Traumatic Ulcerative Granuloma with Stromal Eosinophilia: CD30 analysis and clonality for T cell receptor gene re-arrangement

• Published in: Acta histochemica 2019-11, Vol.121 (8), p.151450-151450, Article 151450
• Main Authors: Aizic, A., Raiser, V., Solar, I., Aharon, Z., Shlomi, B., Kaplan, I.
• Format: Article
• Language: English
• Subjects: Aged; Aged, 80 and over; CD30; Child; Clonality; Eosinophilia; Eosinophilia - genetics; Eosinophilia - metabolism; Eosinophilia - pathology; Female; Follow-Up Studies; Gene Rearrangement, T-Lymphocyte; Granuloma - genetics; Granuloma - metabolism; Granuloma - pathology; Humans; Ki-1 Antigen - genetics; Ki-1 Antigen - metabolism; Lymphomatoid Granulomatosis - genetics; Lymphomatoid Granulomatosis - metabolism; Lymphomatoid Granulomatosis - pathology; Male; Middle Aged; Mouth Neoplasms - genetics; Mouth Neoplasms - metabolism; Mouth Neoplasms - pathology; Neoplasm Proteins - genetics; Neoplasm Proteins - metabolism; Oral Ulcer - genetics; Oral Ulcer - metabolism; Oral Ulcer - pathology; Retrospective Studies; Ulcerative granuloma; Wounds and Injuries - genetics; Wounds and Injuries - metabolism; Wounds and Injuries - pathology
• ISSN: 0065-1281; 1618-0372
• DOI: 10.1016/j.acthis.2019.151450

Traumatic Ulcerative Granuloma with Stromal Eosinophilia (TUGSE) is a rare oral ulcerated lesion of uncertain etiology, showing eosinophil-rich granulation tissue, with occasional large atypical CD30 positive mononuclear cells. It had been suggested that it may represent an oral counterpart of cutaneous lymphomatoid papulosis, with a potential to evolve into CD30 + T cell lymphoma To compare TUGSE and non-specific oral ulcers (NSU) clinically, histopathologically and by clonality analysis for T-cell receptor re-arrangement, aiming to determine whether TGUSE with atypical cells is a lymphomatous premalignant condition, and whether therapeutic approach should be radical or conservative. Retrospective archival analysis included 17 TUGSE and 8 NSU cases. Histopathological parameters included mean eosinophil number per high power field (HPF), presence of infiltration of deep soft tissues and presence of atypical cells. Immuno-morphometry comprised of the mean number of CD30+ atypical cells per HPF. T-cell receptor (TCR) gene rearrangement by polymerase chain reaction (PCR) was performed in all cases showing atypical cells. Clinical and follow up data were retrieved from files. TUGSE showed a significantly higher mean eosinophil number/HPF in comparison to NSU (7.0 + 4.2 cells and 2.3 + 1.72, respectively; p