Uncommon Foreign Body Reactions Occurring in the Lip: Clinical Misdiagnosis and the Use of Special Techniques of Analysis

Gouvêa, Adriele Ferreira; Hanemann, João Adolfo Costa; Pereira, Alessandro Antônio Costa; Ribeiro, Ana Carolina Prado; Romañach, Mário José; Jorge, Jacks; Vargas, Pablo Agustı́n

doi:10.1007/s12105-010-0217-z

Cited by 11 publications

(7 citation statements)

References 17 publications

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“…e.g. foreign body reaction in silicon transplant leaking [25,26], other foreign body reaction [27], fungal infection [28], rarely in some neoplasm [29]. As in our case, palpably asteroid body mechanism of creation is similar for that in foreign body reactions [30,31].…”

Section: Discussionsupporting

confidence: 71%

Histiocytic lymphadenopathy secondary to metallosis following endoprosthetic replacement in osteosarcoma patient – a potential diagnostic pitfall

Sokół

Szostakowski

Chraszczewska

et al. 2020

Nowotwory. Journal of Oncology

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We present the case of a 43-year old patient with inguinal lymphadenopathy 22 years after distal femoral resection for osteosarcoma with cemented distal femoral replacement reconstruction. Seven years after initial distal femoral resection patient underwent metal on metal hip resurfacing arthroplasty on the affected side. Twenty years after distal femoral replacement and 13 years after metal on metal hip resurfacing procedure, the patient underwent left inguinal lymphadenectomy for an enlarged mass of inguinal lymph nodes on suspicion for a sarcoma recurrence. On microscopic examination, excised lymph nodes were massively infiltrated with macrophages and multinucleated giant cells with focal asteroid bodies. An examination in polarized light revealed numerous metal particles; immunohistochemical stainings confirmed reactive character of changes, and florid metal-related sinus histiocytosis was finally diagnosed. Microscopic assessment of lymph nodes in the course of malignancy is a standard procedure; we present a rare case of non-neoplastic lymph node enlargement due to the late onset of metallosis, which might be a diagnostic challenge.

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Section: Discussionsupporting

confidence: 71%

Histiocytic lymphadenopathy secondary to metallosis following endoprosthetic replacement in osteosarcoma patient – a potential diagnostic pitfall

Sokół

Szostakowski

Chraszczewska

et al. 2020

Nowotwory. Journal of Oncology

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“…According to the clinical presentation and taking into account patient demographic features, the presurgical differential diagnosis of this gray-purple mass was basically structured in the following additional entities: peripheral giant cell granuloma, peripheral ossifying fibroma, fibroma, peripheral odontogenic fibroma, infantile hemangioma, conventional granulation tissue, hyperplastic gingival inflammation, Kaposi’s sarcoma, bacillary angiomatosis, angiosarcoma and Non Hodgkin´s lymphoma [ 3 , 16 - 18 ].…”

Section: Discussionmentioning

confidence: 99%

A Gray-purple Mass on the Floor of the Mouth: Gigantic Mucogingival Pyogenic Granuloma in a Teenage Patient

Brunet‐Llobet

Miranda‐Rius²,

Lahor-Soler³

et al. 2014

TODENTJ

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Pyogenic granuloma is defined as a benign neoplasm of vascular phenotype. This case describes the clinical and histopathological features of a gigantic mucogingival pyogenic granuloma, in a 14-year-old healthy black boy. This exophytic gray-purple mass, related to a toothpick injury, had more than twelve-month evolution on the anterior mandible involving lingual area besides to the floor of the mouth pressing the right salivary duct. Conservative excision was performed, followed by uncomplicated healing with no recurrence in two years. The histopathological examination reported a pyogenic granuloma (lobular capillary haemangioma). The authors provide a discussion of the presurgical differential diagnosis of the lesion. This case report presents an extremely uncommon location of a gigantic pyogenic granuloma, involving mucogingival complex and affecting the salivary outflow. This clinical manuscript may shed light on the controversies about possible mechanisms inducing oral pyogenic granuloma.

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“…In the present case, the patient presented 4 sialoliths in the Stensen's duct. Some different blackened foreign materials have been described in different sites of the oral mucosa, 8 such as plastic fragments from a child's toy, artificial finger nail, and iron fragment, 9 but none inserted in the Stensen's duct. Moreover, the clinical and macroscopic appearance of the material (blackened multiple fragments) was very suggestive of foreign bodies, not sialoliths.…”

Section: Discussionmentioning

confidence: 99%

Scanning electron microscope and x-ray diffraction analysis assisting the diagnosis of a sialolith in the parotid duct

Ribeiro

Gouvêa

Lopes

et al. 2011

Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, an

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A 60-year-old man presented with a painless blackish well defined nodule in the parotid duct region of the left buccal mucosa. The nodule was ϳ1.0 cm in diameter, freely movable, and present 2 months (Fig. 1). The medical history was noncontributory, and the main clinical diagnosis was of a foreign body. An excisional biopsy was performed under local anesthesia, and 3 blackened stone-like fragments associated with soft tissue were removed from the parotid duct and submitted to histopathologic examination.Macroscopic analyses of the surgical specimens showed 1 well defined black structure inside the soft tissue and 3 stone-like black fragments (Fig. 2). Microscopic analyses of the soft tissue fragment revealed a sialolith within the dilated excretory salivary duct, which presented squamous metaplasia (Fig. 3, A). The sialolith displayed a lamellated pattern of calcification with alternation between eosinophilic and basophilic zones disposed concentrically (Fig. 3, B). In an attempt to elucidate the nature of the black stone-like material, scanning electron microscopy (SEM; Jeol JSM-5600LV) and energy-dispersive x-ray analysis were performed. The SEM analysis of the external surface displayed a cobblestone aspect, sparse cellular elements, and organic membranous remains on the surface. Also, the longitudinal fracture surface of the black stone-like material showed parallel arrangement of the crystalline structures (Fig. 4, A). The energy-dispersive x-ray analysis detected large amounts of carbon (C), silicium (Si), calcium (Ca), phosphorus (P), and sodium (Na) on the rough external surface, with a predominance of C over the other elements (Fig. 4, B). The chemical components observed in microanalyses of the black stone-like material allowed the diagnosis of sialolith. At the time of writing, the patient had been under clinical follow-up for 12 months with no recurrences and no alteration of parotid gland function.

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Uncommon Foreign Body Reactions Occurring in the Lip: Clinical Misdiagnosis and the Use of Special Techniques of Analysis

Cited by 11 publications

References 17 publications

Histiocytic lymphadenopathy secondary to metallosis following endoprosthetic replacement in osteosarcoma patient – a potential diagnostic pitfall

Histiocytic lymphadenopathy secondary to metallosis following endoprosthetic replacement in osteosarcoma patient – a potential diagnostic pitfall

A Gray-purple Mass on the Floor of the Mouth: Gigantic Mucogingival Pyogenic Granuloma in a Teenage Patient

Scanning electron microscope and x-ray diffraction analysis assisting the diagnosis of a sialolith in the parotid duct

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