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LETTER TO EDITOR |
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Year : 2016 | Volume
: 20
| Issue : 1 | Page : 5 |
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Capillary hemangioma or pyogenic granuloma
Shilpa Trivedi
Department of Periodontology, FODS, King George's Medical University, Lucknow, Uttar Pradesh, India
Date of Web Publication | 25-Feb-2016 |
Correspondence Address: Shilpa Trivedi Department of Periodontology, FODS, King George's Medical University, Lucknow, Uttar Pradesh India
 Source of Support: None, Conflict of Interest: None  | Check |
DOI: 10.4103/0972-124X.177427
How to cite this article: Trivedi S. Capillary hemangioma or pyogenic granuloma. J Indian Soc Periodontol 2016;20:5 |
Sir,
I write to you in regards to a case report “extragingival pyogenic granuloma histologically mimicking capillary hemangioma.” Authored by Dahiya and Kathuria [1] published in September–October 2014 issue of your reputed Journal. The authors have described the cases excellently, but I have a slight disagreement.
Pyogenic granuloma (PG) is a nonneoplastic tumor of the oral cavity, which shows a predilection for the gingiva. The term PG is now considered a misnomer, as it is not caused by pyogenic organisms and it is not a true granuloma as well.[2]
Histopathologically, PG shows a highly vascular proliferation resembling granulation tissue. Numerous small and large endothelium lined blood vessels engorged by red blood cells are often seen. The channels are often organized in a lobular arrangement thus deriving the term “lobular capillary hemangioma (LCH).” Some pathologists consider PG as a polypoid form of capillary hemangioma or an inflamed lobular hemangioma while others consider it as granulation – tissue type hemangioma.[3]
Two histologic variants of PG have been described: LCH and nonlobular capillary hemangioma (non-LCH). The first type has proliferating blood vessels arranged in lobular aggregates although there may not be any edema, capillary dilation or granulation tissue proliferation. The non-LCH has a highly vascular proliferation resembling granulation tissue.[2],[3],[4] Varying degrees of inflammatory cells infiltrate are seen in both types of PG.
Considering the above facts in mind, it seems that capillary hemangioma may be the histopathologic diagnosis of a case clinically presenting as PG and they may not be two different entities.
References | |  |
1. | Dahiya R, Kathuria A. Extragingival pyogenic granuloma histologically mimicking capillary hemangioma. J Indian Soc Periodontol 2014;18:641-3.  [ PUBMED] |
2. | Neville BM, Damm DD, Allen CM, Bouquot JE. Oral and Maxillofacial Pathology. 2 nd ed. Philadelphia: WB Saunders; 2002. p. 447-9. |
3. | Bouquot JE, Nilai H. Lesions of the oral cavity. In: Gnepp DR, editor. Diagnostic Surgical Pathology of the Head and Neck. Philadelphia: WB Saunders; 2001. p. 141-233. |
4. | Thompson LD. Lobular capillary hemangioma (pyogenic granuloma). In: Head and Neck Pathology: Foundations in Diagnostic Pathology. 2 nd ed. Philadelphia: WB Saunders; 2012. |
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