Starch cell granuloma

Abstract

In their recent report in the Journal, Keskin et al 1 Keskin A Duran S Alkan A et al. Hyaline ring granuloma in inflammatory odontogenic cysts: Report of two cases. J Oral Maxillofac Surg. 2000; 58: 115 Abstract Full Text PDF PubMed Scopus (13) Google Scholar appropriately implied that until its precise cause is determined, the term hyaline ring granuloma should be applied to these jaw lesions. They used the Sartur reaction to confirm that their second case contained starch; however, this probably was not necessary because the lower half of the photomicrograph (their Fig 4) shows clear morphologic evidence of starch cells—oval cells containing pale eosinophilic starch granules separated by darker intensely eosinophilic septa of cytoplasm appearing as interconnected triangular or stellate outlines. Several investigators have carefully detailed the characteristics of these starch cells. 2 Mincer HH McCoy JM Turner JE Pulse granuloma of the alveolar ridge. Oral Surg. 1979; 48: 126 Abstract Full Text PDF Scopus (46) Google Scholar , 3 Harrison JD Martin IC Oral vegetable granuloma: ultrastructural and histological study. J Oral Pathol. 1986; 15: 322 Crossref PubMed Scopus (42) Google Scholar , 4 Talacko AA Radden BG The pathogenesis of oral pulse granuloma: An animal model. J Oral Pathol. 1988; 17: 99 Crossref PubMed Scopus (40) Google Scholar , 5 Watson RE Stewart C Experimental oral foreign body reactions: Vegetable materials. Oral Surg Oral Med Oral Pathol. 1991; 71: 312 Abstract Full Text PDF PubMed Scopus (11) Google Scholar Therefore, the cause of this hyaline ring granuloma is not a mystery; the granuloma was induced by leguminous foreign material, as Keskin et al 1 Keskin A Duran S Alkan A et al. Hyaline ring granuloma in inflammatory odontogenic cysts: Report of two cases. J Oral Maxillofac Surg. 2000; 58: 115 Abstract Full Text PDF PubMed Scopus (13) Google Scholar correctly concluded. Simple recognition of starch cells permits a definitive diagnosis. If the pathologist observes a hyaline ring granuloma, he should search for starch cells; if they are identified, then the more specific diagnosis of “pulse granuloma” is warranted.