Oral plasma cell granuloma-a diagnostic enigma

Plasma cell granuloma is a non neoplastic lesion classified and described under pseudoinflammatory tumor category. Frequently these lesions are found in lungs and rather uncommonly seen in the oral cavity, making diagnosis and treatment actually complicated. They can arise in areas such as brain, orbit, paranasal sinuses, head, neck, larynx, tonsils, ears, liver, kidney, stomach and heart. Intraoral plasma cell granulomas are seen involving tongue, lip, oral mucosa and gingiva. Its etiology, biological behavior, ideal treatment and prognosis are still unclear and rather controversial. Both clinically and histopathologically, it may be misinterpreted as various pathological entities thus necessitating the complete evaluation of patient and proper histopathological and immunohistochemical analysis of the tissue to rule out other lesions with poor prognosis. This case presents a 35 year old female with an enlargement in the right buccal mucosa masquerading as carcinoma and the histological evaluation revealed plasma cell infiltrates in the connective tissue. The immunohistochemistry revealed kappa and lambda light chains with a polyclonal staining pattern, which confirmed the diagnosis of plasma cell granuloma.