Plasma Cell Granuloma of Gingiva in Patient on Antihypertensive Therapy: A diagnostic Enigma

  • Ruchi Gulati Post-graduate student, Government College of Dentistry,Indore, Madhya Pradesh, India
  • Madhu Singh Ratre Reader, Department of Periodontology, Government College of Dentistry, Indore (M.P.)
  • Shaleen Khetarpal Lecturer, Department of Periodontology, Govt. College of Dentistry, Indore
  • Manish Varma Tutor, Department of Periodontology, Govt. College of Dentistry, Indore
Keywords: Amlodipine, diagnosis, gingival overgrowth, plasma cells, plasma cell granuloma, reactive lesions.

Abstract

The aim of present report is to discuss a unique case of gingival plasma cell granuloma in a hypertensive patient under Amlodipine. Also, we attempt to emphasize the importance of considering primary and advance investigations before making a definite diagnosis.

 Gingival Plasma cell granuloma (PCG) is extremely rare, reactive, non-neoplastic lesion characterized by predominance of polyclonal plasma cells. Drug induced gingival overgrowth is a known side effect of Amlodipine. A hypertensive 60 years old female patient reported with chief complaint of swollen gums and discomfort in upper front teeth region. A provisional diagnosis of Amlodipine induced GO, Combined gingival overgrowth, and Irritational fibroma was suggested. Surprisingly, histopathology revealed it to be a plasma cell lesion which was confirmed by advanced investigations thus, establishing a confirmatory diagnosis of plasma cell granuloma.

Author Biographies

Ruchi Gulati, Post-graduate student, Government College of Dentistry,Indore, Madhya Pradesh, India

Department of Periodontology,

Post-graduate student.

Madhu Singh Ratre, Reader, Department of Periodontology, Government College of Dentistry, Indore (M.P.)

Reader, Department of Periodontology,
Government College of Dentistry,
Indore (M.P.)

Shaleen Khetarpal, Lecturer, Department of Periodontology, Govt. College of Dentistry, Indore
Lecturer, Department of Periodontology, Govt. College of Dentistry, Indore
Manish Varma, Tutor, Department of Periodontology, Govt. College of Dentistry, Indore
Tutor, Department of Periodontology, Govt. College of Dentistry, Indore

References

Deen-Duggins L, Fly HR, Clay JR, Turner JR. Nifedipine-associated gingival overgrowth: A survey of the literature and report of four cases. Quintessence International. 1996 Mar 1;27(3): 163-170.

Ellis J, Seymour R, Thomason JM, Monkman S, Idle J. Gingival sequestration of amlodipine and amlodipine-induced gingival overgrowth. The Lancet. 1993 Apr 24;341(8852):1102-3.

Sucu M, Yuce M, Davutoglu V. Amlodipine-induced massive gingival hypertrophy. Canadian Family Physician. 2011 Apr 1;57(4):436-7.

Bhaskar SN, Levin MP, Frisch J. Plasma cell granuloma of periodontal tissues. Report of 45 cases. Periodontics. 1968 Dec;6(6):272-6.

Neville BW, Doliglas D, Carl M, Jerry E. Hematologic disorders, Oral and Maxillofacial Pathology. Philadelphia: Saunders, 2002:526–7.

Urschel JD, Horan TA, Unrach HW. Plasma cell granuloma of the lung. J Thorac Cardiovasc Surg. 1992 Oct1;104(4):870-5.

Levine PA, Toriumi DM, Sykes JM, Wolff AP, Goldschmidt RA. Plasma cell granuloma of the paranasal sinuses. Otolaryngology—Head and Neck Surgery. 1987 Jun;96(6):562-4.

Weilbaecher TG, Sarma DP. Plasma cell granuloma of tonsil. J SurgOncol. 1984 Dec;27(4):228-31.

Soares J, Maura Nunes JF, Sacadura J. Plasma cell granuloma of the tongue. Report of a case. HistolHistopathol. 1987Apr;2(2):199-201.

Ide F, Shimoyama T, Horie N. Plasma cell granuloma of the oral mucosa with angiokeratomatous features: A possible analogue of cutaneous angioplasmocellular hyperplasia. Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology and Endodontics. 2000 Feb 1;89(2):204-7.

Acevedo A, Buhler JE. Plasma-cell granuloma of the gingiva. Oral Surg Oral Med Oral Pathol. 1977 Feb;43(2):196-200.

Peacock ME, Hokett SD, Hellstein JW, Herold RW, Matzenbacher SA, Scales DK, Cuenin MF. Gingival plasma cell granuloma. Journal of periodontology. 2001 Sep 1;72(9):1287-90.

Karthikeyan BV, Pradeep AR. Plasma cell granuloma of gingiva. Indian J Dent Res. 2004 Jul-Sep;15(3):114-6.

Baltacioglu E, Akalin FA, Cobanoglu U, Sukuroglu E. Plasma cell granuloma in gingiva. Hacettepe Dişhekimliği Fakültesi Dergisi 2007;31:39-43.

Phadnaik MB, Attar N. Gingival plasma cell granuloma. Indian Journal of Dental Research. 2010 Jul 1;21(3):460-2.

Fang JC, Dym H. Myofibroblastic tumor of the oral cavity. A rare clinical entity. The New York state dental journal. 2004 Mar;70(3):28-30.

Kim SS, Eom D, Huh J, Sung IY, Choi I, Ryu SH, Suh PG, Chung SM. Plasma cell granuloma in cyclosporine-induced gingival overgrowth: a report of two cases with immunohistochemical positivity of interleukin-6 and phospholipase C-gamma1. Journal of Korean medical science. 2002 Oct;17(5):704-7.

Vishnudas B, Sameer Z, Shriram B, Rekha K. Amlodipine induced plasma cell granuloma of the gingiva: A novel case report. Journal of natural science, biology, and medicine. 2014 Jul; 5(2):472-6.

Arthur S. Inflammatory pseudotumor. In: Mills SE, Carter D, Greenson JK, Reuter VE, Stoler MH (ed). Sternberg's Diagnostic Surgical Pathology. Philadelphia: Lippincott Williams and Wilkins, 2010:1024–6.

Fletcher CD, Unni KK, Mertens F (ed). Pathology and genetics of tumours of soft tissue and bone. Lyon: Iarc press, 2002:91-3.

Published
2019-01-30
How to Cite
1.
Gulati R, Ratre M, Khetarpal S, Varma M. Plasma Cell Granuloma of Gingiva in Patient on Antihypertensive Therapy: A diagnostic Enigma. J Dent (Tehran).
Section
Case Report