Traumatic Ulcerative Granuloma With Stromal Eosinophilia: Clinico-Pathologic and Molecular Analysis

This study aimed to retrospectively analyze the prevalence and clinical characteristics of TUGSE and explore the potential role of viral agents in these lesions.

Fifty-seven TUGSE and 50 non-specific ulcer patients were included. Patient demographic and clinical data were collected. Formalin-fixed paraffin-embedded tissues were screened by PCR for Epstein-Barr virus (EBV), cytomegalovirus (hCMV), human papillomavirus (HPV), herpes simplex virus (HSV), and Helicobacter pylori (H. pylori).

The majority of TUGSE patients were in their sixth (29.8%) and seventh (24.6%) decades of life, with a 1:1.6 male-to-female ratio. The tongue is the most common site (47.4%), followed by buccal mucosa (28.1%). The average duration was 13.5 weeks, and almost one-fourth of the lesions were clinically diagnosed as oral squamous cell carcinoma (24.6%). TUGSE showed a significantly higher propensity to harbor macrophage infiltrates and inflammatory involvement with skeletal muscle fibers or salivary gland tissues, compared to non-specific ulcers. EBV was observed in two TUGSE cases (3.5%) and one patient with a non-specific ulcer (2.0%). Other viral agents were undetectable in TUGSE.

TUGSE frequently affects the elderly population with a female predilection. The observed low prevalence of viral agents suggests that these pathogens may not play a direct role in TUGSE development.