Eosinophilic Ulcerative Granulomas in Oral Mucosa

Eosinophilic ulcerative granulomas of the oral mucosa, often encountered as traumatic ulcerative granuloma with stromal eosinophilia, are benign, chronic ulcerative lesions marked by a pronounced infiltration of eosinophils alongside lymphocytes and histiocytes. Clinically, they present as solitary, indurated ulcers with raised margins that can mimic malignant neoplasms, prompting diagnostic uncertainty. The lesions most commonly affect the tongue but may arise on the buccal mucosa, hard palate or retromolar areas. Their aetiology is thought to involve local trauma or irritation that triggers a locotypic immune response, leading to tissue breakdown and granuloma formation. Histopathology reveals a polymorphous inflammatory infiltrate extending into underlying muscle or salivary tissue, often accompanied by large atypical mononuclear cells. Although most lesions resolve spontaneously or after excisional biopsy, recurrences can occur, and thorough clinical evaluation is essential to exclude infectious, neoplastic or autoimmune causes. Management typically centres on biopsy for definitive diagnosis, followed by conservative surgical removal when necessary, with routine follow-up to monitor healing.

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Eosinophilic Ulcerative Granulomas in Oral Mucosa publication trend

The graph below shows the total number of articles in eosinophilic ulcerative granulomas in oral mucosa across all publications each year (not limited to Nature Index journals).

Technical terms

Eosinophil: A white blood cell involved in allergic reactions and defence against parasites, often abundant in these lesions.

Granuloma: A localised aggregation of immune cells formed to isolate persistent irritants or pathogens.

Stromal Eosinophilia: The presence of eosinophils within the supportive connective tissue of a lesion.

CD30: A cell surface protein used in immunohistochemistry to identify certain lymphoid cell populations.

T-cell Clonality: The expansion of genetically identical T cells, indicating a focused immune response rather than a reactive polyclonal process.

References

1. Traumatic ulcerative granuloma with stromal eosinophilia — clinical case report, literature review, and differential diagnosis. World Journal of Surgical Oncology (2019).
2. A Case Report of Traumatic Ulcerative Granuloma With Stromal Eosinophilia (TUGSE): Clinical and Histopathological Diagnostic Challenges. Cureus (2023).
3. Traumatic ulcerative granuloma with stromal eosinophilia: a series of four cases with review of literature. Journal of Pathology of Nepal (2020).
4. Self-healing CD30- T-clonal proliferation of the tongue: report of an extremely rare case. BMC Oral Health (2019).