormally large, rapidly growing hyperplastic lesion originating from the buccal mucosa in a 28-year-old male patient. Clinical examination revealed a well-circumscribed, smooth-surfaced, pinkish nodular lesion measuring 2.3 × 2 cm, which suggested the differential diagnosis of irritation fibroma, pyogenic granuloma, oral lipoma, and other benign or malignant neoplasms such as hemangioma, non-Hodgkin's lymphoma, or metastases to the oral cavity. Dental MRI using a 15-channel mandibular coil was performed to improve perioperative radiological and surgical management, avoiding adverse intraoperative events and misdiagnosis of vascular malformations, especially hemangiomas. Black bone MRI protocols such as STIR (short-tau inversion recovery) and DESS (double-echo steady-state) were used for high-resolution radiation-free imaging. Radiologic findings supported the suspected diagnosis of an irritation fibroma and ruled out any further head and neck lesions, therefore complete surgical resection was performed. Histology confirmed the tentative diagnosis. This article evaluates the use of this novel technique for MR diagnosis in the perioperative management of soft-tissue tumors in oral and maxillofacial surgery. [ABSTRACT FROM AUTHOR]

We hereby report an unusual case which presented as a routinely encountered reactive lesion on the palate, whilst the radiological examination revealed a radiolucent cystic lesion underneath. After the investigations from radiography to histopathology, it was finally diagnosed as a peripheral ossifying fibroma coexisting with a nasopalatine duct cyst. [ABSTRACT FROM AUTHOR]

There are many reports showing localized gingival overgrowth which is most commonly reactive rather than neoplastic. The reactive type of lesion includes pyogenic granuloma, irritation fibroma, peripheral giant cell granuloma, and peripheral ossifying fibroma (POF). Among those, POF is a rare reactive gingival type of lesion. Eversole and Rovin in 1972 first described the POF. The main etiology may be due to trauma, local factors such as plaque and calculus, impingement by dental appliance or restorations. This case report shows a clinical presentation of a 40-year-old male reported with the gingival over growth in the lower front teeth region. The patient was provisionally diagnosed as pyogenic granuloma. Management of the lesion included nonsurgical therapy followed by excisional biopsy. Histologic sections were made and confirmed as POF. The patient was followed up to 6 months with no other complication. [ABSTRACT FROM AUTHOR]

Pyogenic Granulomas (PG) are reactive hyperplastic lesions that are formed in relation to some chronic irritation, physical trauma or hormonal factors. PG may present in various clinical and histological forms. These often present as a smoother lobulated exophytic lesions and at times may show a marked resemblance to Peripheral Ossifying Fibroma (POF). However, the characteristic histologic presentation helps indifferentiating both the lesions. Microscopically, presence of ossification in pyogenic granuloma is not common and could possibly indicate an altered response of the connective tissue stroma. The present case reports occurrence of pyogenic granuloma in a 12-year-old individual which on histological examination not only exhibited proliferating blood vessels, endothelial cells and inflammatory cells which are typical features of pyogenic granuloma but also exhibited areas of ossifications which are not frequently encountered in PG. It is important to explore the underlying aetiological factors that could lead to formation of such ossifications. It has been suggested that pyogenic granuloma and peripheral ossifying fibroma could represent part of same spectrum of focal reactive lesions. However, it is still considered that these two lesions are separate clinical entities and the histologic presentations are different and unique to both of them. [ABSTRACT FROM AUTHOR]

Introduction: Oral lesions are divided into non-neoplastic lesions, potentially malignant lesions and neoplastic lesions. More clinical data are needed to determine their helpful clinical pattern. Aim: To present the epidemiological, clinical and histopathological characteristics of the oral lesions. Material and methods: The retrospective study group comprised records of 208 patients which were reviewed according to selected epidemiological and clinical features. All the biopsy specimens were classified into: reactive lesions, precancerous lesions/potentially malignant lesions, salivary gland pathologies, benign and malignant tumours. Results: The lower lip was the most common site involved followed by buccal and vestibular mucosa. The most frequent diagnoses were fibroma, mucocele and papilloma. The predominant pathomorphological forms were nodule and bulla. The most frequent salivary gland pathology was mucocele. Fibroma was the most frequent pathomorphological diagnosis, followed by mucocele and reactive lesions such as irritation fibroma (IF) and granuloma. Conclusions: In cases of oral mucosal lesions, we propose the following algorithm: the exclusion of all odontogenic and iatrogenic causes; the detection and elimination of harmful habits, parafunctions and irritants from the oral cavity especially from the vestibule of the oral cavity and from the lips; all surgical treatment should be performed only after the proper detection and elimination of causative factors to decrease the risk of recurrence; excisional biopsy or in more diffuse lesions incisional biopsy is recommended to confirm clinical diagnosis; and consideration of other factors that can modify the clinical pattern of oral lesions, such as oral hygiene, systemic diseases, and drugs. [ABSTRACT FROM AUTHOR]

Introduction: Foreign bodies and tissue reactions to foreign materials are commonly encountered in the oral cavity. Exogenous materials causing foreign body reactions may be metallic (amalgam) or nonmetallic (suture materials, vegetable matter). Implantation of food particles in the oral tissues has been known to cause reactive lesions such as oral pulse granuloma. Implantation could be through extraction sockets, deep periodontal pockets, associated with tumor growth, interdental areas of teeth, unfilled root canals, and grossly decayed teeth. These get rapidly digested and altered by host responses. Cellulose persists as hyaline material and invokes chronic granulomatous response. This change may mimic other pathologies.Materials and Methods: Representative specimens from commonly consumed food groups were selected, fixed in 10% neutral buffered formalin, processed, sectioned, stained with hematoxylin and eosin stain and observed under light microscope.Results: Each specimen revealed unique, distinct histology of each food type. The plant materials had a characteristic appearance of rigid double cell wall while rigid regular partitions containing nutrient material were revealed in seeds and beans. Starch-contained lentils exhibited clear spaces. Following is a brief description of some of the significant histological findings of each of the specimens processed and stained.Conclusion: Thus, the study of histological structure of vegetables and legumes will enable their easy recognition in oral biopsy samples and help in distinguishing them from other pathologies and artifact. [ABSTRACT FROM AUTHOR]

Objective: This study reviews, analyzes, and compares the demographic data, histopathological features and discusses the treatment and prognosis of reactive lesions (RLs). Materials and Methods: Retrospective study was performed on the departmental archives from July 2006 to July 2016 (total 5000 cases) comprising of 659 cases of RLs of the oral cavity. The recorded data included age, gender, size, site, duration, habits, etiology, histopathological diagnosis, treatment, and prognosis. Results: The most common lesion was found to be inflammatory fibrous hyperplasia (47%) followed by pyogenic granuloma (PG) (27.16%) and the least cases were of peripheral giant cell granuloma (1.6%). The mean age for the occurrence was 4th-5th decade in all the RL's exceptperipheral ossifying fibroma (POF) which presented in the third decade. Female predominance was noted in all lesions except irritational FIB. The sizes of majority of the lesions were approximately 0.5-1 cm. The common sites were anterior maxilla followed by posterior mandible and least in tongue with no associated habits (82.2%). The duration of all the lesions was seen to be <1 year. Majority of them presented with poor oral hygiene status (87.2%). Recurrences were present in 13.5% of surgically excised lesions. Conclusion: The RLs present commonly in oral cavity secondary to injury and local factors which can mimic benign to rarely malignant lesions. The clinical and histopathological examination helps to categorize the type of lesions. The complete removal of local irritants with follow-up and maintenance of oral hygiene helps to prevent the recurrences of such lesions. [ABSTRACT FROM AUTHOR]

Objectives: Aim of the present study was clinical and histopathological evaluation of a series of epulides to provide clinicians data to frequency distribution and biological behaviour of different underlying entities. Materials and methods: Ninety-two cases of epulides removed by CO-laser at the Department of Oral Surgery and Radiology, Medical University of Graz from 2000 to 2014 were studied retrospectively for clinical data and histopathological diagnosis. Results: In the presented study, histopathological examination revealed peripheral ossifying fibroma (32.6 %), fibroma/fibrosis (29.3 %), giant cell lesion (13.1 %) and granuloma pyogenicum (8.7 %) as the most frequent underlying entities. For the first time, hyperplastic squamous epithelium (7.6 %), granulation tissue (5.4 %) and peripheral odontogenic fibromas (3.3 %) were detected to clinically appear as epulides. Irrespective of the histological diagnosis, the mean age in our patients was 43.8 years. The majority of the lesions were found in the frontal region of both jaws. In all cases, the patients showed poor oral hygiene, local gingivitis and some of them an occlusal trauma. Conclusions: To identify different entities with different biological behaviour, to exclude malignant tumours and to identify new entities among epulides, histopathological examination is required. Poor oral hygiene and occlusal trauma seem to play an important role in the pathogenesis and could be risk factors for recurrences. Clinical relevance: Frequency distribution of different entities in epulides is provided to clinicians, and new histopathological entities were detected to clinically appear as epulides. [ABSTRACT FROM AUTHOR]

Objective of this study was aimed to highlight the frequency and prevalence of oral pathological lesions. Four hundred and twenty five patients visiting the Department of Oral and Maxillofacial Surgery/ Oral Medicine of Qurayyat Specialized Dental Center, Al-Qurayyat, Saudi Arabia, were included in the study. The study was conducted from year 2011 to 2015. Frequency of patients was noted. Males were 260/425 (61.2%) and females 165/425 (38.8%). Age range was 6-77 years with mean 38.4 + 13.65. Reactive lesions were the most common occurrences, diagnosed in 425 cases (8.94%), and followed by fungal infections (7.8%), lichen planus (7.1%) and pulp and periapical lesions (6.82%). Most common malignant lesion was squamous cell carcinoma 4.7 % (30/425). Most common salivary gland pathology was mucoepidermoid carcinoma 3.1% (13/425). [ABSTRACT FROM AUTHOR]

Background/aim: To investigate the relative frequency of biopsied nonneoplastic oral mucosal lesions in Ankara, Turkey. Materials and methods: Biopsy records of a single center from 2000-2012 were retrospectively collected. Diagnosis was recorded and evaluated with respect to patient demographics (age, sex) and location of the lesion. Results: Of 11,980 biopsies, 1732 (14.5%) were mucosal nonneoplastic lesions. Hyperplastic lesions (n = 1000, 57.7%) with fibroepithelial hyperplasia in 30.9% of patients were the most common type of oral nonneoplastic lesions. The mean age of patients differed with respect to type of mucosal lesion, tending to be lower in patients with reactive lesions. Dermatoses showed a female predominance. Conclusion: Our findings revealed that hyperplastic lesions were the most common among nonneoplastic oral mucosa lesions. Geographic and ethnic differences of patients with various types of oral mucosal lesions require further investigation. [ABSTRACT FROM AUTHOR]

Background: Biopsy is an important diagnostic tool used in the diagnosis of lesions ranging from simple non-neoplastic, tumor-like lesions to malignancies, and is often the only way to diagnose oral lesions and diseases. The gingiva is the most common site for some kind of irritation or low-grade injury, resulting in localized overgrowths that are considered to be reactive and non-neoplastic lesions. This aim of this study is to analyze the frequency and distribution of gingival lesions in the Gujarati population. Materials and Methods: In this retrospective study, gingival biopsies submitted for a period of five years were included. Microscopic slides of all the cases were reviewed by two observers for confirmation of the diagnosis. Results: Among the 106 cases of gingival biopsies, the most frequent category of lesions encountered was the non-neoplastic category, which accounted for 73.58% of the cases. Both benign and malignant neoplasms constituted 26.42% of the cases. Among the non-neoplastic lesions, Pyogenic granuloma was the most frequent lesion (38.46%), followed by fibrous hyperplasia (20.51%), inflammatory hyperplasia (19.23%), and Epulis (8.97%). Neoplasms accounted for 26.42% of the gingival biopsies (92.85% benign and 7.15% malignant). Among the benign neoplastic lesions, Fibroma (30.76%) and Fibrolipoma (26.92%) were the most frequent, followed by peripheral ossifying fibroma (23.08%) and peripheral giant cell granuloma (11%). Conclusion: It is difficult to compare studies carried out in various countries due to differences in people's attitudes toward oral health and the accessibility of various population groups to biopsy services. Nevertheless, this study has provided some information about the frequency and distribution of biopsied gingival lesions in the Gujarati population over a period of five years. [ABSTRACT FROM AUTHOR]

Peripheral ossifying fibroma (POF) a is reactive gingival hyperplasia which originates from cells of the periodontal ligament. Clinical presentations of POF are similar to that of other gingival hyperplasias and definitive diagnosis requires histopathological examination. We report a case of POF in maxillary gingiva. The lesion was asymptomatic, slow growing, reddish pink in colour and histopathologically revealing stratified squamous epithelium and foci of mineralization in the form of bony trabeculae in the connective tissue. This article highlights the nomenclature, clinicopathological features and pathogenesis of POF. [ABSTRACT FROM AUTHOR]

Background: Reactive lesions of the oral cavity are non-neoplastic proliferations with very similar clinical appearance to benign neoplastic proliferation. This similarity is troublesome in the differential diagnosis. The aim of this study was to determine the frequency and distribution of oral cavity reactive lesions. Materials and Methods: The study was a retrospective archive review. The medical records of 2068 patients with histopathologic diagnosis of oral cavity reactive lesions were studied. The patients’ clinical data were registered and evaluated retrospectively. The obtained frequency of patients’ age, gender, and anatomic location were analyzed. Descriptive statistics were used for evaluating the registered data. Results: Peripheral giant cell granuloma was the most prevalent lesion (n=623, 30.12%). This was followed by pyogenic granuloma (n=365, 17.65%), epulis fissuratum (n=327, 15.81%), irritation fibroma (n=288, 13.93%), cemento-ossifying fibroma (n=277, 13.40%), inflammatory fibrous hyperplasia (n=177, 8.56%), and inflammatory papillary hyperplasia (n=11, 0.53%). The age ranged from 2 to 85 years, with a mean of 39.56 years. The lesions were more common in males (n=1219, 58.95%) than in females (n=849, 41.05%). Attached gingiva with 1331 (64.36%) cases was the most frequent place of reactive lesions. Conclusion: Peripheral giant cell granuloma was the most prevalent reactive lesion of the oral cavity. The reactive lesions were more common in males, gingival, and the third decade. Some differences have been found between the findings of the present study and previous reports. [ABSTRACT FROM AUTHOR]

Lymphoproliferations are generally diagnosed via histomorphology and immunohistochemistry. Although mostly conclusive, occasionally the differential diagnosis between reactive lesions and malignant lymphomas is difficult. In such cases molecular clonality studies of immunoglobulin (Ig)/T-cell receptor (TCR) rearrangements can be useful. Here we address the issue of clonality assessment in 106 histologically defined reactive lesions, using the standardized BIOMED-2 Ig/TCR multiplex polymerase chain reaction (PCR) heteroduplex and GeneScan assays. Samples were reviewed nationally, except 10% random cases and cases with clonal results selected for additional international panel review. In total 75% (79/106) only showed polyclonal Ig/TCR targets (type I), whereas another 15% (16/106) represent probably polyclonal cases, with weak Ig/TCR (oligo)clonality in an otherwise polyclonal background (type II). Interestingly, in 10% (11/106) clear monoclonal Ig/TCR products were observed (types III/IV), which prompted further pathological review. Clonal cases included two missed lymphomas in national review and nine cases that could be explained as diagnostically difficult cases or probable lymphomas upon additional review. Our data show that the BIOMED-2 Ig/TCR multiplex PCR assays are very helpful in confirming the polyclonal character in the vast majority of reactive lesions. However, clonality detection in a minority should lead to detailed pathological review, including close interaction between pathologist and molecular biologist.Leukemia (2007) 21, 222–229. doi:10.1038/sj.leu.2404482; published online 14 December 2006 [ABSTRACT FROM AUTHOR]

Copyright of Der Pathologe is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Oral and maxillofacial lesions (OMFLs) in pediatrics differ markedly from their adult counterparts in terms of clinical conduct, pathological behavior, and management. This study aims to determine the frequency of OMFLs among pediatric and adolescent patients and to correlate the demographics information to the site, and histopathological findings. Pathological records of pediatric and adolescent patients were retrieved from three major pathological centers in Sulaimani city of Iraq. Demographic information, surgical procedure, anatomical sites, and histopathological diagnosis were recorded. Furthermore, The World Health Organization (WHO) International Statistical Classification of Diseases and Related Health Problems (ICD-10) was used for coding. A Chi-square test was used to find the relation between different variables, and a p-value < 0.05 was considered statistically significant. This study archived 309 (13.3%) out of 2319 pediatric and adolescent patients, with a mean age of 11.04 ± 4.62. Females were more commonly detected (52.8%). The most frequently diagnosed lesions were salivary gland diseases (20.7%), followed by reactive hyperplastic connective tissue (18.4%). A significant relation was found between age groups and diagnostic categories (p = 0.001). The lips were the most commonly detected sites (20.7%). Mucocele was the most frequently seen non-neoplastic lesions (19.4%), followed by pyogenic granuloma (8.7%). Neoplastic lesions revealed predominant hemangioma (3.2%), followed by peripheral ossifying fibroma (1.9%). Traumatic and or reactive lesions were the most commonly reported lesions. Malignant neoplasms can be identified. The current study enabled systematic data recording of pediatric and adolescent patients, encouraging the importance of the oral healthcare system in identifying and managing the problem early in this critical age in this region. [ABSTRACT FROM AUTHOR]

Plasma cell granuloma is a rare benign lesion characterized by the infiltration of plasma cells; primarily occurring in the lungs. It is also seen to occur in the brain, kidney stomach, heart, and so on. In the intraoral region it is seen to involve the tongue, oral mucosa, and gingiva. This case presents a 42-year-old female, with an enlargement in the maxillary anterior region, treated by excisional biopsy. Histological evaluation revealed plasma cell infiltrates in the connective tissue. The immunohistochemistry revealed kappa and lambda light chains with a polyclonal staining pattern, which confirmed the diagnosis of plasma cell granuloma. [ABSTRACT FROM AUTHOR]

Background: Tissue eosinophilia may be caused due to reactive, neoplastic or idiopathic reasons. Reactive eosinophils in allergic and inflammatory conditions are transient and recruited from the circulation in response to various stimuli, whereas neoplastic eosinophils of leukemias and hematological malignancies are involved in the pathogenesis of the disease. The differentiation of reactive from neoplastic eosinophils has a serious implication on the treatment and prognosis of diseases. However, both these types of eosinophils display variation in morphology and staining characteristics in routine histopathology leading to a diagnostic dilemma. Aim: The aim of this study is to evaluate the efficacy of special stains for the demonstration of eosinophils in normal/reactive lesions and leukemias. Methodology: A retrospective study comprising twenty histologically diagnosed cases each of reactive oral lesions and leukemias were obtained from institutional archives. These tissue sections were subjected to staining with routine and special stains – Carbol chromotrope, Congo red, Leishman's stain, Periodic Acid–Schiff-papanicolaou (PAS-PAP) and PAS. Statistical analysis was performed using Pearson's Chi-square test to compare the various parameters in the evaluation of the staining efficacy. Results: Carbol chromotrope and Congo red staining showed increased staining efficacy in normal/reactive eosinophils while PAS-PAP followed by PAS and Leishman's stain showed enhanced features such as homogenicity, specificity, increased staining intensity, enhanced nuclear and cytoplasmic details in leukemic eosinophils. Conclusion: Combined PAS-PAP is a novel and cost-effective staining technique in differentiating reactive and leukemic eosinophils. It is significant in recognizing leukemic eosinophils of routine biopsies and alerts the clinician to rule out any underlying malignancies. [ABSTRACT FROM AUTHOR]

Background: Reactive lesions of the oral cavity are nonneoplastic proliferations with very similar appearance to benign neoplastic lesions and are associated with chronic local irritation or trauma. Although these lesions are uncommonly associated with carcinogen exposure, at times, they present histopathologically with dysplastic epithelium, thus making it difficult to differentiate it from true potentially malignant disorders. Hence, the present study was conducted to evaluate the expression of Bcl-2 protein, an antiapoptotic marker, in reactive lesions with and without atypical epithelium and in true epithelial dysplasia, which clinically presents as premalignant disorders. Materials and Methods: The samples included 15 cases each of normal oral mucosa (NOM), reactive lesions with and without dysplasia and oral epithelial dysplasia (OED) associated with carcinogen exposure. All the samples were subjected to immunohistochemical staining using Bcl-2 antibody. The total number of cells in the basal and parabasal layers in each field and total number of cells expressing Bcl-2 among them and the staining intensity were assessed. Statistical Analysis: Kruskal–Wallis ANOVA test was used to compare the number of positive cells among the four groups. The comparison of average percentage of positive cells between the study groups was done using Mann–Whitney U-test. Results: The immunohistochemical staining for Bcl-2 protein was identified in few cells in the basal layers of NOM, reactive lesions without atypical epithelium and in the basal and parabasal layers in reactive lesions with atypical epithelium and OED, as a granular cytoplasmic staining and as an accentuation around the nuclear membrane. There was a gradual increase in the expression and intensity of staining from Group I to IV. Interpretation and Conclusion: The altered or increased expression of Bcl-2 oncoprotein in reactive lesions with atypical epithelium and in OED with carcinogen exposure may lead to prolonged cell survival and can be considered as an early molecular event in carcinogenesis, helping us in understanding the nature of dysplasia in reactive lesions, which was not considered during the histopathology reporting. [ABSTRACT FROM AUTHOR]