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The goal is to show a rare case of Giant Cell Tumor of Bone in the maxillary sinus implicated in a process coincidentally or casually with another type of lesion primarily developed. A 33-year-old male patient attended a surgical service, presenting swelling, obstruction and firm mass externalizing through the right nostril and perceived during 6 months. During the anamnesis, the patient stated to been underwent an incisional biopsy 4 years ago of a tumor with histopathological diagnosis of the Nasal Paraganglioma, however the immunohistochemical study was negative for this tumor. During the Computed Tomography evaluate was observed a hyperdense mass occupying the entire maxillary sinus. In the Nuclear Magnetic Resonance evaluation, it was showed a hypersignal image in the entire maxillary sinus, invading the nasal cavity and portion of skull base. A bone window was performed in the right maxillary sinus and excisional biopsy was made. In the new histopathological examination, the diagnose was consistent with Giant Cell Tumor of Bone, being observed a large number of multinucleated giant cells, some with disorganized nuclei and others similar to Touton giant cells. A large proliferation of xanthomatous-looking cells was also observed without features of malignity. At the 3-year follow-up, the patient reported no complications such as facial paralysis, infection, relapse or spread. The association between lesions occurring in the same location requires further study, possibly implicated in a new model of clinical, microscopic, and genetic disorders. Thus, masses originating from chronic inflammatory tissue may have the potential to transform into GCTB? El objetivo de este trabajo es reportar un caso raro de Tumor Óseo de Células Gigantes en Seno Maxilar implicado en un proceso coincidente o casualmente con otro tipo de lesión desarrollada primariamente en la región. Paciente masculino de 33 años de edad, atendido en el servicio de cirugía oral y maxilofacial, con tumefacción, obstrucción y masa firme exteriorizada por fosa nasal derecha de 6 meses de evolución. Durante la anamnesis, lo paciente refirió haber sido sometido a biopsia incisional hace 4 años, en la misma región, con diagnóstico de paraganglioma nasal, sin embargo el estudio inmunohistoquímico fue negativo para este tumor. En la tomografía computarizada se observó una masa hiperdensa que ocupaba todo el seno maxilar. En la evaluación de resonancia magnética también se observó una masa con hiperseñal que invadía la cavidad nasal y parte de la base del cráneo. Se realizó una ventana de hueso en el seno maxilar derecho y se instituyó una biopsia excisional. En el nuevo examen histopatológico el diagnóstico fue compatible con Tumor Óseo de Células Gigantes, observándose un gran número de células gigantes multinucleadas, algunas con desorganización nuclear y otras similares a las células gigantes de Touton. También se observó una amplia proliferación de células xantomatosas sin signos de malignidad. Después de 3 años de seguimiento, el paciente evolucionó sin complicaciones ni recurrencia. La asociación entre lesiones que ocurren en el mismo lugar requiere más estudios, posiblemente implicados en un nuevo modelo de trastornos clínicos, microscópicos y genéticos. Entonces, ¿las masas que se originan en tejidos crónicamente inflamados podrían tener el potencial de transformarse en TCGO? O objetivo deste trabalho é relatar um raro caso de Tumor de Células Gigantes do Osso em Seio Maxilar implicado em um processo coincidentemente ou casualmente com outro tipo de lesão primariamente desenvolvida na região. Paciente, masculino, 33 anos, atendido no serviço de cirurgia bucomaxilofacial, apresentando tumefação, obstrução e uma firme massa externalizada pela narina direita com duração de 6 meses. Durante a anamnese o paciente relatou ter sido submetido a biópsia incisional 4 anos atrás, na mesma região, com diagnóstico de paraganglioma nasal, contudo o estudo imunohistoquímico foi negativo para este tumor. Na avaliação Tomográfica foi observado massa hiperdensa ocupando todo o seio maxilar. Na avaliação de Ressonância Nuclear Magnética foi observado também uma massa com hipersinal, invadindo a cavidade nasal e porção da base do crânio. Uma janela óssea foi realizada no seio maxilar direito e a biópsia excisional foi instituída. No novo exame histopatológico o diagnóstico foi consistente com Tumor de Células Gigantes do Osso, sendo observado um largo número de células gigantes multinucleadas, alguns com desorganização nuclear e outras similares às células gigantes de Touton. Larga proliferação de células xantomatosas também foi observado sem sinais de malignidade. Após 3 anos de proservação o paciente evoluiu sem complicações ou recidiva. A associação entre as lesões ocorrendo no mesmo lugar requer estudos mais aprofundados, possivelmente implicado em um novo modelo de desordens clinicas, microscopicas e genéticas. Sendo assim, massas originadas de tecidos cronicamente inflamados poderão ter o potencial de se transformarem em TCGO?

Epidemiologic studies of oral lesions in pediatric patients are scarce in Brazil, and especially in the northern region of the country. We aim to describe the distributions of oral lesions in children and teenagers diagnosed in a Pathology service of Amazon for over 15 years.The oral pathology files were retrospectively retrieved from January 2002 to December 2016 of patients younger than 18 years old at the Pathology Service of the Federal University of Amazonas. Patient information such as gender, age, race, aspect of the lesion, anatomical site, and histological type was compiled from the file of requisitions and histopathologic reports. Oral lesions were subdivided into 11 categories.From a total of 2437 histopathological oral reports, 225 of them were from children. Of these, 125 (55.6%) were from male patients and 100 (44.4%) from female patients with a median age of 13 years. Of the 11 categories of oral pathologies, the one of the highest numbers was salivary gland disease (N.=50, 22.2%) with the subtype mucocele (N.=41, 18.22%) as the most prevalent followed by Miscellaneous pathology (N.=27, 12%) with the predominance of the subtype granulation tissue (N.=11, 4.89%) and finally Odontogenic tumors (N.=26, 11.6%) in third place, with odontoma (N.=16, 7.11%) as the most prevalent subtype.Mucocele was the most prevalent lesion found, showing that a traumatic etiology is likely to be the most common situation in children and teenagers, while neoplastic lesions are generally rare.

Giant Cell Tumor of Bone is an uncommon aggressive benign neoplasm that frequently affecting the epiphysis of long bones especially around the knee. This is a singular rare case of GCTB in the right maxillary sinus implicated in a process coincidentally or casually with another type of lesion primarily developed.

Os linfomas compreendem um grupo diverso de neoplasias malignas, provenientes de células do sistema imunológico em diferentes estágios de diferenciação. Objetivo: o propósito deste artigo é facilitar o diagnóstico do linfoma difuso de grandes células B (LDGCB) por meio de seus aspectos clínicos, morfológicos e imunoistoquímicos, além de suas peculiaridades como manifestação primária em boca. Revisão de literatura: foi realizada uma revisão narrativa da literatura por intermédio de artigos selecionados nas bases de dados PubMed, Medline, SciELO e Lilacs, pela busca por palavras-chave. Aspectos relacionados a classificação e manifestações clínicas também foram considerados, a fim de facilitar o entendimento da lesão e de suas particularidades em boca. Verificou-se que o LDGCB representa a variante mais comum em boca. Os sinais e sintomas clínicos relacionados a essa condição podem ser: aumento de volume, dor, ulceração, alteração de cor da mucosa ou até mesmo parestesia. Morfologicamente, os LDGCBs apresentam células grandes, com padrão de crescimento difuso, citoplasma escasso, nucléolos evidentes e mitoses. Na imunoistoquímica, os LDGCBs são geralmente positivos para CD20 e outros marcadores da linhagem B (CD19, CD79a, PAX5 e CD138), dependendo do estágio de maturação em que se encontram as células B. Considerações finais: o diagnóstico do LDGCB em boca representa um desafio contínuo para os patologistas, em função da heterogeneidade de suas características morfológicas e imunofenotípicas.

OBJECTIVES The aim of this study was to investigate the prevalence of oral sarcomas from geographic regions of Brazil. MATERIALS AND METHODS A cross-sectional study was conducted on biopsies obtained from January 2007 to December 2016 at twelve Brazilian oral and maxillofacial pathology centres. Gender, age, evolution time, clinical aspects, tumour location, tumour size at diagnosis, radiographic aspects and histopathological diagnosis were evaluated. Data were analysed using descriptive statistical methods. RESULTS From 176,537, a total of 200 (0.11%) oral sarcomas were reported, and the most prevalent were osteosarcomas (74 cases; 37%) and Kaposi's sarcomas (52 cases; 26%). Males were more affected than females at a mean age of 32.2 years old (range of 3-87 years). The most common symptoms were swelling¸ localised pain and bleeding at a mean evolution time of 5.14 months (range

Os lipomas são tumores de tecido mole que raramente acometem a cavidade oral. A lesão apresenta variáveis clínicas e histopatológicas que não alteram seu prognóstico. Apesar de suas características comuns, a lesão pode estabelecer diagnóstico diferencial com outras lesões de tecido mole. O objetivo desse artigo é relatar a apresentação clínica não usual de um lipoma localizado em mucosa jugal com 3cm em sua maior extensão, em paciente do sexo masculino com 56 anos de idade. O plano de tratamento foi a biópsia excisional com excelente prognóstico.Descritores: Boca; Lipoma; Neoplasia Bucais.ReferênciasJuliasse LE, Nonaka CF, Pinto LP, Freitas Rde A, Miguel MC. Lipomas of the oral cavity: clinical and histopathologic study of 41 cases in a Brazilian population. Eur Arch Otorhinolaryngol. 2010;267(3):459-65.Naruse T, Yanamoto S, Yamada S, Rokutanda S, Kawakita A, Takahashi H et al. Lipomas of the oral cavity: clinicopathological and immunohistochemical study of 24 cases and review of the literature. Indian J Otolaryngol Head Neck Surg. 2015;67(Suppl 1):67-73.Manor E, Sion-Vardy N, Joshua BZ, Bodner L. Oral lipoma: analysis of 58 new cases and review of the literature. Ann Diagn Pathol. 2011;15(4):257-61.Avelar LR, Carvalho RWF, Falcão PGCB, Antunes AA, Andrade ESS et al. Lipomas da Região Oral e Maxilofacial: Estudo Retrospectivo de 16 Anos no Brasil. Rev Port Estomatol Cir Maxilofac 2008;49(4):207-11.Said-Al-Naief N, Zahurullah FR, Sciubba JJ. Oral spindle cell lipoma. Ann Diagn Pathol. 2001;5(4):207-15.Egido-Moreno S, Lozano-Porras AB, Mishra S, Allegue-Allegue M, Marí-Roig A, López-López J. Intraoral lipomas: Review of literature and report of two clinical cases. J Clin Exp Dent. 2016;8(5):e597-603. A RK, N PN, Y S, A VK, D KK. Intraoral lipoma: a rare case report and review of literature. J Clin Diagn Res. 2013;7(12):3090-91.Raj M, Ramadoss T, Anuradha G, Devi S. Intraoral lipoma: review of literature and case report. J Indian Acad Oral Med Radiol. 2012; 24(1):36-38Carvalho MF, Junqueira TP, Souza RR, Capistrano HM, Chaves MGAM.The importance of early diagnosis of large lipomas in the maxillofacial region. Rev Cubana Estomatol. 2011;48(1):77-83Noro Filho GA, Caputo BV, Santos CC, Souza RS, Giovani EM, Scabar LF et al. Diagnosis and treatment of intraoral lipoma: a case report. J Health Sci Inst. 2010;28(2):129-31.

A 39-year-old female patient with fibromyalgia and complaints of xerostomia was referred to a dental surgeon because of the suggestion of Sjogren Syndrome (SS). She had major salivary gland scintigraphy suggestive of parotid gland obstruction. She also had a positive serologic test for anti-Ro but negative tear break-up and Schirmer tests. Minor salivary gland biopsy was performed, with 7 glands collected. Histologic examination showed the presence of 5 lymphocytic foci (each with ≥ 50 lymphocytes) around ducts (some dilated) or blood vessels, adjacent to normal appearing acini. Fibrosis, adipose infiltration, germinal center, and lymphoepithelial lesion were not observed. The whole gland tissue measurement was 21 mm², resulting in a focal score of 1 (1 focus/4 mm2), which is considered a focal lymphocytic sialadenitis histologically compatible with SS. The final diagnosis of SS was established based on the combination of histology, clinical, and serology results. The patient is under treatment with a rheumatologist.

A 55-year-old male patient attended a dermatology center because of dysarthria and dysphagia. The clinical examination showed swelling in the base of the tongue extending bilaterally to the borders preserving the median longitudinal groove. The patient underwent punch biopsy, and the specimen was referred for anatomopathologic examination with clinical suspicion of hypertrophy of tongue. Histopathologic examination revealed malignant neoplasm of glandular origin composed of cells with scarce eosinophilic cytoplasm and large hyperchromatic nuclei, organized in nests and cords sometimes with cribriform pattern and luminal formation filled with homogeneous eosinophilic material. The morphologic characteristics suggested a diagnosis of adenoid cystic carcinoma (ACC) or metastatic tumor. The immunohistochemical study demonstrated that epithelial/ductal cells were positive for cytokeratins and basal cells for p63 protein revealing their myoepithelial origin, with membrane epithelial antigen being focally positive, which led to the diagnosis of ACC. The patient was referred to an oncologic reference center.

Oral hairy leukoplakia (OHL) is an epithelial disorder related to Epstein-Barr virus (EBV) infection generally seen in immunosuppressed patients infected with HIV, with rare cases reported in immunocompetent individuals. A 19-year-old male patient presented a white lesion on the tongue, clinically suggestive of OHL, with burning sensation episodes. The medical history includes a negative test for HIV infection a year ago. The clinical evaluation revealed a white, painless, nonremovable corrugated plaque on left tongue lateral border, evolving within a month. Exfoliative cytology was performed, exhibiting epithelial cells with intracellular edema, nuclei with peripheral chromatin beading, and cells with Cowdry A inclusion bodies and ground-glass pattern. Those findings were compatible with EBV infection that, in conjunction with clinical appearance, led to the diagnosis of OHL. The patient was then submitted to a blood HIV test showing a negative result. The patient is under follow-up of 3 weeks.

A 50-year-old female patient attended the oral and maxillofacial surgery department presenting a volume increase in the hard palate region extending to the soft palate. The lesion was painful and firm to the palpation. A computed tomography scan revealed a hypodense lesion affecting both the maxillary sinus cavity and left ethmoidal cells as well as the absence of cortical bone on the hard palate. Histopathologic examination revealed the presence of mucoid cells with pleomorphism, hyperchromatism, and alteration in the nucleus-cytoplasm ratio, showing ductal and cystic spaces containing mucoid material. Epidermoid cells arranged in small sheets were also observed. The special periodic acid–Schiff and mucicarmine stains were positive, indicating the presence of mucous material. Morphologic findings demonstrated compatibility with mucoepidermoid carcinoma. The patient was referred to an oncology center and is waiting for definitive treatment.

The orthokeratinized odontogenic cyst is a relatively uncommon developmental cyst of an unknown etiology not constituting a distinct clinical entity. A 23-year-old man reported episodes of pain and swelling in the posterior right mandible. On clinical examination, erythematous mucosa of the region and an expansion of the vestibular cortical plate was seen. Radiographic examination showed and extensive well-circumscribed unilocular radiolucency in the body region extending to angle of the mandible. A fine needle aspiration was performed revealing purulent content. Histopathologic analysis of surgical specimens from an incisional biopsy revealed fragments of tissue exhibiting cystic lesion, with epithelial lining of stratified squamous epithelium with prominent orthokeratinization on the surface; the cyst wall showed areas of inflammation with lymphocyte predominance. A marsupialization was carried out, and the patient is on 1 year of clinical-radiographic follow-up with no recurrences.

A 36-year-old male patient attended the oral and maxillofacial surgery service presenting ulcer in the left upper alveolar ridge after extraction performed 5 months ago. At clinical examination, swelling was observed in the upper left alveolar ridge, near the hamular notch. The aspiration puncture was positive, exhibiting a yellowish liquid. Computed tomography scan examination revealed a lesion with a cystic appearance, containing a tooth in the interior located in the medial wall of the maxillary sinus. An incisional biopsy was performed with a clinical hypothesis of dentigerous cyst. Histopathologic examination revealed benign neoplasia of odontogenic origin characterized by the proliferation of ameloblast-like cells arranged in cords, nests, and sheets delimited by tall cylindrical cells with loosely arranged cells in the center, resembling the star reticulum of the enamel organ, confirming the diagnosis of plexiform ameloblastoma. The patient is waiting for definitive treatment.

A 65-year-old white male patient attended a surgical service because of a maladaptation of upper denture. Clinical examination showed white and erythematous lesions in the vestibular alveolar ridge and hard palate, respectively, with a slight volume increase. Tomographic examination showed expansive lesion associated with the destruction of the left hard palate and maxillary sinus. Incisional biopsy was performed in both lesions, and the specimens were referred for anatomopathologic examination with clinical suspicion of epidermoid carcinoma. Histopathologic examination revealed malignant glandular neoplasm characterized by proliferation of sheets and nests of hyperchromatic cells with scarce cytoplasm forming double layer ductile structures containing intraluminal eosinophilic material and solid areas with central necrosis and discrete mitosis figures. The diagnosis of adenoid cystic carcinoma was established. The patient underwent left maxillectomy, and histologic examination of the surgical specimen confirmed the previous diagnosis and pT4 to pNX staging. The patient is undergoing radiotherapy treatment.

The dentigerous cyst is defined as an odontogenic developmental cyst, which originates from the separation of the follicle that surrounds the crown of an included tooth, accounting for about 20% of all epithelium-lined cysts in gnathic bones. It occurs frequently in the lower third molars. A 9-year-old female patient presented with an increase of volume from the right mandible side for approximately 1 month, with a hardened aspect to the palpation and with moderate pain. Imaging examination revealed a large, hypodense, unilocular lesion associated with the germ of the 45 element. We performed an incisional biopsy, and the diagnosis was dentigerous cyst. After confirming the diagnosis, the marsupialization of the lesion was performed. The patient is undergoing 18-month follow-up, during which regression of the lesion was observed.

Verrucous squamous cell carcinoma is generally a less aggressive subtype of squamous cell carcinoma. It is most common among male patients, especially affecting the intraoral tissues. A 49-year-old male patient, rural worker, was referred to a dental specialty center because of a lesion located in the lower lip evolving within 2 months. Clinical examination showed a ±2-cm painless, hard-to-touch white lesion. No swollen lymph nodes were noticed. An incisional biopsy was performed, and the histopathologic examination revealed sheets of epidermoid cells with discreet pleomorphism, hyperchromasia, altered nuclear-cytoplasm ratio, and a few mitotic figures plus areas showing individual cell keratinization, keratin pearls, and intense deposition of lamellar keratin on the lesion surface, giving it a papillomatous-characteristic look. The diagnosis of verrucous squamous cell carcinoma was established. The patient was referred to oncology and is now waiting for the next phase of treatment.

Ludwig’s angina is a cellulitis affecting the submandibular region, which in most cases arises from an acute infection of lower molars. In immunocompromised patients, it can spread through cervical fascia, leading to cervicofacial necrotizing fasciitis. A 28-year-old male patient was admitted to an emergency department because of mandibular and neck swelling. Medical history showed acute lymphocytic leukemia. Physical examination showed anterior projection of tongue, limitation of buccal opening, dyspnea, dysphagia, and toxic-looking appearance. In the right mandibular region, a fistula was noticed. There was a necrotic area going from the mandible’s base to the chest. Intraoral examination showed a residual root of first inferior molar. Cervicofacial necrotizing fasciitis evolving from Ludwig’s angina due to odontogenic abscess was established. Broad-spectrum antibiotic treatment was initiated. The residual root was removed without complications. After control of fasciitis, a skin graft was performed. The patient died a few weeks later of pulmonary complications.

A 33-year-old male patient attended a surgical service reporting a swelling in the right nasal cavity for around 6 months. Magnetic resonance imaging showed a hypointense image on the upper wall of the right maxillary sinus invading the nasal cavity of the same side. There was a previous biopsy in the same region with an inconclusive diagnosis. The patient was submitted to excisional biopsy, and the surgical specimen was referred for a pathologic service with clinical suspicion of paraganglioma. Histopathologic examination evidenced a lesion characterized by proliferation of vascular spaces and fibroblastic cells with discrete collagen fibers and areas of hemorrhage surrounded by a large number of multinucleated giant cells, some with disorganized nuclei and others similar to Touton giant cells. A large proliferation of xanthomatous-looking cells was also observed. The diagnosis of giant cell tumor was established. Currently the patient is under follow-up with no signs of relapse.

A 7-year-old male patient was referred to a dentistry specialty center because of several papillary lesions of the same color as the surrounding mucosa, which were painless and nonbleeding in the inner cheek and labial mucosa. The diagnosis hypothesis was multifocal epithelial hyperplasia (Heck disease). An incisional biopsy was performed, and the histopathologic findings in stratified squamous epithelium were parakeratosis, acanthosis, and thick epithelial rete ridges, sometimes being club-shaped. The epithelial cells presented nuclei surrounded by clear halos, mitotic figures, and mitosoid cells. The underlying connective tissue presented scarce inflammatory cells. The data confirmed the original clinical hypothesis of multifocal epithelial hyperplasia (Heck disease). No treatment was performed because of the self-limited characteristics of the disease. The patient is now under 6-month follow-up, already showing early signs of lesion remission.

The objective of this study was to evaluate the prevalence of malignant neoplasms in the oral and maxillofacial region (OMF) diagnosed in the Department of Pathology of a public university during 10 years. A cross-sectional and retrospective study was carried out through the collection of clinical-pathologic data from patients with malignant neoplasms in the OMF region obtained through the histopathologic reports and nosologic files from the department from January 2005 through December 2014, excluding the lesions in soft palate, uvula, oropharynx, nasal cavity, and facial skin. There were 46 malignant neoplasms located mainly in the tongue (26%, n = 12) and mouth floor (23.9%, n = 11) of male patients (67.3%, n = 31) during the sixth and seventh decades of life (41.3%, n = 19), 3 of them with indeterminate histogenesis. From the 43 lesions identified, 78.3% (n = 36) were from the lining epithelium, especially the squamous cell carcinoma (SCC). The remaining cases were mesenchymal (6.5%, n = 3), glandular (6.5%, n = 3) and hematolymphoids (2.2%, n = 1) lesions. The literature points to SCC as the most prevalent malignant lesion in the mouth (95%), in agreement with the present study; however, our values are slightly lower than those found in the literature for this lesion.

Immunodeficiency-associated Burkitt lymphoma is a variant of Burkitt lymphoma and occurs frequently in human immunodeficiency virus (HIV)-infected adult patients with high a CD4 T-cell count. A 37-year-old HIV-positive male patient with leukoderma presented with an asymptomatic swelling of 6 months’ duration in left submandibular region, 6 cm in diameter, with a slightly wavy surface and solid consistency. The clinical diagnostic hypothesis was a salivary gland tumor. The ultrasonography revealed an expansive process with a lobed outline in the submandibular gland without lymphadenomegaly or local alteration. Excisional biopsy was performed and histopathologic analysis revealed malignant neoplasia with proliferation of lymphocyticlike cells exhibiting pleomorphism and vacuolated nuclei, evident nucleoli, abundant mitoses, and the presence of hyperchromatic cells in a “starry-sky” pattern. The histopathologic diagnosis compatible with Burkitt lymphoma was established. Immunohistochemical panel showed positive marking for CD20, CD10, and Ki-67 (95%), and a negative marking for Bcl-2, favoring the diagnosis of Burkitt lymphoma. The patient was immediately referred to chemotherapy treatment and after 1 year of follow-up, there is no evidence of recurrence.

The antrochoanal polyp, also called Killian polyp, represents around 4% to 6% of all nasal polyps with a higher incidence in children and young adults. It is a benign lesion that grows from the mucosa of the maxillary sinus and reaches the choana. A 34-year-old male patient attended the surgical service to remove a mesiodens. No noteworthy changes were observed at the intraoral examination. Computed tomography evidenced a well-circumscribed and delimited hypodense mass in the left maxillary sinus. An excisional biopsy was performed, and histopathologic analysis revealed the presence of a loose, edematous connective tissue with thin lines consisting of collagen fibers, congested vessels, and a discrete presence of lymphocytes and plasma cells. Another region exhibited a peduncle composed of connective tissue and the presence of ciliated pseudocolumnar epithelium. The diagnosis of a Killian polyp was established. The patient is under follow-up for 4 months without signs of relapse.

A 36-year-old male patient showed up for evaluation because of lack of adaptation of partial denture with ± 1-year evolution. He had a previous diagnosis of ameloblastoma in the anterior mandible, excised 10 years ago. Intraoral examination revealed solitary swelling with smooth surface with the same color as the adjacent mucosa involving both vestibular and lingual surfaces of the mandible around the left premolars. Panoramic x-ray showed an expansive "soap-bubble" lesion with well-demarcated borders. Histopathologic examination of the incisional biopsy specimen revealed follicles that consist of a core of loosely arranged angular cells resembling the stellate reticulum of the enamel organ, sometimes presenting a squamous differentiation and microcyst formation, surrounded by a single layer of tall columnar ameloblast-like cells with nuclei located at the opposite pole of basement membrane. These findings plus the previous medical history established the diagnosis of ameloblastoma. The patient is waiting for another resection surgery.

Plasma cell gingivitis features a distinctive and rare pattern of gingival inflammation characterized by infiltration of plasma cells in the oral tissues with unknown reason or generally related to an allergen. A 20-year-old female patient attended a surgery service, showing a generalized and painless enlargement of gingiva, with a discrete erythema. She did not have any systemic disease and was not on medication. There was a previous excisional biopsy with an inconclusive diagnosis. The lesion resurged in 3 months, and a new biopsy in the posterior gingiva was then performed with a hypothesis of gingival hyperplasia. Histopathology revealed fibrous connective tissue characterized by deposition of collagenous fibers and intense chronic inflammatory infiltrate predominantly composed of plasma cells but also lymphocytes and eosinophils. The diagnosis of plasma cell gingivitis was then established. Several recommendations were given to the patient in relation to her eating habits and allergen possibilities.