زائر
Peiphea giant e ganma is, f a patia ppses, a site-speifi vaiant f pygeni ganma embedded with steast-ike mtineated giant es and aising exsivey fm the peidnta igament ensing the t f a tth. This niqe igin, f se, means that sh a esin an ny be fnd within pn the gingiva avea idge, n the site is aeptabe. aed vaisy giant e epaative ganma, steastma, giant e epis, and myeid epis, this esin was fist epted as fngs fesh in 1848. Amst haf f a ases have esina es ntaining sfae eepts f estgen and this has ed t speatin that sme peiphea giant e ganmas ae espnsive thmna infen
inia Feates
The sa age at diagnsis is the fth thgh sixth deades, bt thee is n maked age pedietin. Me than 60% f ases in femaes and this femae pedietin is me pnned in the de age gps. Individa esins ae nda and pednated, feqenty with an eated sfae, and feqenty with a ed, bwn bish he
Geneay age than pygeni ganma, the esin may exeed 4 m. in size, bt mst esins emain ess than 2 m. in diamete. Any avea egin may be affeted and adigaphs may shw eithe a saeizatin f ndeying bne, peidntitis f ndeying tisses, an isthms f sft tisse nneting t an intasses enta giant e ganma
Pathgy and Diffeentia Diagnsis
The peiphea giant e ganma is mpised f an nenapsated aggegatin f athe pimitive bt nifm mesenhyma es with va, pae nei and with a mdeate amnt f esinphii ytpasm. Mitti ativity is nt nsa in the esin and may even be pnned in esins deveping in hiden and adesents. Mitti ativity within the giant es is, hweve, nt seen and if pesent shd be nsideed t be a sign f samats hange.
Stma es may be spinded with a bakgnd f ageni fibes, may be nded with a ess fibti bakgnd. Thee may be asina hni infammaty es admixed with the mesenhyma es within snding fibvasa tisses. A thin band f tine fibvasa tisse sepaates the esin fm the veying epitheim, ften with diated veins and apiaies. When sfae eatin is pesent, the e bed nsists f tine fibinid neti debis ve ganatin tisse.
Admixed thght the stma ae nmes steast-ike mtineated giant es ntaining vaying nmbes f pae vesia nei simia t thse within the snding stma es. These es have esinphii ytpasm, whih eetn mispy has shwn t ntain age nmbes f mithndia. Immnhisthemisty has shwn the giant es t be ny sighty diffeent fm te steasts. The igin f the mtineated es is sti nknwn, bt they ae assmed t aise fm synytia fsin f mnnea pesteasts f bne maw igin.
Bd vesses within the esina stma shw pmp endtheia e nei and satteed extavasatin f eythytes is mmny seen. Hemsidein depsitin may be seen in aeas f d hemhage. Metapasti stebasti new bne fmatin may be seen, say in the we thid f the esin. Dystphi aifiatin may be pesent as we.
asina esins shw an admixte f tisse types mpatibe with peiphea giant e ganma, peiphea ssifying fibma and pygeni ganma, pesmaby bease f the mmn pathetigy f these esins. Sh esins ae taditinay diagnsed ading t the dminant tisse type. Peiphea giant e ganma an be diffeentiated fm stebasti stesama by the nifmity f the stma es and by the ak f dyspasia in these es. In yng pesns, hweve, nmes mitti figes and ative pifeatin f stma es may make this distintin diffit. Peiphea giant e ganma may be indistingishabe fm the ae extasses bwn tm f hypepaathyidism
Teatment and Pgnsis
Peiphea giant e ganma is teated by nsevative sgia exisin fwed by ettage f any ndeying bny defet and aef saing and t paning f assiated teeth. A eene ate f 10% me has been epted, hene, e-exisin may be neessay. Vey age eing esins may epesent bwn tms f hypepaathyidism and wi eqie teatment f the ndeying endine dysfntin pi t sgia emva
(منقول)
inia Feates
The sa age at diagnsis is the fth thgh sixth deades, bt thee is n maked age pedietin. Me than 60% f ases in femaes and this femae pedietin is me pnned in the de age gps. Individa esins ae nda and pednated, feqenty with an eated sfae, and feqenty with a ed, bwn bish he
Geneay age than pygeni ganma, the esin may exeed 4 m. in size, bt mst esins emain ess than 2 m. in diamete. Any avea egin may be affeted and adigaphs may shw eithe a saeizatin f ndeying bne, peidntitis f ndeying tisses, an isthms f sft tisse nneting t an intasses enta giant e ganma
Pathgy and Diffeentia Diagnsis
The peiphea giant e ganma is mpised f an nenapsated aggegatin f athe pimitive bt nifm mesenhyma es with va, pae nei and with a mdeate amnt f esinphii ytpasm. Mitti ativity is nt nsa in the esin and may even be pnned in esins deveping in hiden and adesents. Mitti ativity within the giant es is, hweve, nt seen and if pesent shd be nsideed t be a sign f samats hange.
Stma es may be spinded with a bakgnd f ageni fibes, may be nded with a ess fibti bakgnd. Thee may be asina hni infammaty es admixed with the mesenhyma es within snding fibvasa tisses. A thin band f tine fibvasa tisse sepaates the esin fm the veying epitheim, ften with diated veins and apiaies. When sfae eatin is pesent, the e bed nsists f tine fibinid neti debis ve ganatin tisse.
Admixed thght the stma ae nmes steast-ike mtineated giant es ntaining vaying nmbes f pae vesia nei simia t thse within the snding stma es. These es have esinphii ytpasm, whih eetn mispy has shwn t ntain age nmbes f mithndia. Immnhisthemisty has shwn the giant es t be ny sighty diffeent fm te steasts. The igin f the mtineated es is sti nknwn, bt they ae assmed t aise fm synytia fsin f mnnea pesteasts f bne maw igin.
Bd vesses within the esina stma shw pmp endtheia e nei and satteed extavasatin f eythytes is mmny seen. Hemsidein depsitin may be seen in aeas f d hemhage. Metapasti stebasti new bne fmatin may be seen, say in the we thid f the esin. Dystphi aifiatin may be pesent as we.
asina esins shw an admixte f tisse types mpatibe with peiphea giant e ganma, peiphea ssifying fibma and pygeni ganma, pesmaby bease f the mmn pathetigy f these esins. Sh esins ae taditinay diagnsed ading t the dminant tisse type. Peiphea giant e ganma an be diffeentiated fm stebasti stesama by the nifmity f the stma es and by the ak f dyspasia in these es. In yng pesns, hweve, nmes mitti figes and ative pifeatin f stma es may make this distintin diffit. Peiphea giant e ganma may be indistingishabe fm the ae extasses bwn tm f hypepaathyidism
Teatment and Pgnsis
Peiphea giant e ganma is teated by nsevative sgia exisin fwed by ettage f any ndeying bny defet and aef saing and t paning f assiated teeth. A eene ate f 10% me has been epted, hene, e-exisin may be neessay. Vey age eing esins may epesent bwn tms f hypepaathyidism and wi eqie teatment f the ndeying endine dysfntin pi t sgia emva
(منقول)
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