PMC5824500_01
(a) Clinical image showing a tan-red exophytic, lobulated mass of the maxillary anterior facial gingiva. (b) A separate, similar appearing smaller lesion was identified in the right maxillary vestibule
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F1
The lesion measured 3.0 cm x 1.5 cm in greatest dimension and appeared dark-red color with secondary tan-gray ulceration [Figure 1a]. A smaller, similar appearing lesion was identified in the right maxillary vestibule adjacent to the labial frenum [Figure 1b].
Periapical radiograph showing no changes in the quality or quantity of bone and no evidence of odontogenic infections
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F2
A periapical radiograph of the area showed no changes in the quality or quantity of bone and no evidence of tooth-related infections [Figure 2].
(a) Histopathologic image showing tumor cell nests completely effacing the lamina propria, (H&E, x40). (b) These tumor nests were arranged in lobular aggregates separated by thin fibrous septae, (H&E, x100). (c) On high power magnification, the cells displayed pink to vacuolated cytoplasm with vesicular nuclei and prominent nucleoli. Significant nuclear pleomorphism was present and the lesion demonstrated brisk mitotic activity, (H&E, x400)
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F3
Beneath the epithelium, tumor cells were found to completely efface the lamina propria [Figure 3a]. These cells were predominately arranged in lobular aggregates separated by thin fibrous septae [Figure 3b]. Significant nuclear pleomorphism was present and the lesion demonstrated brisk mitotic activity [Figure 3c].
Histopathologic image showing strong positivity for (a) pan-cytokeratin, x40, (b) CK8/18, x40, (c) Pax-8, x40, (d) CD10, x40, (e) CA9, x40, (f) CK19, x40 and (g) vimentin, x40, in the tumor cell population
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F4
The tumor cells were strongly positive for pancytokeratin, CK8/18, Pax-8, CD10, CA9, CK19 and vimentin [Figure 4a-g] and were focally positive for EMA.