Plasma cell gingivitis with severe alveolar bone loss

Abstract

Plasma cell gingivitis is a rare benign condition of the gingiva characterised by sharply demarcated erythaematous and oedematous gingiva often extending up to the muco gingival junction. It is considered a hypersensitive reaction. It presents clinically as a diffuse, erythaematous and papillary lesion of the gingiva, which frequently bleeds, with minimal trauma. This paper presents a case of a 42-year-old man who was diagnosed with plasma cell gingivitis, based on the presence of plasma cells in histological sections, and severe alveolar bone loss at the affected site, which was managed by surgical intervention.

Figure 1

Preoperative facial view.

Figure 2

Intraoral periapical radiograph showing severe alveolar bone loss in affected anterior areas.

Figure 3

Peroperative view.

Figure 4

After complete excision of the lesion.

Figure 5

(A) Histopathological examination at ×10 magnification revealing stratified, squamous, parakeratinised, hyperplastic epithelium overlying a densely infiltrated connective tissue. (B) Histopathological examination at ×60 magnification showing dense infiltrate of plasma cells that was arranged in the form of sheets.

Figure 6

(A) Immunohistochemical staining showing strong positivity for the κ light chain seen in the polyclonal plasma cell population. (B) Immunohistochemical staining showing weak immunohistochemical expression, noted for the λ light chain.

Figure 7

Six month postoperative follow-up.

Figure 8

Six month postoperative intraoral periapical radiograph.