Atypical histiocytic granuloma of the oral mucosa: An unusual clinicopathologic entity simulating malignancy

Abstract

Some conditions possess clinical and histologic features that suggest malignancy, yet they are biologically benign and often self-limiting. Most clinicians and pathologists dealing with head and neck disease are familiar with one of the best examples of such a condition: necrotizing sialometaplasia. However, much less commonly recognized is a group of atypical lymphohistiocytic lesions formerly known as the “pseudolymphomas.” Such lesions are benign; yet, they contain lymphoid cells that have sufficient cytologic atypia to suggest a diagnosis of malignant lymphoma. Although cases exhibiting such features have been described previously, 1 Ruckley RW Gordon D Conroy B Pseudolymphoma of the tongue mimicking Hodgkins' disease (a case report). J Laryngol Otol. 1984; 98: 734 Crossref Google Scholar in 1985 Eversole et al 2 Eversole LR Leider AS Jacobsen PL et al. Atypical histiocytic granuloma. Light microscopic, ultrastructural and histochemical findings in an unusual, pseudomalignant reactive lesion of the oral cavity. Cancer. 1985; 55: 1722 Crossref PubMed Scopus (26) Google Scholar reported four additional cases characterized by atypical histiocytic infiltrates that had sufficiently unique clinical and pathologic features that the authors suggested the appellation “atypical histiocytic granuloma” (AHG) to replace the previous terminology. Through study of subsequent cases, the histiocytic nature and benign self-limiting course of this lesion have been confirmed. 3 Godfrey FM Sloan P. Traumatic (eosinophilic) granuloma of oral soft tissues: A report of two cases with pseudolymphomatous features. Br J Oral Maxillofac Surg. 1985; 23: 351 Abstract Full Text PDF PubMed Scopus (16) Google Scholar , 4 Ankjaergaard O Lawaetz KD Andreassen VK Atypical histiocytic granuloma with eosinophilia. J Laryngol Otol. 1988; 102: 543 Crossref PubMed Google Scholar , 5 Kabani S Cataldo E Folkerth R et al. Atypical lymphohistiocytic infiltrate (pseudolymphoma) of the oral cavity. Oral Surg Oral Med Oral Pathol. 1988; 66: 587 Abstract Full Text PDF PubMed Scopus (22) Google Scholar , 6 Morrison JW Langston JR Slater LJ Atypical histiocytic granuloma. Report of a case. J Oral Maxillofac Surg. 1990; 48: 630 Abstract Full Text PDF PubMed Scopus (7) Google Scholar , 7 de Vicente Rodriguez JC Santos Oller JM Janquera Gutierrez LM et al. Atypical histiocytic granuloma of the tongue: Case report. Br J Oral Maxillofac Surg. 1991; 29: 350 Abstract Full Text PDF PubMed Scopus (13) Google Scholar , 8 del Rio E Sanchez Yus E Requena L et al. Oral pseudolymphoma: A report of two cases. J Cutan Pathol. 1997; 24: 51 Crossref PubMed Scopus (11) Google Scholar We report an additional case of AHG to familiarize clinicians with a condition whose misdiagnosis could result in significant overtreatment and expense.