Kanteti Archana P, Kelsey W Patrick, Duarte Ernesto Martinez
Department of Pathology and Microbiology, University of Nebraska Medical Center, USA.
Creighton University School of Dentistry, USA.
Case Rep Dent. 2020 Dec 26;2020:8861918. doi: 10.1155/2020/8861918. eCollection 2020.
Plasma cell granulomas (PCGs) or inflammatory pseudotumors are nonneoplastic lesions that consist of predominantly antibody-secreting plasma cells and innate immune cells such as neutrophils, macrophages, and eosinophils. Unlike in multiple myeloma, the plasma cells are polyclonal and present in a spindly fibroblast-rich stromal background. These lesions mainly occur in the lungs; however, they can arise in other organs. PCGs from the gingiva are extremely rare, and a proper diagnosis is crucial to treat these patients further. These tumors have an increased number of plasma cells that are immunoreactive with CD138 and are polyclonal for kappa and lambda light chains, confirming these proliferations' nonneoplastic nature. Surgical resection with clear margins, when possible, is the primary choice of treatment. Radiation and anti-inflammatory steroid therapy are other therapeutic approaches. Critical and careful examination by a pathologist is necessary to rule out plasma cell neoplasms. Here, we report a rare occurrence of gingival PCG in an elderly male.
浆细胞性肉芽肿（PCG）或炎性假瘤是非肿瘤性病变，主要由分泌抗体的浆细胞和中性粒细胞、巨噬细胞、嗜酸性粒细胞等固有免疫细胞组成。与多发性骨髓瘤不同，浆细胞是多克隆性的，存在于富含梭形成纤维细胞的基质背景中。这些病变主要发生在肺部；然而，它们也可出现在其他器官。牙龈来源的PCG极为罕见，正确诊断对于进一步治疗这些患者至关重要。这些肿瘤中与CD138免疫反应的浆细胞数量增加，κ和λ轻链呈多克隆性，证实了这些增殖的非肿瘤性质。若可能，手术切除切缘清晰是主要治疗选择。放疗和抗炎类固醇治疗是其他治疗方法。病理学家进行严格仔细的检查对于排除浆细胞肿瘤很有必要。在此，我们报告一例老年男性罕见的牙龈PCG病例。
