Bulletin Board of Oral Pathology
Bulletin Board of Oral Pathology
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Forum for Clinical and Surgical Oral Pathology Case BBOPF 23-1 Dr. John Kalmar (The Ohio State University. Columbus, OH. USA) is seeking your input for an interesting case. The case will be posted until May 14, 2023. A summary of the response will ensue shortly after. HistoryI have a biopsy case that shows a fibroma of the lower labial mucosa in a 71 year old white female. In the subjacent connective tissue; however, there are several small, nodular arrangements of finely fibrillar, basophilic material and chronic inflammatory cells (plasma cells and small lymphocytes) with an associated fine microvasculature but minimal collagen. The fibrillary change extends into mature adipose tissue as the base of the specimen. Verhoeff stain strongly suggests these fibrillar areas represent degenerating elastic fibers and confirms age-related elastosis within the surrounding fibrous connective tissue (yet interestingly not within the fibroma). I didn't see evidence of calcification to support pseudoxanthoma elasticum, but will order a Von Kossa tomorrow to definitively exclude calcific change. QuestionsHas anyone encountered similar granuloma-like clusters of dysmorphic, elastic fibers in the oral mucosa? They appear different from previous reports of elastofibroma or elastotic nodules and also distinct from the PXE cases we?ve seen. It?s a small thing, but unique enough to warrant checking with the collective experience. The lesions were signed out descriptively. We were wondering if anyone else has seen such an appearance before and what they would call this pathologic process. Many thanks. John R. Kalmar, DMD, PhD The Ohio State University College of Dentistry Images
Case prepared by Dr. Alfredo Aguirre (BBOP Manager) and Daniel Emmer (University at Buffalo School of Dental Medicine). |
