Gingival Lesions

What lesion is a painless, red-purple gingival mass that bleeds easily and contains multinucleated giant cells?

Peripheral giant cell granuloma (PGCG)

Which virus causes oral hairy leukoplakia and may involve gingiva in immunosuppressed patients?

Epstein-Barr Virus (EBV)

What test confirms pemphigoid as a cause of desquamative gingivitis?

Direct immunofluorescence (DIF)

Which gingival lesion is associated with phenytoin use and appears as firm, fibrous overgrowth?

Drug-induced gingival hyperplasia

Histology shows suprabasal clefting with acantholysis and positive intercellular IgG — what’s the diagnosis?

Pemphigus vulgaris

A 7-year-old presents with bright red, velvety overgrowth of the anterior maxillary gingiva. No ulceration. No systemic signs.
Q: Most likely diagnosis?

Juvenile spongiotic gingival hyperplasia

45-year-old HIV+ patient presents with white, corrugated lesion on lateral tongue and adjacent gingiva. Doesn’t scrape off.
Q: What virus is implicated? What’s the diagnosis?

EBV — Oral hairy leukoplakia

A 50-year-old man presents with a firm, ulcerated lesion on the mandibular gingiva that hasn’t healed for 3 weeks. He smokes and drinks.

Oral squamous cell carcinoma

What gingival lesion presents as a firm, pale, dome-shaped nodule caused by chronic irritation?

Irritation fibroma

Which gingival lesion contains bone or cementum-like calcifications and occurs exclusively on gingiva?

Peripheral ossifying fibroma (POF)

What vascular lesion presents as a rapidly growing, ulcerated red mass in pregnant women?

Pyogenic granuloma

What non-neoplastic vascular lesion may blanch on pressure and often appears on the lips or gingiva in elderly patients?

Varix

Which virus causes painful vesicles on gingiva and mucosa in children?

HSV-1 (primary herpetic gingivostomatitis)

Which virus causes gingival ulcers with “owl's eye” inclusions on biopsy in immunocompromised patients?

Cytomegalovirus (CMV)

What fungal infection may cause white patches or erythematous gingivitis in immunocompromised hosts?

Oral candidiasis

Which necrotizing gingival condition presents with punched-out papillae and fetid odor?

Acute necrotizing ulcerative gingivitis (ANUG)

What disease shows subepithelial clefting and linear IgG at the basement membrane on DIF?

Mucous membrane pemphigoid

Which autoimmune condition causes suprabasal clefting and intraepithelial IgG on DIF?

Pemphigus vulgaris

What desquamative condition may show saw-tooth rete ridges and Civatte bodies?

Lichen planus

What gingival malignancy is associated with HHV-8 and appears as red-purple nodules?

Kaposi sarcoma

Which malignancy may cause diffuse gingival enlargement with boggy consistency and leukemic infiltrate on biopsy?

Leukemia

What is the most common malignant gingival tumor?

Oral squamous cell carcinoma

A 16-year-old girl on cyclosporine for renal transplant presents with generalized firm gingival enlargement. No pain. Q:What’s the most likely diagnosis?

Drug-induced gingival hyperplasia

A 60-year-old man presents with a painless, red-purple nodule on the attached gingiva. HIV+ status. Lesion bleeds on touch. Q: Most likely diagnosis? What virus is involved?

Kaposi sarcoma — HHV-8

A child presents with painful gingiva, fever, and multiple intraoral vesicles that rupture into ulcers. Gingiva is erythematous and swollen. Q: Diagnosis?

Primary herpetic gingivostomatitis (HSV-1)

A 45-year-old smoker has a non-healing ulcerated lesion on the posterior mandibular gingiva for over a month. Q: Most concerning diagnosis?

Squamous cell carcinoma