Page 52 - AAOMP Meeting 2019

POSTER ABSTRACTS - TUESDAY, JUNE 11, 2019

#55 ANGIOLYMPHOID HYPERPLASIA WITH EOSINOPHILIA IN THE UPPER LIP: A CASE
REPORT WITH
IMMUNOHISTOCHEMICAL ANALYSIS
Prof. Eneida Vencio (Federal University of Goias), Dr. Mario Ferreira (Federal University of Goias),
Ms. Stephany Carvalho (Federal University of Goias), Prof. Maria Silva (Federal University of
Goias)
Angiolymphoid hyperplasia with eosinophilia (ALHE) is a cutaneous tumor uncommon in the oral region. Its
etiopathogenesis remains unknown although some studies suggest abnormal vascular proliferation with
secondary inflammatory response. Clinically, it appears as a red-brown subcutaneous swelling mostly in
patients aged 20–50 years in Asian and Caucasian populations. Here a 52-year-old man was referred for
treatment of a painless mass on the lip. Clinical examination showed a slow-growing, nontender, mobile,
well-defined nodule, located in the upper lip and measuring 1 cm in diameter. Microscopically, the excised
lesion showed proliferation of small blood vessels surrounded by eosinophils, lymphocytes, and plasma cells.
Negative immunostaining for CD1a and absence of lymphoid follicular structures discarded Langerhans cell
histiocytosis and Kimura’s disease, respectively. No recurrence was noted in 1-year follow-up. Here, we
present a case of ALHE in the upper lip and a review of 22 cases of ALHE in the oral cavity.

#56 ORAL MANIFESTATIONS OF LEUKEMIA: A RETROSPECTIVE CASE SERIES.
Ms. Patricia Barros (University of Florida College of Dentistry), Dr. Sarah Fitzpatrick (University of
Florida College of Dentistry), Dr. Donald Cohen (University of Florida College of Dentistry), Dr.
Indraneel Bhattacharyya (University of Florida College of Dentistry), Dr. Nadim Islam (University of
Florida College of Dentistry)
Introduction: Oral manifestations of leukemia are rarely seen, often subtle and overlap with numerous
entities. The varied nature and general lack of familiarity of clinicians with oral presentations of leukemia
makes the diagnosis challenging. We present a case series of leukemias manifesting in the oral cavity.
Methods: Upon IRB approval, the University of Florida Oral Pathology Biopsy Service archives spanning
1994-2018 was queried for oral biopsies diagnosed as atypical hematological proliferation compatible with
leukemia. Cases with insufficient diagnostic information and/or extraoral manifestations were excluded.
Demographic, clinical, and histological findings were analyzed. Results: Ten cases with 12 biopsy sites
were included from 4 female and 6 male patients, mean age of
58.4 years (range 17-88). The most common biopsy sites were the gingiva (50%), palate, tongue, and buccal
mucosa. Fifty percent of the cases had no prior diagnosis of leukemia, and 50% of lesions were present
for unknown duration. Typical oral manifestations of leukemia included: spontaneous gingival
hemorrhage, with diffuse, boggy, non-tender enlargement, unusual ulcerations, petechial hemorrhage ,
diffuse candidiasis and generalized herpetic ulcers. In our case series, mass formation, white lesions with
erythema as well as non-healing extraction site were seen. The clinical impression of submitting clinicians
included gingival hyperplasia, pyogenic granuloma, granulation tissue, deep fungal infection, ANUG, and
leukemic infiltrate. Immunohistochemical stains including those for B and/or T cells, myeloperoxidase,
plasma cells and leukocyte common antigen marker were performed on some cases. Myeloperoxidase and
LCA yielded positive results in most cases whereas studies delineating B, or T- lymphocytes and plasma
cells yielded mostly negative results. Conclusions: This study documents the clinical and
immunohistochemical findings of leukemia in the oral cavity. Clinicians and pathologists should be aware of
these findings in order to ensure prompt, accurate diagnosis and likely save lives.