PMC4065429_01
Lesion over the left maxilla producing facial asymmetry
JOMFP-18-121-g001.jpg
PMC4065429_01_JOMFP-18-121-g001.jpg
F1
Inferiorly the swelling extended upto the line joining the corner of the mouth to the tragus of the ear [Figure 1].
Extensive gingival proliferation of left maxilla covering the teeth in the involved area
JOMFP-18-121-g002.jpg
PMC4065429_01_JOMFP-18-121-g002.jpg
F2
On intraoral examination, a massive, lobulated, firm, nontender and erythematous growth involving the gingiva was seen extending from the left maxillary lateral incisor to the left maxillary third molar [Figure 2].
OPG showing root stumps without much destruction of bone
JOMFP-18-121-g003.jpg
PMC4065429_01_JOMFP-18-121-g003.jpg
F3
However, gross resorption of bone was not evident at the area of lesion [Figure 3].
Hyperplastic epithelium with acanthosis (H&E stain, x40)
JOMFP-18-121-g004.jpg
PMC4065429_01_JOMFP-18-121-g004.jpg
F4
H and E-stained sections showed hyperplastic surface epithelium with extensive aggregates of small round cells with eosinophilic cytoplasm in the underlying connective tissue [Figures 4 and 5].
Sheets of tumor cells in the underlying connective tissue (H&E stain, x400)
JOMFP-18-121-g005.jpg
PMC4065429_01_JOMFP-18-121-g005.jpg
F5
H and E-stained sections showed hyperplastic surface epithelium with extensive aggregates of small round cells with eosinophilic cytoplasm in the underlying connective tissue [Figures 4 and 5].
Positive staining with immunohistochemical marker CD68 (IHC stain, x400)
JOMFP-18-121-g006.jpg
PMC4065429_01_JOMFP-18-121-g006.jpg
F6
Positive staining with immunohistochemical marker CD117 (IHC stain, x400)
JOMFP-18-121-g007.jpg
PMC4065429_01_JOMFP-18-121-g007.jpg
F7
Positive staining with immunohistochemical marker MPO (IHC stain, x100)
JOMFP-18-121-g008.jpg
PMC4065429_01_JOMFP-18-121-g008.jpg
F8
MS, we used MPO to differentiate the lesion from myeloid leukemia. MPO [Figure 8] was strongly positive in the present case confirming the lesion as MS.