Gingival juvenile xanthogranuloma in an adult patient: case report with immunohistochemical analysis and literature review

Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2009 Feb;107(2):246-52. doi: 10.1016/j.tripleo.2008.09.032.

Abstract

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.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Antigens, CD / analysis
  • Antigens, Differentiation, Myelomonocytic / analysis
  • Carrier Proteins / analysis
  • Diagnosis, Differential
  • Factor XIIIa / analysis
  • Gingival Diseases / metabolism*
  • Gingival Diseases / pathology
  • Histiocytosis, Langerhans-Cell / diagnosis
  • Humans
  • Immunohistochemistry
  • Male
  • Mandible
  • Microfilament Proteins / analysis
  • Middle Aged
  • Xanthogranuloma, Juvenile / metabolism*
  • Xanthogranuloma, Juvenile / pathology
  • alpha 1-Antitrypsin / analysis

Substances

  • Antigens, CD
  • Antigens, Differentiation, Myelomonocytic
  • CD68 antigen, human
  • Carrier Proteins
  • Microfilament Proteins
  • alpha 1-Antitrypsin
  • fascin
  • Factor XIIIa