ABSTRACT
Lobular capillary hemangioma or pyogenic granuloma is a benign non-neoplastic lesion that is mainly presented as a tissue growth in response to irritation or trauma. It is located on the skin or on the mucous membrane, with the oral mucosa being the most frequent, with the gingiva standing out, but also appearing in other places such as the lips, buccal mucosa, palate and tongue, the latter being a very unusual location. This is a report of the case of a pediatric patient who underwent a surgical procedure of frenotomy, and who subsequently presented a lesion due to trauma possibly as a consequence of local anes-thesia, which forced an excisional biopsy, the histopathological diagnosis being capillary lobular hemangioma or pyogenic granuloma. Likewise, a literature review of this type of pathology is presented, with emphasis on its location in the tongue.
ABSTRACT
El hemangioma lobular capilar es una hiperplasia inflamatoria en respuesta a una irritación crónica, la cual da lugar a una lesión exofítica eritematosa debido a la proliferación de tejido fibrovascular. En la boca puede verse en cualquier ubicación, pero es más frecuente en la zona gingival. Se reporta el caso clínico de una paciente embarazada de 38 años que consultó al equipo de Cirugía Maxilofacial del Hospital San José al presentar una lesión tumoral compatible con hemangioma lobular capilar en cara lingual lateral derecha, diagnóstico confirmado con histopatología. El objetivo de este reporte es especificar características y tratamiento de dicha lesión con localización infrecuente.
Lobular capillary hemangioma is an inflammatory hyperplasia in response to chronic irritation, resulting in an exophytic erythematous lesion due to proliferation of fibrovascular tissue. Intraorally, it can appear in any location, but it is more frequent in the gingival region. This article describes a case of a 38-year-old pregnant woman who at- tended the Maxillofacial Surgery Unit at San José Hospital, presenting a tumoral lesion on the right lateral area of the tongue compatible with a lobular capillary hemangioma. The diagnosis was confirmed with histopathology. The aim of this report is to specify the characteristics and treatment of a lesion with infrequent location.
ABSTRACT
Pyogenic granuloma is one of the benign vascular neoplasm. The nomenclature is misnomer because pyogenic granuloma is not related to infection and granuloma. It represent histopathologically lobular capillary hemangioma. It is most commonly occurred on skin followed by oral cavity such as gingiva, lip, tongue and buccal mucosa. Herein, we report a extremely rare case of pyogenic granuloma which was developed on larynx of a 81 year-old male with review of literature.
Subject(s)
Humans , Male , Gingiva , Granuloma , Granuloma, Pyogenic , Larynx , Lip , Mouth , Mouth Mucosa , Skin , Tongue , Vascular NeoplasmsABSTRACT
Intravenous pyogenic granuloma (IVPG), also known as intravenous lobular capillary hemangioma, is an extremely rare form of vascular tumor which derives from the lumen of a vein of the head and neck and upper extremities. The treatment of choice is complete local excision of a small portion of the vein. Since first report in 1979, IVPG has been reported in no more than 60 reports abroad. To our knowledge, IVPG originating in the external jugular vein has never been reported in Korea but has important clinical implication. Accurate preoperative diagnosis of neck mass originating in jugular vein is important to plan operative procedures to avoid vascular injury, excessive bleeding, or incomplete excision. Preoperative radiologic examinations such as ultrasonography, computed tomography are useful as first-line diagnostic tools for differential diagnosis of movable neck mass. With a review of literature, the author reports a case of IVPG arising from the left external jugular vein in a 31-year-old male who complained about a palpable neck mass. This patient was successfully managed by ligation and excision of the vein without any complication and no recurrence was found after 6 months.
Subject(s)
Adult , Humans , Male , Diagnosis , Diagnosis, Differential , Granuloma, Pyogenic , Head , Hemorrhage , Jugular Veins , Korea , Ligation , Neck , Recurrence , Surgical Procedures, Operative , Ultrasonography , Upper Extremity , Vascular System Injuries , VeinsABSTRACT
No abstract available.
Subject(s)
Capillaries , Granuloma, Pyogenic , Hyperplasia , Nose , Sebaceous GlandsABSTRACT
El granuloma piógeno se considera una lesión reactiva, que surge en respuesta a variados estímulos. Su etiología más común es el trauma y se asocia a higiene oral deficiente. De tamaño variable, la mayoría de los casos asintomáticos y es común su desarrollo en encía. Principalmente se asocia a mujeres jóvenes, en la segunda década de vida, posiblemente debido a un efecto vascular mediado por cambios hormonales. Se presenta el caso de una paciente de 22 años, que presenta una lesión de 10 años de evolución, dolorosa, en encía en relación con los dientes 1.1 a 1.4, la cual clínicamente era compatible con fibroma. Se dispuso una biopsia excisional, y el diagnóstico histológico fue un granuloma piógeno fibrosado. Al control postquirúrgico, se apreció cicatrización excelente, asintomático y sin signos de recidiva posterior a un año de control. El diagnóstico definitivo fue dado mediante estudio histopatológico, lo que indica la vital importancia de este tipo de exámenes cada vez que se realiza la extirpación de alguna lesión. El granuloma piógeno no se puede considerar como una neoplasia verdadera, sino como una lesión reactiva que va modificándose con el tiempo y va variando su estructura.
Pyogenic granuloma is considered as a reactive lesion, which is produced as a response to various stimuli. Its most common cause is trauma which is associated with poor oral hygiene. Resizable, most asymptomatic cases and are common developed in gum. It is mainly associated to young women, during the second decade of life, possibly due to a vascular effect mediated by hormonal changes. A 22-year-patient is presented, with an injury of 10 years of evolution, painful, in gum relative to the teeth 1.1 to 1.4, which was clinically suitable to fibroma. An excisional biopsy was indicated, with the histological diagnosis, and it resulted in a fibrotic pyogenic granuloma. In the post surgical control, wound healing was excellent, asymptomatic and without signs of recurrence after one year of monitoring. The definitive diagnosis was given by a histopathological study, which indicated the vital importance of these tests each time a removal of injury is made. Pyogenic granuloma can not be considered as a true neoplasm but as a reactive lesion, that evolves over time and is changing its structure.
ABSTRACT
El adenocarcinoma no especificado o adenocarcinoma NOS de glándula salival, como comúnmente se le llama por sus siglas en inglés "Not Otherwise Specified", es un tipo de neoplasia que no cumple con los requisitos histológicos establecidos para lograr categorizarla dentro de los tumores que afectan las glándulas salivales. A causa de que son muy poco frecuentes, se ha dificultado su estudio, y el conocimiento que se tiene sobre esta entidad es escaso. El objetivo del presente artículo es el de reportar el caso de un paciente masculino de 68 años de edad, quien desarrolla un adenocarcinoma NOS a partir de una glándula salival menor a escala del paladar. Se detalla el alcance que tiene este tipo de patología en cuanto a la invasión, destrucción y alteración que puede generar localmente en el paciente, así como su comportamiento bajo la radio y quimioterapia.
Adenocarcinoma NOS of a minor salivary gland is a type of tumor that does not meet the histological requirements that it needs to be categorized within other salivary gland tumors. Because of their infrequency, there is little known about these tumors. The aim of this paper is to report the case of a 68 years old male patient, who developed an adenocarcinoma NOS arising from a minor salivary gland in the palate. The local invasion and destruction, as well as its behavior under radio and chemotherapy is discussed.
ABSTRACT
OBJECTIVE: To compare computed tomography (CT) and magnetic resonance imaging (MRI) findings between two histological types of nasal hemangiomas (cavernous hemangioma and capillary or lobular capillary hemangioma). MATERIALS AND METHODS: CT (n = 20; six pre-contrast; 20 post-enhancement) and MRI (n = 7) images from 23 patients (16 men and seven women; mean age, 43 years; range, 13-73 years) with a pathologically diagnosed nasal cavity hemangioma (17 capillary and lobular capillary hemangiomas and six cavernous hemangiomas) were reviewed, focusing on lesion location, size, origin, contour, enhancement pattern, attenuation or signal intensity (SI), and bony changes. RESULTS: The 17 capillary and lobular hemangiomas averaged 13 mm (range, 4-37 mm) in size, and most (n = 13) were round. Fourteen capillary hemangiomas had marked or moderate early phase enhancement on CT, which dissipated during the delayed phase. Four capillary hemangiomas on MRI showed marked enhancement. Bony changes were usually not seen on CT or MRI (seen on five cases, 29.4%). Half of the lesions (2/4) had low SI on T1-weighted MRI images and heterogeneously high SI with signal voids on T2-weighted images. The six cavernous hemangiomas were larger than the capillary type (mean, 20.5 mm; range, 10-39 mm) and most had lobulating contours (n = 4), with characteristic enhancement patterns (three centripetal and three multifocal nodular), bony remodeling (n = 4, 66.7%), and mild to moderate heterogeneous enhancement during the early and delayed phases. CONCLUSION: CT and MRI findings are different between the two histological types of nasal hemangiomas, particularly in the enhancement pattern and size, which can assist in preoperative diagnosis and planning of surgical tumor excision.
Subject(s)
Adolescent , Adult , Aged , Female , Humans , Male , Middle Aged , Young Adult , Hemangioma, Capillary/diagnostic imaging , Hemangioma, Cavernous/diagnosis , Magnetic Resonance Imaging , Nasal Cavity/diagnostic imaging , Paranasal Sinuses/diagnostic imaging , Retrospective Studies , Tomography, X-Ray ComputedABSTRACT
El Granuloma piógeno (GP), es una lesión vascular benigna común en piel y mucosas, que se incluye en la clasificación de anomalías vasculares de la “International Society for the study of vascular anomalies (ISSVA)”, dentro de “otros” tumores vasculares, a pesar de su controversial denominación y su patogenia “reaccional”. Presentamos un caso de granuloma piógeno en una paciente de 18 años de edad, en el segundo trimestre de embarazo con una presentación atípica por su gran tamaño y localización acral, con excelente respuesta al tratamiento quirúrgico.
Pyogenic Granuloma (GP) is a common vascular lesion of the skin and mucous membranes, usually presented as a solitary neoplasm with a bright red, smooth surface; usually sessile or pedunculated that grows rapidly to reach 1 to 2 inches in a few weeks and then remains stationary. It is included in the classification of vascular anomalies of the International Society for the study of vascular anomalies (ISSVA) to under "other" vascular tumors despite their controversial name and their "reactional" pathogenesis. Our goal is to present a case of pyogenic granuloma in an 18-year-old rural worker in the 2nd trimester with an atypical presentation for its size (4 x 4 cm) and acral location with excellent response to surgery and emphasize that such damage can result from repeated trauma, impaired wound healing and neovascularization and overexpression of the growth factor vascular endothelial (VEGF) at this period of life.
ABSTRACT
BACKGROUND: Pyogenic granuloma is a common vascular neoplasm of the skin and mucous membranes. However, few comprehensive studies are available on the clinical and histopathological characteristics of pyogenic granuloma. OBJECTIVE: To analyze the clinical and histopathological characteristics of pyogenic granuloma. METHODS: Patients with pyogenic granuloma diagnosed clinically and histopathologically were reviewed retrospectively. RESULTS: Fifty patients (17 males and 33 females) were enrolled, and the mean age of onset was 33.6 years old. The mean lesion size was 6.7 mm. Forty-eight patients had a solitary lesion, whereas two patients had multiple lesions on the skin and mucosa. The most common area for lesions was the head and neck followed by the hands, trunk, and lower extremities. Patient complained of easy bleeding, pain, tenderness, and pruritus. Dermoscopic findings of nine lesions showed patterns of a reddish homogenous area, white scaly collarette, white rail lines, and a hemorrhagic crust. Histopathological findings of all biopsy cases showed a lobular pattern of angiomatous tissue with numerous congested capillaries, a flattened epidermis, a well-formed epidermal collarette, and CD34-positive endothelial cells. Various treatment modalities including surgery and laser have been used, but lesions recurred following a single laser treatment with a pulsed dye laser or long-pulsed Nd:YAG laser. CONCLUSION: A correlation between clinicopathological and dermoscopic findings was useful for the differential diagnosis of other diseases mimicking pyogenic granuloma and to detect recurrence after treatment. Laser treatments were less invasive therapy, but the recurrence rate was higher than that of other surgical modalities when used alone. Additional prospective studies are needed to determine the effectiveness of the various treatment modalities.
Subject(s)
Humans , Male , Age of Onset , Biopsy , Capillaries , Dermoscopy , Diagnosis, Differential , Endothelial Cells , Epidermis , Estrogens, Conjugated (USP) , Granuloma, Pyogenic , Hand , Head , Hemorrhage , Lasers, Dye , Lower Extremity , Mucous Membrane , Neck , Pruritus , Recurrence , Skin , Vascular NeoplasmsABSTRACT
Lobular capillary hemangioma occurs as a mass in the oral or nasal cavity in approximately 5% of pregnant women, although its occurrence in the nasal cavity is very rare. A pregnant woman in her 39th gestational week visited our clinic suffering from nasal obstruction and frequent epistaxis. Clinical examination and computed tomography of the nasal cavity revealed a soft tissue mass arising from the caudal aspect of the nasal septum. The mass still existed after she gave birth, and surgical resection was performed.
Subject(s)
Female , Humans , Pregnancy , Epistaxis , Granuloma, Pyogenic , Nasal Cavity , Nasal Obstruction , Nasal Septum , Parturition , Pregnant Women , Stress, PsychologicalABSTRACT
Context: Pyogenic granuloma (PG) is one of the most common reactive vascular lesions in the oral mucosa, which has been divided into the lobular capillary hemangioma (LCH) and the non lobular type (non-LCH) as two distinct entities, on the basis of some investigations. Aims: This study aims to compare the proliferative and angiogenic activity of two histological types of PG to determine whether they have two distinct types of biological behavior. Settings and Design: In this retrospective cross-sectional study, immunostaining was performed on 10 cases of each type of PG. Materials and Methods: About 4μm sections were cut from formalin-fixed paraffin-embedded blocks and each specimen was stained with both anti-CD31 and anti-Ki-67 antibodies simultaneously. Labeling index (LI) was determined for both types by counting Ki-67 and CD31 positive cells separately and simultaneously in 1000 stromal and luminal cells. Micro vessel count (MVC), the mean number of micro vessels in five areas at Χ200 magnification, was also determined for both groups. Statistical Analysis: The results were statistically compared using the Mann-Whitney U-test. Results: Ki-67 LI in LCH (5.4 ± 2.4) was higher than non-LCH (3.9 ± 3.9). The percentage of CD31 positive cells in LCH (28.5 ± 22) was lower than non-LCH (37.1 ± 20.8) and simultaneously immunostaining for both markers in LCH type (2.4 ± 2.1) was higher than non-LCH (1.2 ± 1). The MVC was approximately 77.35 ± 34.6 and 82.6 ± 42.7 in the lobular areas of LCH and central areas of non-LCH PG, respectively. These differences were not statistically significant. Conclusions: These results demonstrate a higher proliferation activity in endothelial cells of LCH PG than in non-LCH.
ABSTRACT
Pyogenic granuloma (lobular capillary hemangioma) is a very common benign vascular lesion that frequently appears as a red to purple colored papule or polypoid mass. Any cutaneous or mucous membrane surface may be affected, they are rarely found intravascular or subcutaneous area. A 67-year-old female presented with a single, 0.5x0.5 cm sized movable subcutanous nodule on the right arm. A biopsy specimen showed multilobulated angiomatous nodule consisted of proliferative capillaries with fibrous septum in the subcutaneous layer. The tumor cells were positive for CD31, CD34, vimentin and smooth muscle actin. The lesion was excised and pyogenic granuloma was given as diagnosis by histopathological evaluation. The Subcutaneous type of pyogenic granuloma is rare but it should be part of the differential diagnosis of solitary nodule of extremities.
Subject(s)
Aged , Female , Humans , Actins , Arm , Biopsy , Capillaries , Diagnosis, Differential , Extremities , Granuloma, Pyogenic , Mucous Membrane , Muscle, Smooth , VimentinABSTRACT
Subcutaneous granuloma pyogenicum is a rare variant of granuloma pyogenicum. It is often difficult to diagnose based on its clinical features because it appears as a nonspecific deep nodule lacking the characteristic surface changes such as erosion or ulceration, which are the characteristics of common polypoid granuloma pyogenicum. A 28-year-old primigravida presented at 6 months' gestation with a 8-week history of an enlarging mass on the volar aspect of her left thumb. Histological examination revealed that a well-defined tumor nodule occupying the lower dermis and subcutaneous layer was composed of a proliferation of capillaries arranged in a distinct lobular architecture, which is the hallmark of all variants of granuloma pyogenicum. This case suggests additional evidence of the possible role of female sex hormones in the pathogenesis of subcutaneous granuloma pyogenicum.
Subject(s)
Adult , Female , Humans , Pregnancy , Capillaries , Dermis , Fingers , Gonadal Steroid Hormones , Granuloma , Granuloma, Pyogenic , Thumb , UlcerABSTRACT
BACKGROUND AND OBJECTIVES: Lobular capillary hemangioma (pyogenic granuloma) is a benign rapidly growing hemorrhagic lesion of unknown etiology and vascular proliferation of endothelial cells arranged in a characteristic pattern of circumscribed capillaries arranged in lobules. The disease usually affects the skin and the oral mucosa, but nose is a relatively rare location. The clinical impression of some lesions can often be misleading due to easy bleeding mass. The purpose of this paper is to present a series of patients seen over a period of 10 years at Inje University Pusan Paik Hospital with nasal capillary hemangioma. MATERIALS AND METHOD: We assessed 19 patients who were confirmed as lobular capillary hemangioma histopathologically and treated at Inje University Pusan Paik Hospital from 1988 to 1998. RESULTS: The study group was composed of 19 patients including nine males and ten females. The ages ranged from 3 to 58 years, with a mean of 36.6 year and four of the ten female patients were pregnant. Epistaxis with nasal obstruction was the most marked symptom. Eight lesions arose from the nasal septum, 7 from the inferior turbinates, 8 from the lateral nasal wall and one from the nasal floor. The size of masses ranged within 1 cm in 11 of the 19 cases. All patients were treated by simple excision and electrocauterization, with only one showing recurrence. CONCLUSION: Uncommon lesions should also be considered in the differential diagnosis of a rapidly growing hemorrhagic lesion if they are within the nasal cavity. Clinical and histological diagnostic pitfalls occur frequently.
Subject(s)
Female , Humans , Male , Capillaries , Diagnosis, Differential , Endothelial Cells , Epistaxis , Granuloma, Pyogenic , Hemangioma, Capillary , Hemorrhage , Mouth Mucosa , Nasal Cavity , Nasal Obstruction , Nasal Septum , Nose , Recurrence , Skin , TurbinatesABSTRACT
Tufted angiomas are rare slowly progressive vascular lesions found typically in children and young adults, usually involving the trunk and neck. Microscopically, groups of capillary tufts, many uncanalized, were found dispersed at various levels in the dermis. Some authors regarded tufted angioma as a member of lobular capillary hemangiomas. We describe a pyogenic granuloma mimicking acquired tufted angioma on the lip in a 59-year-old woman. We suggest that a term lobular capillary hemangioma"" may be preferable in this case.
Subject(s)
Child , Female , Humans , Middle Aged , Young Adult , Capillaries , Dermis , Granuloma, Pyogenic , Hemangioma , Lip , NeckABSTRACT
Subcutaneous granuloma pyogenicum (SGP) is a rare variant of granuloma pyogenicum. In general, it appears as a single subcutaneous nodule with a slight tenderness. We report herein an unusual case of SGP arising from the left palm of an 11-year-old girl. Two mild-tender bean-sized reddish or flesh colored subcutaneous nodules on the lateral border of the left palm, and medial side of 5th left finger, respectively, were noted on physical examination. Histopathologic examination revealed the findings of lobular capillary hemangioma, characterized by localized proliferation of capillary lined by a single endothelial cell layer. Intralesional injection of triamcinolone acetonide (TA) were performed for the treatment. However two new erythematous nodules developed at another area of the left palm, which disappeared without any treatment.
Subject(s)
Child , Female , Humans , Capillaries , Endothelial Cells , Fingers , Granuloma , Granuloma, Pyogenic , Injections, Intralesional , Physical Examination , Recurrence , Triamcinolone AcetonideABSTRACT
We report herein a case of subcutaneous granuloma pyogenicum developed on the fourth interdigital space of right foot of 36-year-old housewife. Histopathological findings showed characteristic lobular capillary hemangioma. The subcutaneous nodule had a thick fibrous capsule and were composed of multiple, confluent cellular, angiomatous lobules separated by loose fibrous tissue. Most lobules contained round, oval or angular capillaries, lined by proliferated prominant endothelial cells projecting into the lumina of the vessels. Clinically, the lesion was a tender subcutaneous nodule with macerated surface aind soft corn or traumatic epidermal cyst were considered in the differential diagnoses.