Histopathological study of peripheral and central giant cell granuloma in Tabriz Faculty of Dentistry (2004-2018)

Abstract

Introduction and objective: Jaws giant cell granuloma is a relatively common tumor lesion of the oral cavity. Giant cell granuloma in the bone is called central giant cell granuloma and those developing in the edentulous alveolar or gingiva are called peripheral giant cell granuloma. Baseline studies on identifying the histopathologic features of these lesions can help to predict the invasive or non-invasive clinical behavior and prognosis of these lesions that leads to making choice of more appropriate therapeutic approaches. The aim of this study was to evaluate the histopathologic features of peripheral and central giant cell granuloma lesions in patients referred to the Department of Oral pathology in Tabriz Faculty of Dentistry.

Methods: This retrospective descriptive-comparative study was performed using available samples of peripheral and central giant cell granuloma lesions in Oral Pathology Archives of Tabriz Faculty of Dentistry during 2004-2018. Information on patients’ records as well as hematoxillin-eosin stained slides were reviewed.

Results: In total 73 patients with giant cell granuloma lesions, 66 cases of peripheral giant cell granuloma and 7 cases of giant cell granuloma were reported. 45.45% of the lesions were located in the maxilla and 51.5% in the mandible. Also, 84.8% of peripheral lesions were observed in the gingiva. In the central lesions, 71.4% of lesions were in the mandible and in the posterior jaw. Mean age of peripheral lesions was 40.09 ± 16.03 and central lesions were 49.57± 16.18. In histopathologic examinations, the majority of the giant cells with less than 20 nuclei were reported in peripheral (100%) and central cases. Giant cells were small in size in the peripheral and central cases. Also, stromal cells were spindle in 85.7% of the central cases and 56.1% of the peripheral lesions. Hemorrhagic areas and blood vessels in peripheral and central lesions were 98.5% and 100%, respectively. In peripheral lesions, 19.7% of myxoid areas, 51.5% of stromal fibrosis and 14.3% and 57.1% of central lesions were reported respectively. Also osteoid in the center of the lesion was found in 45.4% of peripheral and 85.7% of central lesions. There was no significant correlation between the two types of central and peripheral giant cell granuloma in terms of histopathologic features. But in terms of osteoid formation, there was a significant difference between central and peripheral giant cell granuloma and itw as higher in central lesions (P = 0.015).

Conclusion: According to the present study, no significant differences were observed between peripheral and central giant cell granuloma lesions based on histopathologic criteria of lesion including stroma and giant cell granuloma characteristics. Future studies with more samples are suggested to identify the possible differences between these lesions .