Romero-Ruiz Manuel-María, Torres-Lagares Daniel, Alonso-Alejandro Eugenia, Serrano-González Ascensión, Gutiérrez-Pérez Jose-Luis
Department of Dentistry-Oral Surgery, University of Sevilla, Spain.
Med Oral Patol Oral Cir Bucal. 2009 Sep 1;14(9):e480-4.
In this report, we examine a clinical entity called atypical histiocytic granuloma (AHG), which is characterized by ulceroproliferative lesions that clinically simulate a squamous cell carcinoma or specific granulomatous lesions. AHG histologically shows a histiocytic proliferation and is characterized by specific mitotic activity, which has the potential to be confused with malignant processes of a lymphoid origin. There are few cases reported in the literature, and an adequate knowledge of the process is required in order to avoid a misdiagnosis, especially as regards malignant processes. To our knowledge, a case of this type of lesion in the palate has not yet been described. We present a case of an atypical histiocytic granuloma which occurred in the form of an ulcerated pediculated lesion in the palatine mucosa (an uncommon localization that not yet has been researched). This case histologically showed a histiocytic infiltration with an increase in the mitotic index, eosinophils and an accumulation of haemosiderin. The lesion resolved spontaneously after the biopsy, without recurring after a period of five years. This report stresses the important value of immunohistochemistry in diagnosing the lesion and also discusses the similarities and differences between other lesions that may be confused, potentially leading to a misdiagnosis.
在本报告中，我们研究了一种名为非典型组织细胞肉芽肿（AHG）的临床实体，其特征为溃疡性增生性病变，临床上类似鳞状细胞癌或特定的肉芽肿性病变。AHG在组织学上表现为组织细胞增殖，并具有特定的有丝分裂活性，这有可能与淋巴源性恶性病变相混淆。文献中报道的病例很少，为避免误诊，尤其是对于恶性病变，需要对该病症有充分的了解。据我们所知，腭部出现这种类型病变的病例尚未见报道。我们报告一例非典型组织细胞肉芽肿，表现为腭黏膜上带蒂的溃疡性病变（一种尚未研究过的罕见部位）。该病例在组织学上显示组织细胞浸润，有丝分裂指数增加，有嗜酸性粒细胞及含铁血黄素沉积。活检后病变自行消退，五年内未复发。本报告强调了免疫组化在诊断该病变中的重要价值，并讨论了可能导致误诊的其他易混淆病变之间的异同。
