Diagnóstico diferencial entre fibroma oral e hiperplasia fibrosa inflamatória: uma proposta para critério histopatológico

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

doi:10.22456/2177-0018.50379

Authors

Cristiano Macabu Badauy Faculdade de Odontologia da Universidade Federal do Rio Grande do Sul/ Doutor em Odontologia
Vinícius Coelho Carrard Faculdade de Odontologia da Universidade Federal do Rio Grande do Sul/Doutor em Odontologia e Professor Adjunto
Thaíse Gomes e Nóbrega Faculdade de Odontologia da Universidade Federal do Rio Grande do Sul/ Doutoranda em Odontologia
Felipe Nör Faculdade de Odontologia da Universidade Federal do Rio Grande do Sul/ Doutorando em Odontologia
Márcia Gaiger de Oliveira Faculdade de Odontologia da Universidade Federal do Rio Grande do Sul/Doutora em Odontologia e Professora Adjunta
Manoel Sant'Ana Filho Faculdade de Odontologia da Universidade Federal do Rio Grande do Sul/Doutor em Estmatologia Clínica e Professor Associado

DOI:

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

Keywords:

Neoplasms, Human, Connective tissue, Confocal microscopy, Pathology

Abstract

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.