The online version of this article (doi:10.1186/1752-1947-8-198) contains supplementary material, which is available to authorized users.
The authors declare that they have no competing interests.
TB, EB, PB and PN analysed and interpreted the patient data regarding the lesion, the clinical diagnosis and the exclusion of systemic involvement. TB performed the surgery. PN and TB were major contributors in writing the manuscript. AMPR performed the histological examination and the immunohistochemical tests. The conception and design of the study, the acquisition, analysis and interpretation of data were realized by the authors themselves, as well as the draft of the manuscript and its critical revision. All authors read and approved the final manuscript.
Localized amyloidosis in the head and neck is a rare and generally benign condition. In the oral cavity, amyloidosis usually involves the tongue or buccal mucosa. We present the second case of oral amyloidosis arising in the gingiva ever reported, to the best of our knowledge.
A 73-year-old White Spanish man presented a persistent nodular mass involving his upper gingiva. The lesion was surgically resected and the histological examination revealed a subepithelial, multinodular amorphous and fibrillar accumulation. Staining of the specimen for Congo red proved positive, exhibiting a reddish colour under light microscopy and apple-green birefringence under polarized light. With immunohistochemical tests, pentagonal amyloid component was demonstrated. An extensive study excluded any systemic involvement; a diagnosis of localized primary amyloidosis was made. After 2 years of follow-up, no clinical progression to systemic amyloidosis or local recurrence was observed.
Localized amyloidosis of the gingiva is an extremely rare condition that seems to show no clinically distinct feature. Histologic examination is the first step towards diagnosis, followed by immunohistochemical tests. The diagnosis of localized amyloidosis should always be integrated with blood tests, a bone marrow biopsy, echocardiography and digestive endoscopy to intercept systemic involvement.
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- Localized amyloidosis of the upper gingiva: a case report
Ana Maria Puig Rullan
- BioMed Central