Gingival juvenile xanthogranuloma in an adult patient: case report with immunohistochemical analysis and literature review.
Juvenile xanthogranuloma (JXG) is a non-Langerhans cell histiocytosis (nonLCH). It is a benign and self-healing disorder that generally affects infants and children. Oral lesions in adult patients are rare, although the microscopic findings are similar to those observed in other locations. A 56-year-old white man presented with a chief complaint of a gingival mass that had appeared 6 months before and had grown slowly. An intraoral examination revealed the presence of a solitary, softened gingival mass affecting the mandibular lingual gingiva at the right central incisor area. A biopsy of the lesion showed multiple large macrophages and numerous giant cells of Touton type. The immunohistochemistry positivity for CD68, fascin, factor XIIIa, alpha-antitrypsin and negativity for S-100, beta-actin, CD1a, and desmin confirmed the diagnosis of JXG. The occurrence of adult oral JXG is extremely rare. It is a nonLCH that may present variable clinical and microscopic aspects, which leads to a diversity of clinical misdiagnoses. A precise diagnosis of these lesions requires an accurate evaluation of clinical, microscopic, and immunohistochemical features.
Consolaro
Alberto
A
Department of Stomatology, Bauru Dental School, University of São Paulo, Alameda Octávio Pinheiro Brizola 9-75, Bauru-SP, Brazil.
Sant'Ana
Eduardo
E
Lawall
Melaine A
MA
Consolaro
Maria Fernanda M O
MF
Bacchi
Carlos Eduardo
CE
D015703:Antigens, CD / Q000032:analysis; D015214:Antigens, Differentiation, Myelomonocytic / Q000032:analysis; D002352:Carrier Proteins / Q000032:analysis; D003937:Diagnosis, Differential; D026122:Factor XIIIa / Q000032:analysis; D005882:Gingival Diseases / Q000378:metabolism* / Q000473:pathology; D006646:Histiocytosis, Langerhans-Cell / Q000175:diagnosis; D006801:Humans; D007150:Immunohistochemistry; D008297:Male; D008334:Mandible; D008840:Microfilament Proteins / Q000032:analysis; D008875:Middle Aged; D014972:Xanthogranuloma, Juvenile / Q000378:metabolism* / Q000473:pathology; D000515:alpha 1-Antitrypsin / Q000032:analysis; D000097382:CD68 Molecule
D015703:Antigens, CD; D015214:Antigens, Differentiation, Myelomonocytic; D002352:Carrier Proteins; D026122:Factor XIIIa; D008840:Microfilament Proteins; D000515:alpha 1-Antitrypsin; C067980:CD68 antigen, human; D000097382:CD68 Molecule; C020324:fascin