PMC5406796_01
Extraoral photograph of patient
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F1
Clinical photograph showing (a) gingival swelling on palatal aspect of 54.55 and 64.65 (b) diffused, erythematous ulcerated gingival swelling covered with necrotic slough over buccal aspect of 64.65 (c) and (d) gingival swelling with tiny bleeding spots over buccal aspect of 75 and 85
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F2
Mucosa over the swelling was ulcerated covered with necrotic slough with tiny bleeding spots with 55, 65, 75 and 85 [Figure 2a-d].
(a and b) Intraoral radiograph showing radiolucent lesion surrounding root of 55, 74 and 75
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F3
II mobility was recorded with 55, 65, 75 and 85. Intraoral periapical radiograph of 55, 74 and 75 revealed a mild radiolucent lesion surrounding the root of 55, 74 and 75 [Figure 3a and b].
Orthopantomogram revealed multiple areas of bone loss in the left mandibular region
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F4
Orthopantogram [Figure 4] revealed multiple areas of bone loss in the left mandibular region.
(a and b) Axial and coronal computed tomography revealed multiple soft tissue density lesions with irregular and punched out bony destruction noted involving left mandibular, left side of occiput, right maxillary and right temporal bone
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F5
Axial and coronal computed tomography [CT] [Figure 5a and b] revealed multiple soft tissue density lesions with irregular and punched out bony destruction noted involving left mandibular, left side of occiput, right maxillary and right temporal bone.
Three-dimensional computed tomography revealed multiple osteolytic lesions in relation to maxillary alveolar process, body and ramus of left side of mandible
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F6
Three-dimensional CT [Figure 6] revealed multiple osteolytic lesions in relation to maxillary alveolar process, body and ramus of the left side of the mandible.
Histopathological picture showing diffuse infiltrate of Langerhans cell with eosinophils (H&E stain, x40)
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F7
Background is showing a variable number of lymphocyte, eosinophils and plasma cells and occasional mitosis [Figure 7].