Inflammatory Hyperplastic Lesion Research Articles

Case report on Irritational Fibroma

ABSTRACT Traumatic or irritation fibroma is the healed end product of the inflammatory hyperplastic lesion, which can occur at any age from almost any softtissue site, tongue, gingiva, and buccal mucosa being the most common. It is usually characterized by a slow, painless growth accumulated over a period of months or years.

Pyogenic granuloma: Clinicopathological and treatment scenario in Rajshahi Medical College Hospital

Background: Oral pyogenic granuloma is a soft-tissue lesion of the oral mucosa. This lesion has a tendency to recur after surgical excision.
 Materials and Methods: A total of 35 patients underwent surgical excision of pyogenic granuloma in the period from January 2019 to June 2022. Two surgical techniques were used to remove pyogenic granuloma: simple excision with root planing and modified excision with deep curettage.
 Results: Females (54%) were slightly more predominant than males (46%). The upper and lower jaws were almost equally affected by the lesion with more predilection toward the posterior region. The size of the lesion ranged from 0.5 to 3 cm in diameter with slow-growing rate. Rural residents were more affected (57%) than urban people. The lesion appears clinically as a small red mass with sessile base, and these clinical features were similar in pregnant and nonpregnant women. The recurrence rate was 14.8% and seen only in patients treated by simple excision. Histopathological feature was consistent with inflammatory hyperplastic lesion, and there was no radiographic evidence of bone resorption associated with the lesion.
 Conclusion: Modified excision with deep curettage prevents the recurrence of the lesion after 1-year follow-up.
 Central Medical College Journal Vol 6 No 1 January 2022 Page: 39-43

Traumatic gingival fibroma of anterior maxilla: A case report

Traumatic fibroma, also called irritation fibroma is a common oral lesion which is benign and exophytic in appearance. It develops as result of tissue injury and can occur at any age. It is the healed end product of the inflammatory hyperplastic lesion. Sites most commonly involved are buccal mucosa, any soft tissue site, tongue, gingiva. Female predilection seen. It is the most common reactive lesion, and the treatment of choice is surgical excision. The aim of this case report is to present a benign lesion in a 33 years old female patient, who reported to the department with a complaint of pain and swelling in the right upper front tooth region since 12-15 days and on examination, the lesion appeared well circumscribed, lobulated, tender, smooth, firm and reddish pink swelling measuring 2 cm × 3 cm involving right maxillary premolars. Surgical excision of the lesion was done. No recurrence was noted 1 month postoperatively. Radiographic and histopathological examination is essential for diagnosis to accurate as it clinically resembles various lesions such as peripheral giant cell granuloma, pyogenic granuloma or odontogenic tumors.

Adenomyomatous hyperplasia of the extrahepatic bile duct: a systematic review of a rare lesion mimicking bile duct carcinoma.

Adenomyomatous hyperplasia (AH) is a tumor-like inflammatory hyperplastic lesion. In the biliary system, AH commonly arises in the gallbladder, but AH of the extrahepatic bile duct is extremely rare. AH usually develops and is found with symptoms related to biliary stenosis or obstruction, but there are few disease-specific manifestations. It is difficult to make a definitive diagnosis by imaging or cytopathological examination; thus, surgical resections were performed in all past reported cases. The pathophysiological etiology of AH is unknown, but it is considered to be associated with chronic inflammation. According to the epidemiological findings of cases reported to date, the possibility of malignant transformation is considered to be negative. However, the symptoms and imaging findings of AH are difficult to distinguish from those of early-stage bile duct carcinoma. In the current review, we discuss the epidemiology, pathophysiology, diagnosis, and management of AH of the bile duct.

PERIPHERAL OSSIFYING FIBROMA: A CASE REPORT

Peripheral ossifying fibroma (FOP) is characterized as a reactive inflammatory hyperplastic lesion of multifactorial etiology. It is predominant in adolescents and young adults, female sex, and by occurrence in maxilla. The reported case is of a 36-year-old male patient with complaint see what is in my mouth. The extraoral examination showed a slight increase in the upper right labial region. On intraoral examination, a nodule was found in the region of the lateral incisor to right first premolar approximately 1.5 cm, single, with red coloration, smooth and hemorrhagic surface, clear boundaries, irregular format, firm/fibrous consistency, pediculated, and fixed. On the radiograph, calcification was observed in teeth regions 12, 13, and 14 with radiographic clinical hypothesis from FOP. The proposed treatment was excisional biopsy. Complete enucleation of lesion is fundamental to ensure the removal of all base of the lesion and reactional factors that cause it because the risk of relapse is high.

Pyogenic granuloma: Clinicopathological and treatment scenario

Background:Oral pyogenic granuloma is a soft-tissue lesion of the oral mucosa. This lesion has a tendency to reoccur after surgical excision.Materials and Methods:A total of 28 patients underwent surgical excision of pyogenic granuloma in the period from September 2014 to May 2016. Two surgical techniques were used to remove pyogenic granuloma: simple excision with root planing and modified excision with deep curettage.Results:Females (54%) were slightly more predominant than males (46%). The upper and lower jaws were almost equally affected by the lesion with more predilection toward the posterior region. The size of the lesion ranged from 0.5 to 3 cm in diameter with slow-growing rate. Rural residents were more affected (57%) than urban people. The lesion appears clinically as a small red mass with sessile base, and these clinical features were similar in pregnant and nonpregnant women. The recurrence rate was 14.8% and seen only in patients treated by simple excision. Histopathological feature was consistent with inflammatory hyperplastic lesion, and there was no radiographic evidence of bone resorption associated with the lesion.Conclusion:Modified excision with deep curettage prevents the recurrence of the lesion after 1-year follow-up.

Management of perennial pyogenic granuloma by platelet-rich fibrin membrane in a 62-year-old patient

Pyogenic granuloma (PG) is an inflammatory hyperplastic lesion of the oral cavity with common etiological factors such as low-grade local irritation, traumatic injury, or hormonal factors. The lesion is nonneoplastic in nature with the recurrence rate of 15.8%. Moreover, as it is a benign lesion, the choice of treatment is surgical excision with the removal of underlying cause if any. The present article highlights the use of platelet-rich fibrin (PRF) membrane in the management of PG. This case report presents a 62-year-old female patient who had reported with PG that recurred twice in 7-year period. The lesion appeared with a sessile base and was diagnosed clinically and histopathologically as PG. The PG was surgically excised exposing the underlying bone. The exposed bone surface was then covered with PRF membrane. At 6-month follow-up period, the patient did not show any further recurrence of the lesion.

Fibroepithelial polyp from retromolar trigone

A fibroepithelial polyp is an inflammatory hyperplastic lesion in response to chronic irritation. It is most commonly seen in the buccal mucosa where it is more prone to trauma. Clinically, the features of fibroepithelial polyp overlap with other lesions. Therefore, histopathological confirmation is necessary. The current study presents a case in which the fibroepithelial polyp was arising from the retromolar trigone which is not reported in English literature.

Prevalence and Distribution of Gingival Pyogenic Granuloma in Sulaimani population - Kurdistan Region - Iraq

Pyogenic granuloma is an inflammatory hyperplastic lesion seen in the oral cavity. It is commonly appear in the gingiva. The objectives of the research were to determine the percent of gingival pyogenic granuloma in the population of Sulaimani city -Iraq in relation to gender, age, pregnancy ,systemic diseases ,oral hygiene and site of occurrence of pyogenic granuloma. Materials and Methods: In this study the total stratified sample [1136 (568 male +568 female] and the randomly selected sample [248 (124 male and 124 female their age range (from 10 to 70 year) .They were examined orally for inspection of gingival pyogenic granuloma and determination of oral hygiene. The percent of the total sample with gingival pyogenic granuloma was (11.3%). The most of patients with gingival pyogenic granuloma was in females in their Second decade. The high percent of gingival pyogenic granuloma was found in buccal gingiva in upper jaw. Highly significant relationship was found between gingival pyogenic granuloma and its’ history. There was significant correlation between gingival pyogenic granuloma and oral hygiene status and systemic condition.

Validating the use of napsin A as a marker for identifying tumorigenic potential of lung bronchiolo-alveolar hyperplasia in rodents

There are two types of bronchiolo-alveolar hyperplasia (hyperplasia) in rodent lungs. The first is “inflammatory hyperplasia” that retains its ability to revert to normal epithelia upon removal of the stimulating insult. The second is “latent tumorigenic hyperplasia”, which is irreversible and causes independent preneoplastic lesions that can progress to bronchiolo-alveolar adenocarcinoma. Previously, lung samples with hyperplastic lesions were obtained from rats exposed to N-bis (2-hydroxypropyl) nitrosamine (DHPN) and fine particles (e.g. quartz), and 19 specific markers were examined immunohistochemically to identify latent tumorigenic hyperplasia. In the cytoplasm of the cells that make up the alveolar wall, we found that napsin A was weakly expressed in the inflammatory hyperplastic lesions, and was strongly expressed in the latent tumorigenic hyperplastic lesions induced by DHPN.To validate the possibility that napsin A may serve as a tumorigenic hyperplastic marker, additional experiments were performed with rats and mice. Latent tumorigenic hyperplasia induced by various carcinogens were positive for napsin A, similar to hyperplasia induced by DHPN. Thus, high expression of napsin A in alveolar walls may serve as a useful marker for detecting the tumorigenic potential of lung hyperplasia in rodents.

Nawrotowy nadziąślak olbrzymiokomórkowy – opis przypadku

Peripheral giant cell granuloma is an inflammatory hyperplastic lesion that commonly occurs on peripheral tissues like gingiva, periodontal ligaments or alveolar mucosa. Clinically it is only seen in gingiva, particularly between the first permanent molars and incisors. It manifests itself as a benign tumor consisting of multinucleated giant cells. This article reports a case of peripheral giant cell granuloma in the left mandibular premolar region in a 34-year-old man. The lesion was excised and sent for histopathological examination, and was diagnosed as peripheral giant cell granuloma. The lesion was recurrent. This case report shows the importance of confirming the diagnosis of the lesion by histopathological examination. Peripheral giant cell granuloma is a reactive lesion that shows a rapid growth rate and can cause minor tooth movement. As the name suggests, there is no bony involvement and the enlargement is a soft tissue extension. Early conservative management will reduce the risk of tooth loss.

Irritation fibroma: Report of a case

Traumatic or irritation fibroma is the healed end product of the inflammatory hyperplastic lesion which can occur at any age from almost any soft-tissue site, tongue, gingiva, and buccal mucosa being the most common. The aim of this case report is to present the clinical features and management of the benign lesion which was posteriorly positioned in the interdental papillary region of mandibular premolars. A female patient, 40 years old, reported to the department with a chief complaint of pain and swelling in the right lower back tooth region for the past 1 year. On examination, the lesion was found to be a well circumscribed, smooth, tender, firm and lobulated pink swelling measuring 2 cm × 2 cm in its greatest diameter in relation to right mandibular premolar region. Surgical therapy was carried out for the management of the same. There was no recurrence reported at the end of 2 months showing that treatment with electrocautery was highly effective as it was a relatively simple and safe method with easy handling of the electrodes without any bleeding or scarring. Irritation fibroma clinically resembles as pyogenic granuloma, peripheral giant cell granuloma, or odontogenic tumors, so radiographic and histopathological examination is essential for accurate diagnosis. Furthermore, complete excision is the choice of treatment as recurrence has been associated with incomplete removal of the lesion.

An unusual oral squamous cell carcinoma of the mandible, mimicked inflammatory hyperplastic lesions: A case report

Abstract Squamous cell carcinoma (SCC) is the most common malignant tumors of oral cavity. The ratio of men to women is about 2: 1. Generally, it is admitted that 60% of carcinoma of the mandibular gingival are located in the posterior of premolars. Gingiva is one of the less common sites of oral squamous cell carcinoma (OSCC). Due to the variable clinical and behavioral presentations, it can easily be misdiagnosed as benign neoplasms or other inflammatory reactions. We encountered a 76-year-old woman with an unusual OSCC on the anterior mandibular ridge, imitating inflammatory hyperplastic (IH) lesion in May 2013. She complained that her denture was not seated suitably because of a mandibular lesion. After biopsy of the lesion, the surgeon noticed that real bone resorption was not visible in the x-ray image. Then histopathological evaluation detected the OSCC. Patient was referred to the CT-Scan and MRI. Three months later, the lesion recurred, enlarged and extended rapidly and she was emphasized the importance of a secondary surgery in a timely fashion.. She did not accept and then underwent radiotherapy and chemotherapy. In November 2013, the patient passed away because of the progress of OSCC. This case reminded us to keep the possibility of oral SCC in mind while examining every intra-oral lesion.

An Unusual Oral Squamous Cell Carcinoma of the Mandible Similar to Inflammatory Hyper Plastic Lesions: A Case Report

An Unusual Oral Squamous Cell Carcinoma of the Mandible Similar to Inflammatory Hyper Plastic Lesions: A Case Report

Focal fibrous hyperplasia: A review of 193 cases.

Context:Focal fibrous hyperplasia, also known as irritation or traumatic fibroma, is a reactive, inflammatory hyperplastic lesion of the connective tissue.Aim:The aim of this study is to perform a retrospective study of a focal fibrous hyperplasia of 18 years.Materials and Methods:We retrospectively reviewed 193 cases of focal fibrous hyperplasia of the oral cavity from the medical and histological reports of the Department of Oral Pathology, Pernambuco University, Brazil, during the period between January 1992 and December 2009.Settings and Design:Data with regard to age, gender, location, size of the lesion (equal to or less than 1 cm, between 1 and 2 cm and greater than 2 cm), pain, history of trauma, treatment, length of follow-up (from diagnosis to release or last review) and recurrence, were collected.Results:The most commonly affected site was the buccal mucosa (n = 119, 61.7%). Almost two-thirds of the cases were concentrated from the second to the fifth decade of life. Females were more affected than men and a history of trauma was related by 90.7% of the patients. Two recurrences were notified (1.0%).Conclusion:Further studies are needed on the distribution of the lesion in different ethnic and geographical populations. The influence of sex hormones on the development of focal fibrous hyperplasia must be clarified.

Intra Oral Multiple Pyogenic Granuloma- A Rare Case Report

Pyogenic Granuloma (PG) is a type of inflammatory hyperplastic lesion seen in the oral cavity. The etiology for this lesion is hyperplasia in response to various stimulus corresponding to low grade local irritation like interdental calculus, traumatic injury or hormonal factors. It commonly occurs in young females as a result of the vascular effects of sex hormones. Intra orally it is mostly solitary and occurs commonly in the gingiva. This case report describes a rare presentation of multiple pyogenic granulomas of the maxillary and mandibular gingivae in a 48 year old female patient.

Reactive Localised Inflammatory Hyperplasia Of The Oral Mucosa

To document the histopathological pattern and distribution of reactive localised inflammatory hyperplastic lesions of the oral mucosa diagnosed at the University of Nairobi Dental Hospital over a 14 year period. A retrospective, cross-sectional descriptive study. Division of Oral Pathology and Oral Medicine, histopathology laboratory, School of Dental Sciences, University of Nairobi. A total of 3135 oral biopsies were accessioned in the oral diagnostic histopathological Laboratory registry over a period of 14 years from March 1991 to December 2005. Three hundred and thirty three cases were histopathologically diagnosed as reactive inflammatory hyperplasias of the oral mucosa. This constituted 10.6% of the total oral biopsy specimens analysed during this period. Fibrous epulis was the most common histological sub-type with 129 cases (38.7%) followed by pyogenic granuloma with 94 (28.3%) cases. Six (1.8%) cases were peripheral giant cell granuloma and three cases (0.9%) were those of denture irritation hyperplasia. The age distribution ranged from 2 to 78 years (mean = 30.5 years) with a peak at 20-29 years. Gender distribution showed that 107 (32%) cases occurred in males and 226 (68%) cases females. Similar trends were observed in most of the histological sub-types. Fibrous epulis occurred in 41 male (31.8%) cases and in 88 (68.2%) females with an age range of 2 to 78 years (mean = 30.5 years). As for the pyogenic granuloma, 26 (27.7%) lesions occurred in males and 68 (72.3%) in females with an age range of 2 to 75 years (mean = 30.1 years). Among all the histopathological sub-types it was shown that 223 (67.0%) cases were fibrous, 104 (31.2%) vascular and six (1.8%) peripheral giant cell granuloma. Gingival lesions were the most common with 257 (77.2%) cases followed by 28 (8.4%) in the tongue, 16 (4.8%) lips, 15 (4.5%) cheek, six (1.8%) palate and the rest on the floor of the mouth and other mucosal sites. The duration of these lesions was recorded in 182 (54.7%) cases and ranged from 1 week to 16 years (mean = 1.8 years). Only 15 (4.5%) cases were reported to have recurred and all of them were gingival lesions. The present study has shown that the prevalence of reactive localised inflammatory hyperplasia (RLIHs) of the oral mucosa was 10.6% with fibrous epulis and pyogenic granuloma having been the most common histopathological sub-types predominantly affecting females. Although RLIHs are distinguished on clinical or histopatholocal grounds, it is important to appreciate that they are variations of the same basic process.

Eosinophilic bodies in the epithelium of oral inflammatory hyperplastic lesions: Histopatholgic and histochemical study

Four hundred twenty-three specimens of inflammatory hyperplastic lesions of the oral cavity were examined for changes in the epithelium. Amorphic eosinophilic material was found in the superficial layers of the epithelium in 12 per cent of the cases. The incidence and severity of the changes were related to the intensity of the inflammatory reaction in the underlying tissue. Histochemically, the material contained protein, disulfide and sulfhydryl groups, tryptophan, and carbohydrate.