Plasma cell granuloma of gingiva
Journal name: Journal of Indian Society of Periodontology
Original article title: Plasma cell granuloma of gingiva
The Journal of Indian Society of Periodontology (JISP) publishes original scientific articles on periodontology (the study of supporting structures of teeth) and oral implantology. It is a bimonthly open-access journal with special issues for specific occasions.
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Original source:
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Balaji Manohar, S Bhuvaneshwari
Journal of Indian Society of Periodontology:
(A bimonthly open-access journal)
Full text available for: Plasma cell granuloma of gingiva
Year: 2011 | Doi: 10.4103/0972-124X.82275
Copyright (license): CC BY-NC-SA
Summary of article contents:
Introduction
Plasma cell granuloma, also referred to as inflammatory pseudotumor, is a rare benign lesion that predominantly occurs in the lungs but can also be found in various other anatomical sites including the brain, kidneys, stomach, and oral cavity. In the intraoral region, it notably affects areas such as the tongue, oral mucosa, and gingiva. Although not frequently encountered, these lesions are recognized for their potential to arise from inflammatory conditions, with various other names attributed to them, such as inflammatory myofibroblastic tumor and xanthomatous pseudotumor. The case report discusses a 42-year-old female presenting with a gingival enlargement in the maxillary anterior region, diagnosed through histological and immunohistochemical evaluations.
Diagnosis and Histopathological Findings
The diagnosis of plasma cell granuloma relies heavily on histopathological examination, which in this case revealed a stratified squamous parakeratinized hyperplastic epithelium along with a fibrocellular connective tissue stroma rich in plasma cells. Immunohistochemical analysis demonstrated a polyclonal population of plasma cells, with a predominant presence of kappa light chains over lambda light chains, establishing the benign nature of the lesion. The significance of differentiating plasma cell granuloma from other plasma cell-related lesions, such as plasmacytomas and multiple myeloma, is underscored due to their varying biological behaviors and implications for treatment and prognosis. Plasma cell granuloma's pathogenesis may be linked to autoimmune reactions or responses to unidentified external stimuli, but further research is warranted to clarify its etiology.
Conclusion
This case report highlights the rarity of plasma cell granuloma occurring on the gingiva, emphasizing the importance of histopathological examination for accurate diagnosis. Plasma cell granuloma should be recognized as a benign reactive lesion that may stem from non-specific inflammatory responses, and distinguishing it from more aggressive plasma cell disorders is crucial for patient management. The findings support the necessity for thorough microscopic evaluation of excised gingival tissue, regardless of initial clinical presumptions, to ensure appropriate diagnosis and treatment.
FAQ section (important questions/answers):
What is plasma cell granuloma and where does it commonly occur?
Plasma cell granuloma is a rare benign lesion characterized by plasma cell infiltration, predominantly occurring in the lungs. It is also found in other regions, including the brain, kidney, stomach, heart, and less commonly in the oral cavity.
How is plasma cell granuloma diagnosed?
Diagnosis is primarily based on histological examination revealing plasma cell infiltrates. In immunohistochemistry, a ratio of kappa to lambda light chains is analyzed; a 2:1 ratio typically indicates a benign reactive lesion.
What treatment is typically performed for plasma cell granuloma?
The most common treatment for plasma cell granuloma is complete surgical excision. In some cases where total excision is not feasible, other approaches may be considered depending on the lesion's characteristics.
What are the clinical implications of plasma cell granuloma?
Although benign, plasma cell granuloma can cause significant swelling and bleeding, interfering with oral hygiene practices. Proper diagnosis and treatment are essential to prevent complications and ensure complete resolution.
What is the role of immunohistochemistry in diagnosing this condition?
Immunohistochemistry plays a crucial role in determining the clonality of plasma cells within the lesion. The presence of a polyclonal staining pattern with a 2:1 kappa to lambda ratio supports the diagnosis of plasma cell granuloma.
Glossary definitions and references:
Scientific and Ayurvedic Glossary list for “Plasma cell granuloma of gingiva”. This list explains important keywords that occur in this article and links it to the glossary for a better understanding of that concept in the context of Ayurveda and other topics.
1) Kappa:
Kappa refers to one of the two types of light chains found in immunoglobulins (antibodies). In this case report, immunohistochemical staining showed strong positivity for kappa light chains in the plasma cells, indicating their reactive nature. The kappa to lambda ratio aids in differentiating benign reactive lesions from malignant conditions.
2) Inflammation:
Inflammation is a crucial biological response of the immune system to harmful stimuli, such as pathogens or irritants. In the context of plasma cell granuloma, the lesion is characterized by an inflammatory condition resulting in plasma cell infiltration, highlighting the lesion’s non-neoplastic nature and the body's attempt to heal.
3) Substance:
In this report, substances may refer to the various foreign materials or irritants thought to incite the cellular response resulting in plasma cell granuloma. Identifying potential substances contributing to the inflammatory reaction is important for understanding the lesion's etiology and guiding treatment and preventive measures.
4) Bleeding:
The patient reported bleeding associated with the gingival enlargement, a critical clinical symptom. This bleeding indicates the inflammation and possible fragility of the surrounding tissues. Such symptoms are essential for diagnostic evaluation and can influence treatment choices, particularly concerning excision and postoperative care.
5) Hygiene (Hygienic):
Oral hygiene is vital for maintaining healthy gingival tissues and preventing conditions like plasma cell granuloma. The patient's complaint of the lesion obstructing hygiene practices underlines the significance of preventing inflammation and related lesions through effective oral care, which is an essential aspect of periodontal health.
6) Allergy:
Allergy refers to the hypersensitive immune response to foreign substances. Some historical interpretations of plasma cell granuloma suggested that they could be allergic reactions, although extensive testing proved inconclusive. Understanding allergy can help in investigating potential triggers of lesions with similar clinical presentations in the oral cavity.
7) Indian:
The patient demographic, identified as Indian, provides context for ethnic and geographical considerations in the manifestation of oral lesions like plasma cell granuloma. Awareness of possible variations in incidence and presentation among different populations can inform clinical practice and research regarding these rare lesions.
8) Blood:
Blood plays a crucial role in the immune response, supplying plasma cells that accumulate in lesions like plasma cell granuloma. The hematological findings, which were normal in this case, are essential as they help differentiate benign conditions from systemic diseases, emphasizing the importance of comprehensive evaluations.
9) Study (Studying):
The term study refers to this clinical case report's comprehensive examination of plasma cell granuloma. It reinforces the need for thorough histological and immunohistochemical assessment to differentiate between reactive lesions and malignancies, thereby contributing valuable insights into diagnostic protocols and management strategies for similar cases.
Other Health Sciences Concepts:
Discover the significance of concepts within the article: ‘Plasma cell granuloma of gingiva’. Further sources in the context of Health Sciences might help you critically compare this page with similair documents:
Prognosis, Periodontitis, Histopathological examination, Autoimmune reaction, Hemogram, Excisional biopsy, Immunohistochemical Staining, Maxillary anterior region, Gingival enlargement, High power microscopy, Plasma cell granuloma, Inflammatory pseudotumor, Polyclonal staining pattern, Kappa and lambda light chains, Firm lobulated mass, Bony involvement, Stratified squamous parakeratinized epithelium, Fibrocellular connective tissue, Hyperplastic epithelium, Differentiating type, Non-specific inflammatory response, Plasma cell.