The Histopathological Spectrum of Pyogenic Granuloma: A Case Series

Background.Pyogenic granuloma is a reactive tumor-like lesion commonly affecting the oral cavity. These lesions usually appear as localized solitary nodule with a sessile or pedunculated base and colour varying from red, purplish, or pink, depending on the vascularity of the lesion. Pyogenic granuloma shows predilection for gingiva and is usually slow growing, but at times it shows rapid growth. The natural course of this lesion can be categorized into three distinct phases, namely, (i) cellular phase, (ii) capillary phase/vascular phase, and (iii) involutionary phase. Histopathologically, pyogenic granuloma is classified into lobular capillary hemangioma (LCH) and non-lobular capillary hemangioma (non-LCH).Case Presentation. In this series, four cases (varied age groups and both genders) of pyogenic granuloma showing varying histopathological presentation in relation to its clinical course have been described. The lesion in its early phase reveals diffuse endothelial cells, with few budding into capillaries. Among the capillary phase, the LCH type shows numerous blood vessels organized into lobular aggregates whereas the non-LCH type does not show any such organization and resembles granulation tissue. The involutionary phase shows healing of the lesion and is characterized by extensive fibrosis in the connective tissue.Conclusion.In conclusion, knowledge of the various histopathological presentation of this lesion is necessary for proper identification.

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Gastrointestinal Pyogenic Granuloma (Lobular Capillary Hemangioma): An Underrecognized Entity Causing Iron Deficiency Anemia

Case Reports in Gastrointestinal Medicine ◽

10.1155/2016/4398401 ◽

2016 ◽

Vol 2016 ◽

pp. 1-8 ◽

Cited By ~ 2

Author(s):

Marshall W. Meeks ◽

Umar M. Kamal ◽

Muhammad B. Hammami ◽

Jason R. Taylor ◽

M. Louay Omran ◽

...

Keyword(s):

Gastrointestinal Tract ◽

Iron Deficiency ◽

Case Series ◽

Pyogenic Granuloma ◽

Vascular Tumor ◽

Capillary Hemangioma ◽

Deficiency Anemia ◽

Review Of The Literature ◽

Lobular Capillary Hemangioma ◽

Actual Incidence

Pyogenic granuloma (PG), more accurately known as lobular capillary hemangioma, is a benign vascular tumor that usually occurs in the skin or oral mucosa. This lesion is rarely reported in the gastrointestinal tract but is known to bleed if not resected. We herein describe a case series with the clinical, endoscopic, and histologic findings of four cases of gastrointestinal PG at our institution. In addition, we provide a review of the literature and summation of all reported cases of PG specific to the gastrointestinal tract. Based on our experience, we suggest that the actual incidence of gastrointestinal PG may in fact be higher than reported because PG can be unrecognized or improperly diagnosed. It is important for the clinician to properly recognize this lesion as a source of anemia and its propensity to bleed during biopsy or resection.

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Pediatric Nasal Lobular Capillary Hemangioma

Case Reports in Medicine ◽

10.1155/2012/769630 ◽

2012 ◽

Vol 2012 ◽

pp. 1-4 ◽

Cited By ~ 2

Author(s):

Jordan M. Virbalas ◽

John P. Bent ◽

Sanjay R. Parikh

Keyword(s):

Nasal Obstruction ◽

Pediatric Population ◽

Case Series ◽

Epidemiological Data ◽

Pyogenic Granuloma ◽

Capillary Hemangioma ◽

Retrospective Case ◽

Lobular Capillary Hemangioma ◽

Image Guided ◽

Recurrent Epistaxis

Background.LCH is a benign vascular growth of the skin and mucous membranes commonly affecting the head and neck. Since it was first described in the nineteenth century, this entity has been variously known as “human botryomycosis” and “pyogenic granuloma.” The shifting nomenclature reflects an evolving understanding of the underlying pathogenesis. We review the histopathology of and current epidemiological data pertaining to LCH which suggests that the development of these lesions may involve a hyperactive inflammatory response influenced by endocrine factors. We report two new cases of pediatric lobular capillary hemangioma (LCH) of the nasal cavity and review current theories regarding the etiology, diagnosis, and treatment of nasal LCH.Methods. Retrospective case series.Case Series. Two adolescent females presented with symptoms of recurrent epistaxis, nasal obstruction, and epiphora. Both patients underwent computed tomography imaging and biopsy of their intranasal mass. The tumors were excised using image-guided transnasal endoscopic technique. Seven other cases of nasal LCH have been reported to date in the pediatric population.Conclusion. Nasal LCH is a rare cause of an intranasal mass and is associated with unilateral epistaxis, nasal obstruction, and epiphora. We advocate for image-guided endoscopic excision of LCH in the adolescent population.

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A Sheep in Wolf’s Clothing: Lobular Pyogenic Granuloma Masquerading Nodular Amelanotic Melanoma

Open Access Macedonian Journal of Medical Sciences ◽

10.3889/oamjms.2019.417 ◽

2019 ◽

Vol 7 (18) ◽

pp. 3015-3017

Author(s):

Jacqueline Schönlebe ◽

Uwe Wollina

Keyword(s):

Pyogenic Granuloma ◽

Capillary Hemangioma ◽

Amelanotic Melanoma ◽

Complete Excision ◽

Lobular Capillary Hemangioma ◽

Histologic Analysis ◽

Amelanotic Malignant Melanoma ◽

The Right ◽

Delay Of Diagnosis ◽

Slow Growing

BACKGROUND: Tumor masquerading is a common phenomenon seen in clinical dermatology. While amelanotic melanoma is known to simulate pyogenic granuloma, a benign vascular tumour, the contrary has been reported exceptionally scarce. CASE PRESENTATION: We present a 52-year-old woman with a slow-growing lesion on her right flank, which developed over 12 months. On examination, we observed a large exophytic, easily bleeding tumour on the right flank, that resembled amelanotic malignant melanoma. Histologic analysis after complete excision of the lesion confirmed a pyogenic granuloma of the lobular capillary hemangioma subtype. In the present case masquerading of the lesion went to the better site after histologic investigations despite the delay of diagnosis caused by the patients. CONCLUSION: Nevertheless, the diagnosis of uncertain lesions needs a rapid histologic analysis to gain the best possible prognosis for the patient.

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Pyogenic Granuloma or Lobular Capillary Hemangioma

Minor Emergencies ◽

10.1016/b978-0-323-08346-1.50182-0 ◽

2007 ◽

pp. 736-738

Author(s):

Philip Buttaravoli

Keyword(s):

Pyogenic Granuloma ◽

Capillary Hemangioma ◽

Lobular Capillary Hemangioma

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Pyogenic Granuloma: A Case Report

Health Renaissance ◽

10.3126/hren.v8i3.4215 ◽

1970 ◽

Vol 8 (3) ◽

pp. 196-198 ◽

Cited By ~ 1

Author(s):

Md T Rizwanulla ◽

Bandana Koirala ◽

Shivalal Sharma ◽

Lalita Adhikari ◽

Anju Pradhan

Keyword(s):

Case Report ◽

Inflammatory Response ◽

Pyogenic Granuloma ◽

Capillary Hemangioma ◽

Definitive Diagnosis ◽

Vascular Lesions ◽

Minor Trauma ◽

Lobular Capillary Hemangioma ◽

Dental Restorations ◽

Foreign Materials

Anju Pradhan was added as an author of this paper on 04/03/2011Pyogenic granulomas (PG) are common benign vascular lesions of the skin and mucosa. They are neither infective, purulent nor granulomatous as the name might suggest-rather a reactive enlargement that is an inflammatory response to local irritation such as calculus, fractured tooth, minor trauma, rough dental restorations and foreign materials. Here, we report a case of 13 year old patient with PG and in addition to the knowledge, the importance of biopsy findings in establishing definitive diagnosis has been emphasized. Keywords: pyogenic granuloma; inflammatory hyperplasia; lobular capillary hemangioma. DOI: 10.3126/hren.v8i3.4215Health Renaissance, September-December 2010; Vol 8 (No.3);196-198

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Wilms tumor 1 protein is not expressed in oral lymphangiomas

Brazilian Dental Journal ◽

10.1590/s0103-64402012000600014 ◽

2012 ◽

Vol 23 (6) ◽

pp. 707-710 ◽

Cited By ~ 3

Author(s):

Ana Carolina de Mesquita Netto ◽

Mariana Batista de Oliveira ◽

Vanessa Fátima Bernardes ◽

Carolina Cavaliéri Gomes ◽

Ricardo Santiago Gomez

Keyword(s):

Endothelial Cells ◽

Wilms Tumor ◽

Vascular Malformations ◽

Lymphatic Vessels ◽

Case Series ◽

Pyogenic Granuloma ◽

Positive Staining ◽

Female Ratio ◽

Wilms Tumor 1 ◽

Wt1 Protein

Lymphangiomas are benign hamartomatous lesions of lymphatic vessels. Wilms Tumor 1 (WT1) is a transcription factor that is activated in some human neoplasias. WT1 protein expression is observed in endothelial cells during angiogenesis and is a useful marker to distinguish between vascular proliferations and vascular malformations. The purpose of the present study is to report a case series of oral lymphangiomas together with an immunohistochemical investigation of WT1. Seventeen cases of oral lymphangioma were retrieved and reviewed. Immunohistochemical analysis of WT1 protein was performed and pyogenic granuloma samples were used as positive controls. The male/female ratio was 1.125 and most of the lesions occurred in young subjects. While pyogenic granuloma showed positive staining for WT1, the endothelial cells lining the thin-walled dilated lymphatic vessels of lymphangiomas were negative for this protein. The findings strengthen the idea that oral lymphangioma is a vascular malformation characterized by lymphatic dilatation without significant endothelial proliferation.

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