PMC4512596_01
Mild mucosal erythema of the right anterior maxillary gingiva.
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Intraoral examination revealed a very subtle area of mucosal erythema involving the gingiva buccal to the right primary maxillary molar, canine, and lateral incisor (Figure 1) and a more well-defined area of erythema involving the alveolar mucosa facial to the left primary maxillary central and lateral incisors and canine (Figure 2).
A demarcated area of mucosal erythema involving the left anterior maxillary alveolar mucosa.
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Intraoral examination revealed a very subtle area of mucosal erythema involving the gingiva buccal to the right primary maxillary molar, canine, and lateral incisor (Figure 1) and a more well-defined area of erythema involving the alveolar mucosa facial to the left primary maxillary central and lateral incisors and canine (Figure 2).
Nodular swellings of the interdental papillae between the right permanent mandibular central and lateral incisors and primary canine. An ulceration of the free gingival margin between the incisors is seen. Also noted is a linear ulceration with hyperplastic margins involving the alveolar mucosa.
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Also noted were multiple mucosal-colored swellings and ulcerations of the gingiva facial to the right permanent mandibular central and lateral incisors and primary canine (Figure 3).
Histopathologic images of the right mandibular gingiva. (a) Low-power view showing stratified squamous epithelium with scattered intraepithelial lymphocytes (exocytosis). The underlying fibrous connective tissues are characterized by a patchy chronic inflammatory cell infiltrate and an isolated granuloma (arrow) (hematoxylin and eosin, 40x). (b) High-power view showing a well-defined, noncaseating granuloma composed predominantly of epithelioid histiocytes and lymphocytes (hematoxylin and eosin, 100x).
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Microscopic examination revealed curved portions of oral mucosa surfaced by spongiotic stratified squamous epithelium with evidence of mild inflammatory cell exocytosis; beneath the epithelium, there was a proliferation of fibrous connective tissue with a patchy infiltrate of lymphocytes and plasma cells (Figure 4(a)). In isolated areas, there were well-formed, noncaseating granulomas composed of epithelioid histiocytes and lymphocytes (Figure 4(b)).