5: Fibrous, Gingival, Lipocytic, and Miscellaneous Tumors

5 Fibrous, Gingival, Lipocytic, and Miscellaneous Tumors

Fibrous Lesions

Fibroma (“Bite” or “Irritation” Fibroma, Fibroepithelial or Fibrovascular Polyp) and Giant Cell Fibroma

Etiopathogenesis and Histopathologic Features

Fibroma is a reactive fibrosis and scarring (similar to a hypertrophic scar on the skin) from bite trauma and is not a true neoplasm.

Gingival Masses

Classification is as follows:

Reactive/Inflammatory Gingival Nodules

Etiopathogenesis and Histopathologic Features

Pluripotent cells in the gingival tissues when traumatized or irritated (usually by accumulation of dental calculus or bacterial plaque, rough edges of restorations, or presence of implants) differentiate toward endothelial cells, fibroblasts, osteoblasts, or osteoclast-like cells, giving rise to four distinct histologic entities or combinations thereof. Estrogen and progesterone causes overexpression of vascular endothelial growth factor in granuloma gravidarum. See Table 5-1 and Figures 5-11 to 5-19 for histopathologic features.

TABLE 5-1 Reactive Gingival Nodules

Diagnosis Histopathology
Fibroma
(fibrovascular hyperplasia/polyp)
Giant cell fibroma

Pyogenic granuloma Peripheral ossifying fibroma (fibroma with osseous prosoplasia)

Peripheral giant cell granuloma

References

Buchner A, Hansen LS. The histomorphologic spectrum of peripheral ossifying fibroma. Oral Surg Oral Med Oral Pathol. 1987;63:452-461.

Buchner A, Shnaiderman-Shapiro A, Vered M. Relative frequency of localized reactive hyperplastic lesions of the gingiva: a retrospective study of 1675 cases from Israel. J Oral Pathol Med. 2010;39:631-638.

Carvalho YR, Loyola AM, Gomez RS, Araujo VC. Peripheral giant cell granuloma. An immunohistochemical and ultrastructural study. Oral Dis. 1995;1:20-25.

Epivatianos A, Antoniades D, Zaraboukas T, et al. Pyogenic granuloma of the oral cavity: comparative study of its clinicopathological and immunohistochemical features. Pathol Int. 2005;55:391-397.

Giunta JL. Gingival fibrous nodule. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 1999;88:451-454.

Gordon-Nunez MA, de Vasconcelos Carvalho M, Benevenuto TG, et al. Oral pyogenic granuloma: a retrospective analysis of 293 cases in a Brazilian population. J Oral Maxillofac Surg. 2010;68:2185-2188.

Hirshberg A, Kozlovsky A, Schwartz-Arad D, et al. Peripheral giant cell granuloma associated with dental implants. J Periodontol. 2003;74:1381-1384.

Katsikeris N, Kakarantza-Angelopoulou E, Angelopoulos AP. Peripheral giant cell granuloma. Clinicopathologic study of 224 new cases and review of 956 reported cases. Int. J Oral Maxillofac Surg. 1988;17:94-99.

Ono A, Tsukamoto G, Nagatsuka H, et al. An immunohistochemical evaluation of BMP-2, -4, osteopontin, osteocalcin and PCNA between ossifying fibromas of the jaws and peripheral cemento-ossifying fibromas on the gingiva. Oral Oncol. 2007;43:339-344.

Yuan K, Wing LY, Lin MT. Pathogenetic roles of angiogenic factors in pyogenic granulomas in pregnancy are modulated by female sex hormones. J Periodontol. 2002;73:701-708.

Diffuse/Multifocal Gingival Hyperplasia

Jan 12, 2015 | Posted by in Oral and Maxillofacial Pathology | Comments Off on 5: Fibrous, Gingival, Lipocytic, and Miscellaneous Tumors
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