Abstract
Eosinophilic ulcer (EU) is an uncommon, self-limiting lesion of the oral mucosa. Histopathologically, is characterized by an intense inflammatory cellular infiltration, admixed with abundant eosinophils that deeply extend to involve muscular fibers. Herein we present 2 EU cases. The first case, on the dorsal surface of the tongue with 1 week of evolution and the second case on the upper lip with 20 days of evolution. Both lesions showed large ulceration with elevated and indurated borders. Remarkably, histopathologic analysis showed, beyond the typical features, numerous large epithelioid cells with nuclear grooves, isolated or in clusters, resembling Langerhans cell histiocytosis (LCH). After immunohistochemical analysis, using Langerhans cell markers, appreciable cellular heterogeneity within this population in relation to cell size and surface morphology was observed, being highly consistent with Langerhans cell hyperplasia (LCHyp). Our results show that LCHyp can be observed in some EU cases, which should be recognized to avoid misdiagnosis.
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