7.31.24

Quick Review #192 - #pathology #oralpathology #doctorgallagher #oralsurgery #oralsurgeon #dentist #dentistry #dental

The peripheral and central giant cell granulomas are distinct pathological entities with different characteristics, despite both involving the proliferation of multinucleated giant cells. Here are the key differences:

Peripheral Giant Cell Granuloma (PGCG)

1. Location:

• Peripheral: Occurs exclusively in the gingiva or alveolar mucosa.

2. Clinical Presentation:

• Appears as a reddish-blue or purplish lesion, often ulcerated.

• Typically, it is a painless, slow-growing, and sessile or pedunculated mass.

3. Demographics:

• More common in younger individuals and females.

4. Radiographic Features:

• Usually not seen on radiographs because it is confined to the soft tissue.

• If there is bone involvement, it appears as superficial erosion or cupping resorption of the alveolar bone.

5. Etiology:

• Often associated with local irritation or trauma, such as from dental appliances, calculus, or poor oral hygiene.

Central Giant Cell Granuloma (CGCG)

1. Location:

• Central: Occurs within the bone, commonly in the anterior region of the mandible or maxilla.

2. Clinical Presentation:

• Presents as a swelling or expansion of the jawbone, which may cause displacement of teeth.

• Pain and paresthesia can occur but are less common.

3. Demographics:

• Also more common in younger individuals, with a slight female predilection.

4. Radiographic Features:

• Appears as a radiolucent lesion that can be unilocular or multilocular.

• Can cause thinning or perforation of the cortical bone, root resorption, and tooth displacement.

5. Etiology:

• The exact cause is unclear, but it is considered to be a reactive lesion rather than a true neoplasm. It may be related to trauma or other local factors.

Histopathological Features (Common to Both)

• Both lesions consist of a proliferation of multinucleated giant cells within a background of ovoid and spindle-shaped mesenchymal cells.

• There is often hemorrhage and hemosiderin deposition, with a variable amount of collagenous stroma.

References:

1. Limongelli, L., Tempesta, A., Lauritano, D., Maiorano, E., Ingravallo, G., Favia, G., & Capodiferro, S. (2020). Peripheral giant cell granuloma of the jaws as first sign of primary hyperparathyroidism: A case series. Journal of Clinical Medicine, 9(12), 4042. [Figure].

2. Marx, R. E., & Stern, D. (2012). Oral and Maxillofacial Pathology: A Rationale for Diagnosis and Treatment (2nd ed.). Quintessence Publishing Co Inc.

3. Neville, B. W., Damm, D. D., Allen, C. M., & Chi, A. C. (2015). Oral and Maxillofacial Pathology (4th ed.). Elsevier Health Sciences.

4. Gnepp, D. R. (2012). Diagnostic Surgical Pathology of the Head and Neck (2nd ed.). Saunders.

5. ChatGPT. 2024.

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