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PubMed1998

Phacomatosis pigmentovascularis type IIb associated with Sturge-Weber syndrome and pyogenic granuloma.

A case of phacomatosis pigmentovascularis (PPV) in a 6-year-old girl with Sturge-Weber syndrome, pyogenic granuloma, and other complications is described. It is relatively rare that a complete form of Sturge-Weber syndrome was associated with PPV. A review of the literature on PPV, focusing on total number of reported cases and etiological speculations, is presented. To our knowledge, a total of 118 cases of PPV, including the present one, have been reported to date. Regardless of many speculations, the true etiology remains unknown. The average "density" of mast cells (MCs) per mm2 appearing in the central region of the pyogenic granuloma was calculated to be 86.3/mm2 and that in the adjacent nevus flammeus was 37.9/mm2. The "density" of mast cells in pyogenic granuloma separately calculated from ten other cases was 105.5 +/- 28.6/mm2 (mean +/- SD), compared with that in normal skin, 6.85 +/- 4.9/mm2 (n = 20). There was a significant difference between the two, indicating that MCs are closely associated with angiogenesis in pyogenic granuloma.

Biopsy, Needle↗
PubMed1997

[Recurrent pyogenic granuloma or Warner and Wilson-Jones syndrome].

BACKGROUND: Recurrent pyogenic granuloma with multiple satellite lesions is a rare and benign condition; its diagnosis may be clinically evoked from a characteristic natural history. CASE REPORTS: Two 12 year-old boys developed multiple small cutaneous lesions following removal of pyogenic granuloma, at the periphery of the scar. A CO2 laser treatment was decided in one case, and therapeutic abstention in the other one. CONCLUSION: Our two cases completely fit with the classical features of such a condition that generally clears spontaneously. This syndrome must be known because of its "pseudo-metastatic" clinical features, which may mislead the physician.

Child↗
PubMed2004

The roles of vascular endothelial growth factor and angiopoietin-2 in the regression of pregnancy pyogenic granuloma.

OBJECTIVES: The molecular mechanism for the regression of pregnancy pyogenic granuloma after parturition remains unclear. It has been proposed that, in the absence of vascular endothelial growth factor (VEGF), angiopoietin-2 (Ang-2) causes blood vessels to regress. Therefore, we investigated the roles of Ang-2 and VEGF in the regression of pregnancy pyogenic granuloma. MATERIALS AND METHODS: The effects of tumor necrosis factor-alpha (TNF-alpha) on the transcription of Ang-2 were tested in endothelial cells by reverse transcriptase-polymerase chain reaction. A total of 15 specimens, including granulomas taken from five gravidas during pregnancy, five after parturition, and five from normal gingiva were compared by immunoblot assays for their relative expressions of Ang-1, Ang-2, Tie-2, VEGF, and beta-actin. Double staining, immunohistochemistry for Ang-2, and terminal deoxynucleotidyl transferase-mediated dUTP nick-end-labeling for apoptotic cells, were used to evaluate their regression. Finally, a fibrin gel culture system was used to investigate whether the withdrawal of VEGF and addition of Ang-2 could cause newly grown microvessels to regress. RESULTS: TNF-alpha upregulated the expression of Ang-2 in all endothelial cell types tested. The protein levels of Ang-2 and Tie-2 were highest in the granulomas in pregnancy, followed by those after parturition and normal gingiva, while Ang-1 and beta-actin exhibited no significant differences. The amount of VEGF was high in the granulomas in pregnancy and almost undetectable after parturition. Double staining on granulomas after parturition revealed more apoptotic cells and less Ang-2 than did those in pregnancy. In the fibrin gel assay, VEGF alone or in combination with Ang-2 could protect microvessels from apoptosis, while Ang-2 alone had no effect. CONCLUSIONS: Our findings suggest that a lack of VEGF is associated with apoptosis of endothelial cells and regression of granuloma. The roles of Ang-2 require additional study.

Actins↗
PubMed1993

Recurrent pyogenic granulomas: a form of lobular capillary hemangioma.

Two cases of pyogenic granuloma recurred despite what was originally thought to be a sufficient surgical excision. The granulomas presented clinically as polypoid structures, one on the finger and one on the chin. On histologic examination, all showed polypoid configuration with lobules of small vessels and endothelial cell proliferation. The recurrent lesions also showed similar lobules, but interspersed between the collagen bundles in the deeper dermis. Vascular tumors such as the lobular pyogenic granulomas, intravenous capillary hemangiomas, and acquired tufted angiomas were compared to our tumors.

Chin↗
PubMed1996

The late development of oral pyogenic granuloma as a complication of pregnancy: a case report.

An oral pyogenic granuloma can develop during or just after the first trimester of pregnancy. Usually, an oral pyogenic granuloma is an early, slow-growing mass that, on excision, does not leave a large defect in the periodontium that requires surgical repair. This article presents an unusual case of a very late, rapidly growing, large tumor that developed as a complication of pregnancy and an undiagnosed isolated area of periodontal disease.

Adult↗
PubMed1983

Pyogenic granuloma (lobular capillary hemangioma) within port-wine stains.

We observed two patients who developed pyogenic granulomas within port-wine stains. One had a single lesion without recurrence, whereas the second had multiple lesions that developed during a 6-year period. It has been postulated that arteriovenous anastomoses are associated with the pathogenesis of pyogenic granuloma. Formation of pyogenic granuloma within a port-wine stain, a lesion often associated with arteriovenous anastomoses, provides further support for this idea.

Adult↗
PubMed2005

Assessment of angiogenic markers in oral hemangiomas and pyogenic granulomas.

The purpose of this research was to evaluate the immunohistochemical expression of the vascular endothelial growth factor (VEGF-C1) and measuring the angiogenic activity by the staining for von Willebrand factor (vWF) and CD31 in oral pyogenic granulomas and hemangiomas. The results showed that there was no statistically significant difference in the angiogenesis index between the lesions evaluated. The average microvessel density determined for MVC (microvessel count) using CD31 was 60.64 for hemangiomas and 59.64 for pyogenic granulomas, while angiogenic index determined using vWF was 64.24 and 62.20 in these lesions. The results showed that the cells highlighted by staining for vWF were more uniform than in those stained for CD31. There was no statistically significant difference between the lesions for the number of cells highlighted by staining for VEGF-C1. However, the mean number of cells highlighted in pyogenic granuloma specimens was higher (153.23) when compared to oral hemangioma specimens (115.17). The VEGF-positive cells were endothelial cells and fibroblasts in hemangiomas and macrophages and fibroblasts in pyogenic granulomas. These results effort the role of the angiogenic factors in the etiopathogenesis of the hemangiomas and pyogenic granulomas, however, it showed that microvessel quantification is not useful in the differential diagnosis of these lesions.

Biomarkers↗
PubMed2005

Pyogenic granuloma of the stomach successfully treated by endoscopic resection after transarterial embolization of the feeding artery.

Pyogenic granulomas represent the aquisition of vasodilative granulation tissue in the skin or mucosa. They are extremely rare in the alimentary tract, other than in the oral cavity. Here, we report a case of pyogenic granuloma arising from the gastric mucosa. An 82-year-old man was admitted to our hospital because of melena of more than 3 months, duration. Esophagogastroduodenoscopy (EGD) revealed a 30-mm-diameter semipedunculated lesion with an irregular surface in the fundus of the stomach. During hospitalization, the patient's anemia worsened due to loss of blood from the lesion, with the level of hemoglobin declining to 6 g/dl, and a blood transfusion was required. Because radiological and endoscopic findings indicated the lesion was hypervascular, transarterial embolization of the nutritional artery of the lesion was performed before endoscopic resection of the lesion. One week after the embolotherapy, endoscopic mucosal resection was performed, without any complications, such as massive bleeding. Histological studies of the resected specimen revealed many capillaries of various sizes, lined with plump endothelial cells, and accompanied by acute and chronic inflammatory infiltrates. On the basis of these observations, the lesion was diagnosed as a pyogenic granuloma. One year later, the patient was asymptomatic and there was no evidence of tumor recurrence on follow-up EGD.

Aged↗
PubMed1977

Recurrent multiple pyogenic granuloma with multiple satellites. Features of Masson's hemangioma.

The case of a thirteen year old white girl who had multiple recurrences of pyogenic granuloma arranged in a satellite fashion is presented. The incidence and frequency of pyogenic granuloma with or without recurrences is discussed, stressing the unusual nature of the present problem. In addition to the microscopic features of pyogenic granuloma, the changes seen in Masson's hemangioma were demonstrable in some of the sections. The microscopic distinguishing feature of Masson's hemangioma is discussed, with emphasis on the importance of recognizing this as a benign structure rather than a malignant one. Opinions concerning the etiology of pyogenic granuloma as well as the reasons for the development of multiple satellites are presented, along with suggestions for therapy.

Adolescent↗
PubMed1992

Pyogenic granulomas of the lacrimal sac.

Eight cases of pyogenic granulomas of the lacrimal sac are reported. The clinical symptoms were consistent with chronic dacryocystitis which was unresponsive to previous probing and antibiotics. Extirpation of the sacs was done because of dacryocystocoele, pyocoele, or fistula formation through the skin. Trauma and inflammation were thought to have contributed to the growth of the pyogenic granulomas. The histopathological examination revealed nonspecific granulomas consisting of well vascularised, friable tissue of a myxomatous nature containing an infiltration of lymphocytes, plasma cells, and a few eosinophils. Over the granulomas an epithelial layer of cells is stretched showing no signs of dysplasia or neoplastic growth. The term 'lobular capillary hemangioma' has been suggested to describe lesions morphologically similar to those observed in the study. These masses made up 53.3% of a total of 15 lacrimal sac tumour biopsy specimens examined over a period of 10 years (1979-1989). The few reported cases of primary lacrimal sac tumour of non-epithelial origin suggest that they make up a large minority of the lacrimal sac tumours. A review shows that relatively few of these lesions have been described in recent English literature but these growths are probably not being as consistently reported as primary epithelial tumours.

Adult↗
PubMed2000

Expression of Tie-2, angiopoietin-1, angiopoietin-2, ephrinB2 and EphB4 in pyogenic granuloma of human gingiva implicates their roles in inflammatory angiogenesis.

Tie-2, angiopoietin-1 (Ang-1), angiopoietin-2 (Ang-2), ephrin-B2 and Eph-B4 are all important vascular morphogenesis factors which exhibit their functions in angiogenesis and blood vessel remodeling in embryonic stage. However, their roles in post-natal inflammatory angiogenesis are still unclear. Pyogenic granuloma is a benign inflammatory lesion that mostly occurs on the gingiva of females with high levels of steroid hormones. Prominent capillary growth in hyperplastic granulation tissue is characteristic histopathologically in pyogenic granuloma. The purpose of this study was to detect and compare the expressions of Tie-2, Ang-1, Ang-2, ephrin-B2 and Eph-B4 among pyogenic granuloma on human gingiva, gingiva diagnosed with periodontitis and healthy gingiva by immunohistochemistry. The immunostaining revealed that all of the endothelial cells and some mesenchymal cells expressed Tie-2. The cells which expressed Ang-1 and Ang-2 were mainly macrophage- or monocyte-like mesenchymal cells and smooth muscle cells surrounding blood vessels. The expression of ephrin-B2 and Eph-B4 was not exclusively limited to the endothelial cells of arteries and veins, respectively, as in mice embryo. Eph-B4 was expressed in the endothelial cells of newly budding capillaries and venules while ephrin-B2 was expressed in macrophage-like mesenchymal cells. Some of the ephrin-B2 positive cells were in direct contact with endothelial cells. The statistical analysis demonstrated that all of the five factors were upregulated in pyogenic granuloma compared to healthy gingiva. In conclusion, the 5 polypeptides mentioned above may play important roles in the process of adult inflammatory neovascularization, especially in pyogenic granuloma. It is highly plausible that most of the new capillaries in inflammatory angiogenesis originated from venules instead of arterioles.

Adult↗
PubMed2006

[Lobular capillary hemangioma on the floor of the mouth (pyogenic granuloma). Report of a case and literature review].

Lobular capillary hemangioma or pyogenic granuloma is a benign lesion with a focal reactive development of fibrovascular tissue and endotelial proliferation. It can appear to any age in different locations and usually has the aspect of a pediculate mass with or without ulceration zones on the area. Its treatment is the simple surgical removal and the control of the traumatic and infectious influential factors. We report a case of pyogenic granuloma on the floor of the mouth making a literature review at respect of that common clinical entity.

Aged, 80 and over↗
PubMed1991

Pyogenic granuloma following treatment of verruca vulgaris with cryotherapy and Duoplant.

We report an unusual case of pyogenic granuloma that appeared after the application of liquid nitrogen and 27 percent salicylic acid (Duoplant, Stiefel Inc.) to a verruca vulgaris. Only two cases of pyogenic granuloma following cryotherapy appear in the literature and pyogenic granuloma as a complication of salicylic acid application has not been documented.

Cryosurgery↗
PubMed1979

Pyogenic granuloma recurrent with satellite lesions.

Pyogenic granuloma recurrent with satellite lesions is an uncommon clinical entity. The condition occurs most often on the back of young individuals and runs a benign course. A case is presented and the literature is reviewed.

Adult↗