in the oral cavity have been identified with disruption and damage of surrounding tissues. In comparison, PCGs manifesting in other internal organs are usually secondary findings on radiographic images. Occasionally, plasma cell granulomas are misdiagnosed as malignant lymphoma or malignant plasmacytoma during initial examination due to radiological evidence of its ability to erode and infiltrate bone. Typically, under microscopic analysis, a plasma cell granuloma will display a dense population of morphologically similar plasma cells sporadically mixed together with other inflammatory lymphocytes seen in a storiform orientation of fibrotic connective tissue. To avoid the misdiagnosis of a PCG as a plasmacytoma, it should be noted PCGs are formed from typical plasma cells while plasmacytomas consist of both atypical and typical plasma cells. It is imperative that such differentiation between plasma cell granuloma and plasmacytomas are completed prior to informing the patient undergoing clinical examination. The importance of an accurate diagnosis between the two is due to the different prognosis and progression of the mass-forming lesions. While plasma cell granulomas are often found to be benign, plasmacytomas have been associated with a more aggressive and invasive behavior in which they have the ability to transform or evolve into multiple myeloma. One of the most reliable distinguishing factors from plasmacytomas and plasma cell granulomas, is the polyclonality of the plasma cells involved with plasma cell granulomas. PCGs that manifest in the mouth, specifically the gingiva, have been seen to exhibit similar physical characteristics of other conditions such as epulis, fibroma, pyogenic granuloma, and peripheral giant cell granuloma. Histopathological analysis of plasma cell granulomas have been found to be the most precise confirmative diagnosis to distinguish PCGs from other lesional tumors of plasma cell origins. Histopathology Analyzing the changes that arise in the tissue associated with the mass-forming lesion has been found to be the most accurate and precise method for confirming the diagnosis of plasma cell granulomas. This can be achieved by taking excision biopsies of the unknown mass for examination. Typically, plasma cell granulomas appear microscopically as a lesional mass consisting of an abundance of plasma cells intermingled among different inflammatory cells set in fibrous connective tissue displayed in a spiral appearance. Depending on the location of the plasma cell granuloma, vasculitis can be present but is not considered a confirmatory factor for diagnosis. Kappa/lambda in-situ hybridization is another diagnostic test that needs to be done when trying to characterize the lesion