PMC4706661_01
Intraoral (a) and panoramic radiograph (b) showed a lesion around the upper left first and second molars
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Fig1
Intraoral examination revealed a destructive ulcerative lesion around the upper left first and second molars, which showed mobility and poor dental conditions, including dental caries, gingival recession and bone loss (Fig. 1a). A panoramic radiograph revealed a radiolucent area in the periapical region of the upper left first molar, suggesting an osteolytic lesion (Fig. 1b).
Hematoxylin-eosin staining showed basophilic nuclei and eosinophilic cell plasma
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Fig2
It showed a proliferation of cells resembling histiocytes with an occasional pale nucleus edentulous with a lobular, grain bean-like appearance (Fig. 2).
Immunohistochemical staining showed cells positive for S-100 protein (a) and CD1a protein (b)
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Fig3
Microscopic findings and the presence of histiocytic cells led to the performance of an immunohistochemical staining panel using monoclonal antibodies for S-100 (Fig. 3a), CD1a (Fig. 3b), pan-cytokeratin, CD-68, melanoma marker (HMB45) and melanoma A protein.
Intraoral (a) view and panoramic radiograph (b) showed no bone disease (8 years later during follow-up)
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Fig4
We have been following up with the patient for 8 years (2006-2014) without signs of disease recurrence (Fig. 4a and b).