Differential diagnosis between oral fibroma and inflammatory hyperplasia: a proposal for histopathological criteria

Cristiano Macabu Badauy, Vinícius Coelho Carrard, Thaíse Gomes e Nóbrega, Felipe Nör, Márcia Gaiger de Oliveira, Manoel Sant'Ana Filho


Oral Fibroma and Inflammatory Hyperplasia display similarities in their clinical and histopathological appearance. The present study proposed histopathological criteria for the differential diagnosis between those pathological entities. Histological sections of lesions histopathologically diagnosed as Oral Fibroma (n=61) and Inflammatory Hyperplasia (n=75) and were submitted to different techniques (Hematoxylin-Eosin; Masson Trichrome and Phosphomolybdic acid - Picrosirius red) to allow quantitative and qualitative analysis. The qualitative analysis of collagen density was based on sections stained by Hematoxylin-Eosin and focused in the center and periphery of each lesion. Wound and collagen fibers were more frequent and higher in Oral Fibroma, while parallel fibers were more frequent in Inflammatory Hyperplasia (Fisher’s exact test, p<0.05). The percentage of parallel collagen fibers beneath the epithelium was 72.22% and 92.3% in Oral Fibroma and Inflammatory Hyperplasia, respectively (Mann Whitney U test, p<0.05). The parallel collagen fibers in the center of the lesion was found in 84.6% of Inflammatory Hyperplasia cases and was absent in 88.88% of Oral Fibroma. The central portion of Oral Fibroma had characteristically a dense and wound arrangement of collagen fibers. It may be concluded that Oral Fibroma and Inflammatory Hyperplasia have distinctive features that may be useful in routine histopathological analysis, supporting the differential diagnosis.


Neoplasms; Human; Connective tissue; Confocal microscopy; Pathology

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DOI: https://doi.org/10.22456/2177-0018.50379

Licença Creative Commons

e-ISSN 2177-0018 / ISSN 0566-1854.

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