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The gastrointestinal system
Published in C. Simon Herrington, Muir's Textbook of Pathology, 2020
Sharon J. White, Francis A. Carey
Fibrous overgrowth of the oral mucosa is very common and frequently presents as a fibroepithelial polyp secondary to chronic trauma. An epulis is a localized swelling on the gingiva. A fibrous epulis typically occurs as a reaction to chronic irritation, e.g. from dental calculus (calcified plaque) or the rough margin of a carious cavity or filling. It consists of a mass of cellular fibrous tissue often with metaplastic bone formation. Pyogenic granulomas comprise a mass of granulation tissue, often ulcerated, and are found at any intraoral site, but most often form on the gingiva as a vascular epulis or, in pregnancy, as a pregnancy epulis. Giant cell epulis (peripheral giant cell granuloma) is a distinct lesion consisting of numerous multinucleated giant cells in a vascular stroma. It is a superficial lesion with minimal bone involvement. However, intraosseous lesions, such as central giant cell granuloma or lesions of hyperparathyroidism, may mimic a giant cell epulis clinically and histologically if they extend to involve the gingival soft tissues; thus, radiological and biochemical investigations are warranted in such cases.
Oral health status of pregnant women in Ilorin, Nigeria
Published in Journal of Obstetrics and Gynaecology, 2018
Kikelomo T. Adesina, Moninuola A. Ernest, Abiola O. Tobin, Salamat A. Isiaka-Lawal, Moshood F. Adeyemi, Adebunmi O. Olarinoye, Grace G. Ezeoke
The low prevalence of pregnancy epulis in this study was comparable to findings at the oral examination among pregnant women in Raichur India, and in Accra, Ghana (Annan and Nuamah 2005; Gupta and Acharya 2016). Pregnancy epulis, also known as pyogenic granuloma, results from the interplay between the hormonal effects, gingival vasculature and a poor oral hygiene in pregnancy. This causes a chronic gingivitis that is commonly observed in the third trimester and resolves spontaneously at 1–4 weeks’ postpartum. (Rabinerson et al. 2002; Saravanum et al. 2012). Epulis-like lesions outside a pregnancy are peripheral giant cell granuloma, a central giant cell granuloma and fibroma (Agrawal 2015).
Oral manifestations of extranodal lymphomas – a review of the literature with emphasis on clinical implications for the practicing dentist
Published in Acta Odontologica Scandinavica, 2022
Malin Höglund Wetter, Ulf Mattsson
The diagnostic challenge for the dentist was, based on information in the case reports, mostly related to lymphomas in gingiva/alveolar crest or maxilla/mandible. The clinical presentations were frequently described as a broad-based swelling or bulging mass/ulcerated bulging mass, often with a rather rapid growth and considerable size at time of diagnosis. A common tentative diagnosis in the case reports was a reactive lesion, which is tumour-like hyperplasia associated with chronic local irritation or trauma. The gingiva is the most common location for reactive lesions (irritation hyperplasia, peripheral giant cell granuloma, pyogenic granuloma and cemento-ossifying fibroma), but they can also be found in other parts of the oral cavity [59,60]. The clinical appearance of reactive lesions is usually different from the descriptions given for intraoral lymphoma and present as clinically elevated, well circumscribed, often pedunculated lesions with a smooth or sometimes ulcerated appearance depending on the kind of reactive lesion [61]. They may vary in size but are usually only slightly larger than 1 cm [60] and therefore seldom reach the size of lymphomas described in the case reports. Clinical description of a lymphoma with a pedunculated lesion was extremely rare and only described in a single case [62]. Also, lymphomas located on gingiva frequently affected the underlying bone (Table 2b), which is in accordance with results by Bagan et al. [6]. Although there were individual cases where the initial biopsy only revealed a reactive lesion [63,64], a biopsy can most likely enable a correct diagnosis [60] and should be performed when there is any doubt on the nature of the lesion, not only do differentiate from lymphoma but also from other malignant diagnoses.