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Published on: August 6, 2019
Lymphangioma mimicking apical periodontitis
Cleomar Donizeth Rodrigues1, Máximo Joaquim Calvo Villar-Neto, Ana Paula Veras Sobral
1Department of Health Sciences, Federal University of Goiás, Goiânia, GO, Brazil. cleomarrodrigues@hotmail.com
Journal of Endodontics
|December 15, 2010
Summary
Lymphangioma, a rare soft tissue tumor, can mimic apical periodontitis in older patients, presenting as a bone lesion. Histopathologic examination is crucial for accurate diagnosis and treatment of this non-endodontic pathology.
Area of Science:
- Oral pathology
- Radiology
- Vascular tumors
Background:
- Lymphangiomas are typically found in young children's soft tissues.
- Their occurrence in elderly patients, especially within bone, is exceptionally rare.
- This case highlights a lymphangioma mimicking apical periodontitis in an 81-year-old woman.
Observation:
- A panoramic radiograph revealed a multilocular radiolucent lesion in the mandibular molar region.
- Cone beam computed tomography (CBCT) and magnetic resonance imaging (MRI) confirmed a well-circumscribed lesion within the mandibular bone.
- The lesion was located below the roots of endodontically treated teeth #17 and #18.
Findings:
- Microscopic examination showed vascular endothelium proliferation with eosinophilic material resembling lymph.
- Histopathology confirmed the diagnosis of lymphangioma.
- The lesion was confined to the mandibular bone, with no soft tissue involvement.
Implications:
- Lymphangioma should be considered in the differential diagnosis of apical periodontitis, particularly in atypical presentations.
- Advanced imaging techniques like CBCT and MRI are valuable for characterizing such lesions.
- Histopathologic examination is essential for definitive diagnosis and appropriate management of non-endodontic pathologies in the jawbone.