Bordignon Natália-Cristina-Trentin, Correia-Neto Ivan-José, Gondak Rogério, de Albuquerque-Júnior Ricardo-Luiz-Cavalcanti
DDS, MSc, PhD. Department of Pathology, Federal University of Santa Catarina, Postgraduate Program in Dentistry, Florianópolis, Santa Catarina, Brazil.
DDS, MSc, PhD student. Piracicaba Dental School, University of Campinas (UNICAMP), Postgraduate Program in Stomatopathology, Piracicaba, São Paulo, Brazil.
J Clin Exp Dent. 2024 Mar 1;16(3):e377-e382. doi: 10.4317/jced.61322. eCollection 2024 Mar.
Traumatic ulcerative granuloma with stromal eosinophilia (TUGSE) is a rare lesion of a traumatic-reactive nature of the oral mucosa that can clinically mimic an oral carcinoma. A 59-year-old male patient presented painful ulceration with indurated margins on the base of the tongue, extending to the floor of the mouth. The use of ill-fitting denture hurting the mucosa of the region was reported by the patient. The evolution time was 45 days. The presumptive diagnoses were oral squamous cell carcinoma and chronic ulcer. An incisional biopsy revealed an ulceration associated with an eosinophil-rich inflammatory infiltrate and a bed of proliferating histiocyte-like cells in either diffuse or fasciculate arrangement. There was diffuse immunopositivity for CD3, but focal for CD68 and α-SMA, and negativity for CD30. The final diagnosis was TUGSE. The use of the ill-fitting dental prosthesis was suspended and the lesion had complete spontaneous remission three weeks later. TUGSE is an uncommon traumatic self-limiting lesion that must be included in the differential diagnosis of ulcerative lesions resembling oral cancer. The correlation of clinical and histopathological findings is pivotal for a proper diagnosis, avoiding unnecessary aggressive surgical approaches. Oral ulcer, eosinophilia, immunohistochemical, differential diagnosis.
伴有基质嗜酸性粒细胞增多的创伤性溃疡性肉芽肿(TUGSE)是一种口腔黏膜创伤反应性的罕见病变,临床上可酷似口腔癌。一名59岁男性患者舌根部出现疼痛性溃疡,边缘硬结,累及口底。患者自述使用的义齿不合适,对该区域黏膜造成损伤。病程为45天。初步诊断为口腔鳞状细胞癌和慢性溃疡。切开活检显示溃疡伴有富含嗜酸性粒细胞的炎性浸润以及呈弥漫性或束状排列的增生性组织细胞样细胞层。CD3呈弥漫性免疫阳性,CD68和α - SMA呈局灶性阳性,CD30呈阴性。最终诊断为TUGSE。停用不合适的假牙,三周后病变完全自发缓解。TUGSE是一种罕见的创伤性自限性病变,在类似口腔癌的溃疡性病变鉴别诊断中必须予以考虑。临床和组织病理学结果的相关性对于正确诊断至关重要,可避免不必要的激进手术方法。口腔溃疡、嗜酸性粒细胞增多、免疫组织化学、鉴别诊断。