Angiolymphoid Hyperplasia with eosinophilia (ALHE) is considered a rare, benign vascular lesion that mainly affects the skin and subcutaneous tissues of the head and neck, but is uncommon in the oral cavity. Its etiology remains unclear and it has been described as a reactive vascular proliferation, vascular malformation or neoplasm. Kimura' s disease is the primary entity to consider in differential diagnosis. Here we report on a rare case of ALHE involving the upper lip of a 50-year-old male patient that had a nodular swelling with approximately 3 cm, 7 years after initial onset. An excisional biopsy was performed and histopathologic examination revealed a well-encapsulated, multi-lobed lesion with proliferation of blood capillaries, displaying endothelial cells of epithelioid appearance, diffuse inflammatory infiltrate with lymphocytes, plasma cells, numerous eosinophils, and presence of lymphoid follicles. Immunohistochemical tests were positive for the markers CD34 and Ki-67 that, in combination with the results of morphological examination, were suggestive of a diagnosis of ALHE.Keywords: vascular system lesions; hemangioma; differential diagnosis. ResumoA hiperplasia angiolinfoide com eosinofilia (HALE) é considerada uma lesão vascular benigna rara que acomete, principalmente, o tecido cutâneo e subcutâneo da região de cabeça e pescoço, mas incomum na cavidade oral. Sua etiopatogenia permanece indefinida, sendo descrita como proliferação vascular reacional, malformação vascular ou neoplasia. Tem como principal diagnóstico diferencial a doença de Kimura. Este trabalho relata um caso de um paciente do sexo masculino, de 50 anos, que exibia aumento de volume nodular na mucosa do lábio superior, com 3 cm de dimensão e 7 anos de evolução. Após a biópsia excisional, o exame histopatológico mostrou lesão bem encapsulada multilobulada com proliferação de capilares sanguíneos com células endoteliais de aspecto epitelioide, infiltrado inflamatório difuso com linfócitos, plasmócitos, inúmeros eosinófilos e presença de folículos linfoides. A análise imuno-histoquímica revelou positividade para CD34 e Ki-67, o que, juntamente com o exame morfológico, direcionou o diagnóstico para HALE.Palavras-chave: lesões do sistema vascular; hemangioma; diagnóstico diferencial.
Background and objective The aim of this study was to evaluate the angiogenesis and lymphangiogenesis in gingival tissue biopsy specimens of individuals with clinically healthy gingiva, chronic gingivitis, and chronic periodontitis (n = 30 per clinical condition). Material and methods Histological sections were stained using hematoxylin and eosin as well as immunohistochemically with hematopoietic progenitor cell antigen CD34 and podoplanin (PDPN) antibodies to evaluate the microvascular count, area, and perimeter of blood and lymphatic vessels, respectively. Results The results revealed a correlation between the microvascular count of blood and lymphatic vessels (P = 0.03; however, in individuals with chronic periodontitis, fewer lymphatic vessels were present than in the clinically healthy gingival tissue (P = 0.01), which was not observed in the case of microvascular area and perimeter. Podoplanin labeling was present in the epithelium, and the intensity of labeling was positively correlated to the intensity of the inflammatory infiltrate (P = 0.03). Conclusion In this study, we concluded that an increase in the number of blood and lymphatic vessels was not observed in bouth gingivitis and periodontitis samples. Podoplanin expression is highly associated with an increased inflammatory infiltration suggesting that PDPN might play an additional role in periodontal disease, other than solely as a lymphangiogenesis marker.
Prezados Colegas, É com imensa satisfação que convido a comunidade odontológica para participar do I Congresso Internacional de Reabilitação Oral - COREO, a ser realizado no Centro de Convenções de João Pessoa, nos dias 27, 28 e 29 de setembro de 2018. O COREO surgiu da necessidade de trazer para a região nordeste uma agenda científica em odontologia, com foco voltado para a reabilitação oral, priorizando a prática clínica baseada em evidências científicas. O tema central do I COREO será “Mudança de paradigma com relação às novas tecnologias”. Baseado nessa temática, serão discutidos nesse evento, as novas condutas e protocolos clínicos e científicos com o objetivo de usufruir dos novos recursos tecnológicos disponíveis nas diversas especialidades, na busca de tratamentos mais previsíveis em longo prazo. Para abrilhantar o evento, selecionamos conceituados conferencistas com expressivo conhecimento científico, aliado a experiência clínica. Aproveitando o ensejo, reiteramos o nosso convite aos colegas Cirurgiões-Dentistas, Acadêmicos de Odontologia, Técnicos em Prótese Dentária, Auxiliares e Técnicos em Saúde Bucal para fazer um grande e inesquecível evento, que ficará para a história da Odontologia Brasileira.Diogo José Barreto de Menezes - Presidente do 1º COREO
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