PMC4334617_01
Clinical and macroscopic features. (a) Two pedunculated reddish nodules located in the mandible and maxilla. ((b) and (c)) The lesions following surgical excision.
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A female Caucasian neonate presented two exophytic lesions of the mandible and maxilla, associated with feeding difficulties, described as pedunculated nodules, reddish in color, with an irregular surface, located at the anterior alveolar region between the future eruption sites of the incisors and canines, measuring approximately 3 cm (Figure 1(a)). The specimens (Figures 1(b) and 1(c)) were fixed in 10% formalin and sent for histological examination.
Histological and immunohistochemical sections. (a) Large round granular cells with an abundant eosinophilic cytoplasm and basophilic nuclei in a background of prominent vasculature and lined by an atrophic epithelium (H&E 200x). (b) Granular cells demonstrating strong positivity for CD68 (400x). ((c) and (d)) Endothelial cells positive for CD105 and CD34, respectively. (e) D2-40 positive immunostaining for granular cells and lymphatic vessels. (f) Weak staining for Ki67, showing a low grade of proliferation. ((g) and (h)) Overexpression of VEGF and FGF in granular cells and endothelial cells, respectively.
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Proliferation of large round granular cells with an abundant eosinophilic cytoplasm and basophilic nuclei, ranging from round to oval, was observed in the lamina propria (Figure 2(a)). The granular cells were found to be negative for S-100, CD34, and CD105, yet positive for CD68, VEGF, FGF, D2-40, and Ki67 (Figures 2(b)-2(h)).