Sadasivan Arun, Ramesh Roshni
Department of Periodontics, SMIDS, Kulashekaram, Tamil Nadu, India.
Department of Periodontics, Government Dental College, Trivandrum, Kerala, India.
Clin Cosmet Investig Dent. 2022 Jul 11;14:199-206. doi: 10.2147/CCIDE.S367281. eCollection 2022.
Lymphangiomas or microcystic lymphatic malformations (MLM) are hamartomatous formations that occur due to the proliferation of lymphatic vessels. They commonly manifest in the head and neck region with only a few cases reported within the oral cavity. Lymphangioma circumscriptum in the gingiva is a rare condition which presents as asymptomatic pebbly gingival enlargement. They are characterized by lesions that are microscopic thin-walled cysts. Histopathologically, they show multiple dilated lymphatic channels which are lined by endothelial cells. The lumen is filled with lymphatic fluid, red blood cells, and other inflammatory cells. These are dispersed within connective tissue stroma. Multiple modalities of treatment have been reported, including surgical excision, laser therapy, and sclerotherapy.
This paper reports a rare case of multiple lymphangiomas of the gingiva in a 21-year-old female patient. The clinical picture, surgical treatment, histologic features, and immunohistochemistry [IHC] findings are presented. The histologic findings of lymphangioma were confirmed with IHC being positive for lymphatic marker D2-40. The patient was followed up for a period of 2 years, with no recurrence noted.
Lymphangiomas or microcystic lymphatic malformations presenting as a gingival enlargement are a rare occurrence. Therefore, lymphangiomas may also be considered in the differential diagnosis of gingival enlargements.
淋巴管瘤或微囊性淋巴管畸形(MLM)是由于淋巴管增殖而形成的错构瘤。它们通常表现在头颈部区域,口腔内仅有少数病例报道。牙龈局限性淋巴管瘤是一种罕见的病症,表现为无症状的鹅卵石样牙龈肿大。其特征是病变为微小的薄壁囊肿。组织病理学上,它们显示多个扩张的淋巴管,内衬内皮细胞。管腔内充满淋巴液、红细胞和其他炎症细胞。这些细胞分散在结缔组织基质中。已报道了多种治疗方式,包括手术切除、激光治疗和硬化治疗。
本文报告了一例21岁女性患者牙龈多发性淋巴管瘤的罕见病例。介绍了临床表现、手术治疗、组织学特征和免疫组织化学(IHC)结果。淋巴管瘤的组织学结果经免疫组织化学证实,淋巴标志物D2-40呈阳性。对患者进行了2年的随访,未发现复发。
表现为牙龈肿大的淋巴管瘤或微囊性淋巴管畸形很少见。因此,在牙龈肿大的鉴别诊断中也可考虑淋巴管瘤。