Unusual Presentation of Vegetable Cell Granuloma: A Case Report
Manjunath M Sirsalmath
Department of Oral & Maxillofacial Pathology and Microbiology, Vananchal Dental College and Hospital, Farathiya, Garhwa, Jharkhand, India.
Tarique Mahmood *
Department of Oral & Maxillofacial Pathology and Microbiology, Vananchal Dental College and Hospital, Farathiya, Garhwa, Jharkhand, India.
Shilpa Hosallimath
Department of Oral & Maxillofacial Pathology and Microbiology, Vananchal Dental College and Hospital, Farathiya, Garhwa, Jharkhand, India.
Santosh Kumar
Department of Oral & Maxillofacial Pathology and Microbiology, Vananchal Dental College and Hospital, Farathiya, Garhwa, Jharkhand, India.
Shipra Bharti
Department of Oral and Maxillofacial Surgery, Vananchal Dental College and Hospital, Farathiya, Garhwa, Jharkhand, India.
Cherian Koshy
Department of Oral and Maxillofacial Surgery, Vananchal Dental College and Hospital, Farathiya, Garhwa, Jharkhand, India.
*Author to whom correspondence should be addressed.
Abstract
Vegetable cell granuloma is a rare granulomatous foreign-body reaction caused by the impaction of vegetative or plant material within oral tissues, particularly in periapical and sulcular areas. It is also described as pulse granuloma, chronic mandibular periostitis, hyaline ring granuloma and giant cell hyaline angiopathy. Because its clinical appearance may resemble other oral lesions, microscopic examination is important for establishing the diagnosis. This case report describes a 32-year-old female who presented with pain and gradually increasing swelling in the right mandibular region. Oral examination showed poor oral hygiene and a non-healing socket associated with the right mandibular first molar. The socket was curetted, and the tissue was submitted for histopathological evaluation. Microscopic examination demonstrated stratified squamous epithelium and a concentric, lamellated, amorphous eosinophilic structure surrounded by a fibrovascular connective tissue capsule, supporting a diagnosis of vegetable cell granuloma. Recognition of the characteristic histopathological appearance is important because the lesion may clinically mimic conditions such as tuberculosis, deep fungal infection or malignancy. Complete excision of the lesion, together with maintenance of good oral hygiene, is the treatment described in the manuscript. This case emphasises the value of careful histopathological assessment for identifying this uncommon foreign-body reaction in routine oral pathology practice.
Keywords: Vegetable cell granuloma, pulse granuloma, hyaline ring granuloma, foreign-body reaction, plant material, oral pathology, histopathology, mandibular lesion, extraction socket, granulomatous inflammation