Hyaline ring granuloma in inflammatory odontogenic cysts: Report of two cases

Abstract

Since 1971, 66 cases o f hyal ine ring granuloma (HRG) have b e e n repor ted . The ent i ty has b e e n descr ibed in the l i terature unde r a variety of terms inc luding chron ic periost i t is wi th hyaline rings, L2 granu loma in eden tu lous jaws, 3 giant cell hyal ine angiopathy, 4 pulse granuloma, 5 and oral vege tab le granuloma. 6 HRG was originally descr ibed by Lewars 1 and Adkins, 3 w h o sugges ted that it r ep re sen t ed a reac t ion to foreign material such as food. Later invest igators suppor t ed this v i e w and cons ide red the possibil i ty that the hyaline rings w e r e residues o f substances such as beans and peas. 5 However , o the r invest igators did not endorse this v i e w and sugges ted that the hyaline rings instead r ep re sen t ed degenera t ed b lood vessels, 4 degene ra t ed collagen, z or f ibrosed extravasated serum proteins. 7 Some even cons ide red the lesion to be due to infec t ion by Torulopsis glabrata, s HRG is f requent ly r epor t ed in the walls o f dentigerous, 7,9 residual, 7 and nasopalat ine 4,1° cysts, and it shows the same radiographic features as an intraosseous jaw cyst. T rea tment involves rout ine cyst enucleation; r e cu r r ence is rare. 11,12 The nature o f this g ranulomatous lesion remains obscure . The pu rpose o f this article is to cons ide r the origin and pa thogenes i s o f HRG in 2 cases.