Pyogenic granuloma associated with Actinomyces israelii.

Peculiar findings of orofacial actinomycosis mimicking the clinical appearance of a tumor of the upper gingiva are reported. An 83-year-old man with bleeding of the gingiva visited our hospital. The clinical diagnosis was a benign gingival tumor, and the lesion was surgically removed. Histologically, the excised specimens showed an ulcerative granuloma lesion covered by bacterial colonies consisting of club-shaped filaments. DNA samples were extracted from paraffin sections and examined by polymerase chain reaction (PCR) for Actinomyces species. The PCR products examined by direct DNA sequencing demonstrated the presence of Actinomyces israelii. Finally, a pathological diagnosis was made of a pyogenic granuloma associated with actinomycosis. The PCR method aided the early and exact diagnosis of the paraffin-embedded sample of oral mucosal infectious diseases including actinomycosis.

Rare example of the use of fine-needle aspiration cytology for periapical osseous dysplasia.

Osseous dysplasia (OD) is one of the fibro-osseous jaw lesions characterized by cellular fibrous tissue with hard tissue formation. We report a rare fine-needle aspiration cytology (FNAC) for periapical OD. A 34-year-old woman had well-defined, round, mixed radiolucent lesions in the periapical regions of the bilateral mandibular canines. FNAC showed hypocellular with some multinucleated giant cells and a few clusters of fibroblastlike cells. These cells had bland nuclei, with no nuclear atypia or mitotic figures. No calcified materials or bony spicules were evident. Microscopically, the lesions consisted of cellular fibrous tissue and hard tissue. The final diagnosis was bilateral periapical OD. FNAC alone may not be an accurate procedure for definitive diagnosis of a fibro-osseous lesion, but it can be a useful and reliable diagnostic method when used in conjunction with clinical and imaging findings.