Demystifying "Hyaline Angiopathy" of Pulse Granuloma in Oral and Extraoral Surgical Pathology.

IF 2.9 3区 医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE Oral diseases Pub Date : 2025-02-17 DOI:10.1111/odi.15287
Felipe Fornias Sperandio, Matheus de Castro Costa, Marina Lara de Carli, Rani Kanthan
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Abstract

Background and objectives: Pulse granuloma (PG), or giant cell hyaline angiopathy, is an immune-mediated reaction often following the implantation of plant-derived food particles. PGs are primarily found in the oral cavity and gastrointestinal tract and may represent a histopathological pitfall, being mistaken for other granulomatous conditions or tumors. This study is the first to compare oral to extraoral PGs, aiming to clarify the "hyaline angiopathy" seen in PGs by developing a detailed histochemical and immunohistochemical profile of oral and colonic PGs.

Methods: A computer search of 135,972 surgical pathology cases was conducted. PG histopathological slides, along with demographic and clinical data, were reviewed. Stains including Congo red, Masson trichrome, PAS, and immunostains CD31, ERG, and D2-40 were applied.

Results: Sixteen cases (11 oral, 5 extraoral) were identified, ranging from 7 to 81 years of age. Oral PGs were linked to odontogenic cysts, while extraoral PGs were associated with intestinal inflammation and perforation. Angiolymphatic marker expression was limited to the inflamed connective tissue surrounding PG.

Conclusions: Our findings suggest that PGs reflect a granulomatous response to edible components and support surgical excision. The absence of vascular markers indicates that the term "angiopathy" is misleading, proposing that these "wormy" structures are fibrocollagenous responses.

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背景和目的:脉冲肉芽肿(PG)或巨细胞透明血管病是一种免疫介导的反应,通常发生在植入植物源性食物颗粒之后。脉冲肉芽肿主要出现在口腔和胃肠道,可能会被误认为是其他肉芽肿病症或肿瘤,是一种组织病理学陷阱。本研究首次比较了口腔和口腔外的 PGs,旨在通过对口腔和结肠 PGs 进行详细的组织化学和免疫组化分析,澄清 PGs 中的 "透明血管病":方法:对 135,972 例外科病理病例进行了计算机检索。方法:通过计算机检索了 135,972 例手术病理病例,并对 PG 组织病理切片以及人口统计学和临床数据进行了审查。染色包括刚果红、Masson 三色、PAS 和免疫标记 CD31、ERG 和 D2-40:结果:共发现 16 个病例(11 个口腔内病例,5 个口腔外病例),年龄从 7 岁到 81 岁不等。口腔PG与牙源性囊肿有关,而口外PG则与肠道炎症和穿孔有关。血管淋巴标记物的表达仅限于PG周围发炎的结缔组织:我们的研究结果表明,PG 反映了对可食用成分的肉芽肿反应,支持手术切除。血管标记物的缺失表明,"血管病变 "一词具有误导性,这些 "蚯蚓状 "结构是纤维胶原反应。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Oral diseases
Oral diseases 医学-牙科与口腔外科
CiteScore
7.60
自引率
5.30%
发文量
325
审稿时长
4-8 weeks
期刊介绍: Oral Diseases is a multidisciplinary and international journal with a focus on head and neck disorders, edited by leaders in the field, Professor Giovanni Lodi (Editor-in-Chief, Milan, Italy), Professor Stefano Petti (Deputy Editor, Rome, Italy) and Associate Professor Gulshan Sunavala-Dossabhoy (Deputy Editor, Shreveport, LA, USA). The journal is pre-eminent in oral medicine. Oral Diseases specifically strives to link often-isolated areas of dentistry and medicine through broad-based scholarship that includes well-designed and controlled clinical research, analytical epidemiology, and the translation of basic science in pre-clinical studies. The journal typically publishes articles relevant to many related medical specialties including especially dermatology, gastroenterology, hematology, immunology, infectious diseases, neuropsychiatry, oncology and otolaryngology. The essential requirement is that all submitted research is hypothesis-driven, with significant positive and negative results both welcomed. Equal publication emphasis is placed on etiology, pathogenesis, diagnosis, prevention and treatment.
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