Pyogenic Granuloma Histological — ORE Part 1 MCQ

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ModerateOral PathologyPyogenic Granuloma HistologicalORE Part 1

A patient has a 12 mm dark-red, pedunculated swelling arising from the interdental papilla between the maxillary central incisors. It bleeds on gentle probing. Biopsy shows ulcerated surface epithelium overlying oedematous granulation tissue containing numerous thin-walled capillaries arranged in lobules. What is the most likely histopathological diagnosis?

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Correct answer: B — Pyogenic granuloma

Explanation lettering: E = shown as A · A = shown as B · B = shown as E

A is correct. Oral pyogenic granuloma is a reactive vascular lesion, often arising on gingiva as a red, pedunculated mass that bleeds readily. Its key histological pattern is granulation tissue with numerous thin-walled capillaries, characteristically arranged in lobules, with oedema, inflammation and frequent surface ulceration. Peripheral giant cell granuloma instead contains numerous multinucleated giant cells in a haemorrhagic stroma. Peripheral ossifying fibroma is a fibrous proliferation with calcified material. Kaposi sarcoma shows spindle-cell proliferation and irregular slit-like vascular spaces. Capillary haemangioma is vascular but does not best account for the ulcerated reactive gingival lesion with the characteristic lobular granulation-tissue architecture described.

Reference: Epivatianos A, Antoniades D, Zaraboukas T, et al. Pyogenic granuloma of the oral cavity: comparative study of its clinicopathological and immunohistochemical features. Pathology International. 2005. https://pubmed.ncbi.nlm.nih.gov/15982213/