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Pyogenic Granuloma — MFDS Part 1 MCQ

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ModerateOral PathologyPyogenic GranulomaMFDS Part 1

An excision biopsy from a gingival lesion clinically diagnosed as a pyogenic granuloma is examined. Which histopathological finding is most characteristic?

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Correct answer: C — A capillary-rich proliferation, often lobular, with inflammation and granulation-tissue change

Option C is correct. Oral pyogenic granuloma is a highly vascular lesion showing proliferation of capillary-sized vessels, often in a lobular arrangement, with variable inflammation, ulceration and granulation-tissue change. Lobular capillary haemangioma and non-lobular patterns are recognised. Despite its name, it is neither a suppurative infection nor a true histological granuloma. Caseating granulomas with Langhans-type giant cells suggest tuberculosis, while non-caseating granulomas occur in conditions such as orofacial granulomatosis, Crohn disease or sarcoidosis. An infiltrative proliferation of cytologically atypical endothelial cells would raise concern for a malignant vascular tumour such as angiosarcoma. Dense, poorly vascular collagen is more typical of a mature fibrous lesion and is not the characteristic appearance of pyogenic granuloma.

Reference: Ribeiro JL et al. Oral pyogenic granuloma: An 18-year retrospective clinicopathological and immunohistochemical study. Journal of Cutaneous Pathology. 2021;48(7):863–869. https://pubmed.ncbi.nlm.nih.gov/33486806/