Traumatic ulcerative granuloma with stromal eosinophilia of the palate showing an angiocentric/angiodestructive growth pattern

Abstract

Traumatic ulcerative granuloma with stromal eosinophilia (TUGSE) is a benign, self-limiting lesion of the oral mucosa with unknown pathogenesis. A 65-year-old male patient presented with an ulcerative palate lesion, which on microscopic examination exhibited an exuberant polymorphic lymphoid proliferation, numerous eosinophils, and extensive vascular destruction. The atypical lymphoid cells infiltrating the medium-sized vessels showed positivity for CD3, CD30, and granzyme B, implicating an activated cytotoxic T-cell phenotype. The lesion diagnosed as TUGSE achieved complete resolution within 3 months. This unusual presentation has expanded the spectrum of oral CD30+ T-cell atypical infiltrates and must be distinguished from lymphomas showing angiocentric/angiodestructive growth pattern.

Keywords

• Angiocentric growth pattern
• Eosinophilic ulcer
• Immunohistochemistry
• Malignant lymphoma
• Traumatic ulcerative granuloma with stromal eosinophilia