Clinicopathological and immunohistochemical study of oral amalgam pigmentation

Acta Otorrinolaringol Esp. 2012 Sep-Oct;63(5):376-81. doi: 10.1016/j.otorri.2012.02.004. Epub 2012 Apr 12.
[Article in English, Spanish]

Abstract

Amalgam tattoo, the most common exogenous oral pigmentation, can sometimes be confused with melanotic lesions, being then biopsied. We present the clinicopathological characteristics of 6 biopsied cases (5 females and 1 male) of oral amalgam pigmentation. The most common location was the gingival mucosa, followed by the buccal and palatal mucosa. Morphology and distribution (stromal, perivascular, perineural, endomysial) of pigmentation was variable; there was only 1 case with fibrous capsular reaction and likewise only a single case of granulomatous foreign body reaction. Morphological variability is conditioned by the timing and amount of the pigment deposit, which is often associated with infiltration by mast cells (CD117+), as well as overexpression of metallothionein and HLA-DR at different tissue levels.

MeSH terms

  • Antigens, CD / analysis
  • Antigens, Differentiation, Myelomonocytic / analysis
  • Biopsy
  • Corrosion
  • Dental Amalgam / adverse effects*
  • Dental Amalgam / chemistry
  • Diagnosis, Differential
  • Female
  • Foreign-Body Reaction / diagnosis
  • Foreign-Body Reaction / etiology
  • Foreign-Body Reaction / pathology
  • Gingiva / pathology*
  • Granuloma / chemically induced
  • Granuloma / diagnosis
  • Granuloma / pathology
  • HLA-DR alpha-Chains / analysis
  • Humans
  • Macrophages / physiology
  • Macrophages / ultrastructure
  • Male
  • Mast Cells / physiology
  • Mast Cells / ultrastructure
  • Melanosis / diagnosis
  • Metallothionein / analysis
  • Metals, Heavy / analysis
  • Microscopy, Polarization
  • Middle Aged
  • Mouth Mucosa / pathology*
  • Phagocytosis
  • Pigmentation Disorders / chemically induced*
  • Pigmentation Disorders / diagnosis
  • Pigmentation Disorders / pathology
  • Proto-Oncogene Proteins c-kit / analysis

Substances

  • Antigens, CD
  • Antigens, Differentiation, Myelomonocytic
  • CD68 antigen, human
  • HLA-DR alpha-Chains
  • Metals, Heavy
  • Dental Amalgam
  • Metallothionein
  • Proto-Oncogene Proteins c-kit