The spectrum of granulomatous lesions of oral mucosa and jaws

Objectives: To characterize the types of lesions of oral mucosa and jaws presenting as granulomatous inflammation.
Methods: Retrospective analysis of cases with microscopic diagnosis of granulomatous lesions, 1996-2015
Results: The study included 49 cases, 30 females and 19 males. Age ranged between 9-88 (mean 48)years. Most of the lesions (46, 95.8%) were of the non-necrotizing granulomatous variant. The spectrum of diagnosis included foreign body granuloma( 27,56%),non- necrotizing granuloma(not otherwise specified,10,20%),granulomatous cheilitis(4,8%),sarcoidosis(4,8%),orofacialgranulomatosis(1,2%),Chron's disease(1,2%), necrotizing granulomatous lesion (not otherwise specified, 2,4%).
28 cases (57%) developed in soft tissues (including lymph nodes and salivary glands) and 21, (42%) involved jaw bones (including the maxillary sinus). From the group of foreign body granulomas, 20(71%) were taken from the jawbones and 8(29 %) from soft tissues.
Histochemical stains for micro-organisms (Pas,Gram,Zhiel- Neelsen and Silver) were negative in all cases from necrotizing granulomatous lesion (not otherwise specified),non-necrotizing granulomatous lesions, granulomatous cheilitis and sarcoidosis. In cases of foreign-body granuloma this battery of stains was usually not performed.
Conclusions: Granulomatous foreign body inflammation were the most common types of granulomatous lesions in the study group, followed by non-necrotizing granulomatous inflammation(not otherwise specified).A specific disease or entity could be identified in only 75.5% of cases, and the remaining patients were referred for further investigation for a final diagnosis