Pyogenic Granuloma (Lobular Capillary Hemangioma)

Epidemiology:

• Children or young adults often
• Related to trauma often

Common sites:

• Hands
• Fingers
• Face
• Lips
• Gums
• Gingiva (epulis of pregnancy) is a special subgroup

Gross features:

• polypoid, exophytic red nodule attached by a stalk to the skin or oral mucosa
• often ulcerated
• up to 1-2 cm usually

Histologic features:

• resemble exuberant granulation tissue
• often ulcerated
• edema
• acute and chronic inflammatory infiltrates
• mitotic activity varies and can be prominent
• KS / angiosarcoma (DDx):
• spindle cells woven between delicate vascular spaces not seen in PG
• nuclear atypia slight / mild in PG

Immunophenotype:

Marker:

Sensitivity:

Specificity:

Molecular features:

Other features:

• rapidly growing for a few weeks before stabilizing
• may persist indefinitely unless destroyed
• recurrence after surgery or cautery is not rare
• friable
• 1/3 develop after trauma
• granuloma gravidarum occurs in the gingival of 1% of pregnant women, regresses after delivery

References:

• Robbins 2005
• Elder DE (ed.) Lever’s Histopathology of the Skin, 10^th ed. (2009)