Oral vegetable granuloma: ultrastructural and histological study

An unusual giant-cell granulomatous inflammatory oral lesion is characterised by the presence of hyaline rings and by a lack of agreement on their nature, opinions ranging from their being hyaline degenerative blood-vessels to remains of leguminous cells. Ten such lesions and a variety of vegetables have been examined in the present investigation. Light-microscopical examination of the lesions revealed the hyaline rings surrounded by inflamed granulation tissue with associated multinuclear giant cells. Electron-microscopical examination showed them to consist of a material similar to that of vegetable cell walls, sometimes with an associated superficial layer of collagen. The observations indicate that the lesions consist of vegetable remains with an associated foreign-body type of inflammatory response.     

Peripheral giant cell granuloma. An immunohistochemical and ultrastructural study

OBJECTIVE: To study the nature of multinucleated and mononuclear cells from peripheral giant cell granuloma (PGCG).
MATERIALS AND METHODS: Formalin-fixed, paraffin-embedded sections of 40 cases of PGCG were immunohistochemically stained for vimentin, alpha I-antichymotrypsin, CD68, S-100 protein, lysozyme. leucocyte common antigen (LCA), factor VIII-retated antigen and muscle cell actin. Six cases of PGCG were also studied by transmission etectron microscopy.
RESULTS: Vimentin, alpha I-antichymotrypsin and CD68 were expressed in both the mononuclear and multinucleated giant cells. Dendritic mononuclear cells, positive for 5–100 protein, were noted in 67.5% of the lesions, whereas lysozyme and leucocyte common antigen were detected in occasional mononuclear cells. Ultrastructural examination showed mononuclear cells with signs of phagocytosis and sometimes interdigitations with similar cells. Others presented non-specific characteristics and the third type exhibited cytoplasmic processes and occasional Birbeck granules. Some multi-nucleated giant cells showed oval nuclei, abundant mitochondria and granular endoplasmic reticulum whereas others presented with irregular nuclei and a great number of cytoplasmic vacuoles.
CONCLUSIONS: lmmunohistochemical and ultrastructural results suggest that PGCGs of the jaws are composed mainly of cells of the mononuclear phagocyte system and that Langerhans cells are present in two thirds of the lesions.     

Oral granular cell tumours: a histological and immunocytochemical study

In a series of nine cases of intra-oral granular cell tumours (GCTs) an attempt was made, using both histochemical and immunocytochemical methods, to determine whether these tumours show Schwann-cell or neuroendocrine differentiation. Positive immunostaining with protein gene product 9.5 (PGP 9.5). neurone-specific enolase (NSE) and S-100. in contrast to predominantly negative immunostaining in 12 cases of neurilemmoma of the head and neck, and a similar pattern of staining with luxol fast blue to five known neuroendocrine tumours, strongly suggests that granular cell tumours may be neuroendocrine in nature.     

Hydroxyapatite biomaterial implanted in human periodontal defects: an histological and ultrastructural study

The purpose of the present work was to study the response of human periodontium to hydroxyapatite biomaterial particles (180-200 microns). The biomaterial was implanted in two infra-osseous periodontal defects (two patients) after clearing of the granulation tissue. At two months post-surgery, biopsies were studied using light and electron microscopy. No sign of inflammation was observed, the biomaterial aggregates were surrounded either by typical fibroblasts or larger phagocytotic cells with phagocytosis vesicles containing biomaterial crystals. These intracellular crystals were noticeably smaller than the non-phagocytized ones. Some of the phagocytized crystals showed morphological signs of intracellular dissolution. The spaces between the crystals constitutive of the aggregates were filled with organic substance containing collagen fibers.     

Oral pyogenic granuloma: a review

Pyogenic granuloma is one of the inflammatory hyperplasias seen in the oral cavity. This term is a misnomer because the lesion is unrelated to infection and in reality arises in response to various stimuli such as low-grade local irritation, traumatic injury or hormonal factors. It predominantly occurs in the second decade of life in young females, possibly because of the vascular effects of female hormones. Clinically, oral pyogenic granuloma is a smooth or lobulated exophytic lesion manifesting as small, red erythematous papules on a pedunculated or sometimes sessile base, which is usually hemorrhagic. The surface ranges from pink to red to purple, depending on the age of the lesion. Although excisional surgery is the treatment of choice for it, some other treatment protocols such as the use of Nd:YAG laser, flash lamp pulsed dye laser, cryosurgery, intralesional injection of ethanol or corticosteroid and sodium tetradecyl sulfate sclerotherapy have been proposed. Because of the high frequency of pyogenic granuloma in the oral cavity, especially during pregnancy, and necessity for proper diagnosis and treatment, a complete review of published information and investigations about this lesion, in addition to knowledge about new approaches for its treatment is presented.     

Posteruptive changes in human dental fluorosis--a histological and ultrastructural study.

The aim of the present study was to describe the structural features characterizing the severe grades of human fluorotic enamel (TF scores 5-9) with particular emphasis on the posteruptive changes in severely fluorosed teeth. Dental fluorosis is a subsurface hypomineralized lesion deep to a well-mineralized outer enamel surface, which in severe cases breaks apart shortly after eruption. Early signs of posteruptive changes comprise small defects corresponding to the opening of striae of Retzius. The enamel pits which develop after eruption in more severe cases exhibit an increase in mineral content at their base which correspond to the exposed subsurface hypomineralized lesions. Likewise, the extensive removal of surface enamel in the most severe cases of human fluorosis results in a highly varying uptake of mineral into the exposed subsurface hypomineralized lesions. The uptake varies greatly within apparently similar degrees of hypomineralized lesions. In approximal abrasion facets, however, where the subsurface lesions are also exposed, no evidence of mineral uptake was found. At the ultrastructural level, the well-mineralized surface zone consists of large hexagonal enamel crystals separated by rather large intercrystalline spaces in which numerous irregular small crystals are observed. Moreover, the large crystals may exhibit central and peripheral dissolution. In addition, mineral appeared to be deposited into such defects as well as along the side of the crystals, often with the lattices being continuous from the original crystal into the apparently posteruptive formed crystal material. It is concluded that a substantial mineral uptake can take place in exposed porous hypomineralized fluorotic enamel after eruption, but is most likely to be associated with the presence of microbial deposits, the metabolic activity of which may play a keyrole in mineral exchange.     

Hyaline bodies in ameloblastoma: histological and ultrastructural observations

An exceedingly rare case of ameloblastoma. plexiform type, which contained numerous hyaline bodies was reported. Hyaline bodies occurred within the parenchyma, and showed similar histochemical reactions to those of hyaline bodies in odontogenic cysts. Ultrastructurally, hyaline bodies found in the present case of ameloblastoma were composed of a peripheral electron-dense area and central electron-lucent area. Well-developed endoplasmic reticulum containing electron-lucent and homogeneous substance were seen in the epithelial cells adjacent to hyaline bodies. Furthermore, electron-dense spherical granules, with or without limiting membrane, were scattered in the cytoplasm of epithelial cells. It is thought that hyaline bodies in the present case of ameloblastoma are particular products formed by odontogenic epithelial cells.     

Clinical and histological evaluation of granuloma gravidarum: case report

Granuloma gravidarum is a benign lesion of the oral mucosa which occurs during pregnancy. This case report presents the clinical and histological evaluation and treatment of a granuloma gravidarum in a patient in the 9th month of pregnancy.     

Hyaline bodies in ameloblastoma: histological and ultrastructural observations

An exceedingly rare case of ameloblastoma, plexiform type, which contained numerous hyaline bodies was reported. Hyaline bodies occurred within the parenchyma, and showed similar histochemical reactions to those of hyaline bodies in odontogenic cysts. Ultrastructurally, hyaline bodies found in the present case of ameloblastoma were composed of a peripheral electron-dense area and central electron-lucent area. Well-developed endoplasmic reticulum containing electronlucent and homogeneous substance were seen in the epithelial cells adjacent to hyaline bodies. Furthermore, electron-dense spherical granules, with or without limiting membrane, were scattered in the cytoplasm of epithelial cells. It is thought that hyaline bodies in the present case of ameloblastoma are particular products formed by odontogenic epithelial cells.     

Oral hairy leukoplakia: ultrastructural features

Ten instances of a white plaque of the lateral tongue unique to homosexual males and referred to as oral hairy leukoplakia were analysed ultrastructurally. The surface epithelial layer exhibited extracellular, intracellular and intranuclear penetration by hyphae of Candida albicans, sometimes accompanied by coccobacilli in the extracellular space. The subcorneal epithelial layer included koilocytoid ballooned cells which had a paucity of cytoplasmic organelles and displayed condensation and emargination of the chromatin. Cells that exhibited these nuclear changes were found to be infected by a herpes-type virus which was visualized by electron microscopy in all ten cases. Clusters of nucleocapsids (86-110 nm in diameter) occurred in the nuclei and enveloped virions (111-175 nm in diameter) occurred in the cytoplasm and extracellular spaces. Virions showed budding from the nuclear envelope. Bundles of tubular structures (20 nm diameter) arranged in parallel occurred in the cytoplasm of some koilocytoid cells. There was no evidence by electron microscopy of the presence of papilloma virus within koilocytotic nuclei.     

Oral hairy leukoplakia: ultrastructural features

Ten instances of a white plaque of the lateral tongue unique to homosexual males and referred to as oral hairy leukoplakia were analysed ultrastructurally. The surface epithelial layer exhibited extracellular, intracellular and intranuclear penetration by hyphae of Candida albicans , sometimes accompanied by coccobacilli in the extracellular space. The subcorneal epithelial layer included koilocytoid ballooned cells which had a paucity of cytoplasmic organelles and displayed condensation and emargination of the chromatin. Cells that exhibited these nuclear changes were found to be infected by a herpes-type virus which was visualized by electron microscopy in all ten cases. Clusters of nucleocapsids (86-110 nm in diameter) occurred in the nuclei and enveloped virions (111-175 nm in diameter) occurred in the cytoplasm and extracellular spaces. Virions showed budding from the nuclear envelope. Bundles of tubular structures (20 nm diameter) arranged in parallel occurred in the cytoplasm of some koilocyloid cells. There was no evidence by electron microscopy of the presence of papilloma virus within koilocytotic nuclei.     

Oral hairy leukoplakia: ultrastructural observations

On the basis of the clinical appearance and the light microscopic findings, we determined 16 biopsy specimens to be possible examples of oral hairy leukoplakia. All 16 specimens were studied by means of electron microscopy. Ten of these specimens contained typical herpes-type viral particles in the epithelial cells of the upper stratum spinosum. None of the specimens contained ultrastructural evidence of human papillomaviruses.     

成人髁突软骨潮标的组织学及超微结构研究

目的 研究成人髁突软骨潮标的组织学形态、超微结构及其意义。方法 50例成人髁突常规石蜡制片，HE染色，部分标本行Van-Gieson及组织化学染色，光镜观察。并对3例潮标作透射电镜、5例作扫描电镜观察。结果 髁突软骨潮标区碱性磷酸酶及钙质大量存在、蛋白多糖缺乏；膜被基质小泡、羟磷灰石结晶、脂质小结样物质丰富，且多见于关节负重区。未钙化软骨内的胶原纤维斜行通过潮标后与钙化软骨内的纤维相连续，水平纤维束环绕整个潮标区域，负重区较宽，并与斜行纤维交织成网状。经木瓜蛋白酶消化，潮标表面高低不平，可见许多被钙质包绕的软骨细胞陷窝。结论 髁突软骨潮标区有生理性钙化发生，其活性在负重区高于非负重区；斜行纤维与水平纤维交织成网，与关节受力有关。     

An ultrastructural study of eosinophilic granuloma: the Langerhans cell--its role in histogenesis and diagnosis.

An electron microscopic study of a case of eosinophilic granuloma of the mandible was performed. The fine structural similarity between the "histiocytic" cells of the lesion and epidermal Langerhans cells is discussed with regard to current theories and information on the origin of Langerhans cells and their potential role in the histogenesis of eosinophilic granuloma and other variants of histiocytosis X.     

Histochemical and polarization microscopic study of two cases of vegetable/pulse granuloma.

Vegetable granuloma (VG) or pulse granuloma (PG) results from the implantation of food particles of plant or vegetable origin. It is usually seen in the periapical or in the sulcus areas. These lesions have been described as a distinct entity and classified into central and peripheral lesions according to the location. Central lesions are asymptomatic, whereas peripheral lesions present as painless sub-mucosal swellings. Many authors have postulated that food particles in VG or PG get implanted and are rapidly digested, and sometimes partly get altered by host responses. The cellulose part of plant foods being indigestible persists in the form of hyaline material, whereas the starch matter gets digested. This cellulose moiety invokes chronic granulomatous response.     

Oral hairy leukoplakia among HIV-positive intravenous drug abusers: a clinicopathologic and ultrastructural study

During a prospective investigation of oral lesions of 120 consecutive patients positive for human immunodeficiency virus, belonging to the intravenous drug abuser risk group and other risk categories, we observed hairy leukoplakia (HL) in 23 cases (19%). The median age of the patients was 27 years (range, 20 to 50 years). Twenty patients were men and three were women. All but two of the twenty three patients used intravenous drugs for a median period of 6 years (range, 5 to 18 years) and were involved in several episodes of needle sharing. Eight men were also bisexual, one man was homosexual, and one man was hemophiliac and bisexual. Eleven patients had asymptomatic infection, five had lymphadenopathy syndrome, six had AIDS-related complex, and one had acquired immunodeficiency syndrome. In all patients, HL lesions were localized on the lateral borders of the tongue. In twelve patients, the lesion was unilateral, and in eleven patients, it was bilateral. Microscopically, hyperparakeratosis and the presence of koilocytes were observed in all cases. Surface candidiasis could be detected with staining with periodic acid-Schiff in two thirds of the cases. In four cases, electron microscopy showed the presence of intracellular and extracellular hyphae of Candida albicans in the parakeratin layer associated with coccobacilli in the spaces between surface epithelial cells. The spinous layer included koilocytes, which had a clear cytoplasmic matrix, sparse organelles and tonofilaments, and dispersed chromatin. These cells were found to be infected by a herpes-type virus in all cases examined. There was no ultrastructural evidence of human papillomavirus in the nuclei of the epithelial cells.(ABSTRACT TRUNCATED AT 250 WORDS)     

Oral pyogenic granuloma: A review of 137 cases

We retrospectively reviewed 137 cases of histologically confirmed pyogenic granuloma of the oral cavity from the records of the Department of Oral Surgery, Bharat Heavy Electricals Hospital, Trichy, India between 1996 and 2006. The most commonly affected site was the gingiva (n = 114, 83%). Mean age of patients was 31 years (range 6–85, male to female ratio 1:2.6).     

Oral traumatic granuloma: Characterization of the cellular infiltrate

Oral traumatic granulomas are reactive mucosal lesions that are characterized by an intense mononuclear infiltrate (usually with eosinophils) that may mimic neoplasia. These pseudoneoplastic infiltrates were evaluated with the use of lineage-associated antibodies (CD3, OPD4, L26, KP1, XIIIa. S-100, HPCA-1, HHF-35). We determined that the large distinguishing mononuclear cells were either CD68-positive macrophages or factor XIIIa-positive dendrocytes (the oral counterparts to dermal dendrocytes). S-100-positive connective tissue cells occasionally contributed to this infiltrate. Also abundant in the infiltrate were smaller CD3-positive T-lymphocytes. Double-staining confirmed that there were separate populations of CD68-positive macrophages and Xllla-positive dendrocytes. Because some XIIIa dendrocytes coexpressed CD68, phagocytosis may be one of the functions of dendrocytes.     

Oral granuloma gravidarum: a retrospective study of 41 cases in Southern Brazil

Granuloma gravidarum (GG) is an inflammatory lesion, which develops in the oral mucosa of pregnant women in response to chronic low-grade irritants, under the influence of hormonal factors.

Objective:

To characterize GG clinically by means of a retrospective study of the cases of the Oral Medicine Division, São Lucas Hospital, Brazil.

Material and Methods:

Cases of GG diagnosed between 1980 and 2012 were analyzed. Data were obtained referring to the age of the patients, lesion location, clinical features, as well as the presence of local irritants. The gestation period in which the lesion developed was also investigated.

Results:

Forty-one cases of GG were found. The lesions developed predominantly in the third trimester of pregnancy (51.22%) and the mean age of the patients was 28 years. Most GG was found in the gingiva (73.17%), was reddish color and had a mean diameter of 1.5 cm. Local irritants were involved in 75.6% of the cases.

Conclusions:

The hormonal conditions of pregnancy can have an impact on the oral cavity, predisposing the patient to inflammatory lesions such as GG.