Abstract
Introduction
Lymphangiomas mimicking apical periodontitis, usually found in soft tissue of children
and infants younger than 2 years, are extremely rare in aged patients, particularly
in bone tissues.
Methods
An 81-year-old woman was seen in a radiological service to undergo imaging studies
for the placement of dental implants. A panoramic radiograph showed a radiolucent
multilocular structure in the left mandibular molar region, where teeth #17 and #18
had previously been treated endodontically. A fracture in tooth #17 was detected.
Because of the patient’s clinical history and the characteristics of the image, which
showed changes in trabecular bone structure, the patient was referred for cone beam
computed tomography (CBCT) and magnetic resonance imaging (MRI) for further evaluation.
CBCT scans demonstrated a well-circumscribed lesion immediately below the roots of
teeth #17 and #18. MRI showed no involvement of the surrounding soft tissues, and
the lesion affected only the mandibular bone. Incision biopsy was performed, and the
tissue sample (histopathology specimen) was sent to microscopic evaluation.
Results
Microscopically, there was a proliferation of vascular endothelium covered by long
and mature endothelial cells. In the vessel lumens, there was eosinophilic material
similar to lymph. The microscopic examination suggested the diagnosis of lymphangioma.
Conclusions
Pathologies of non-endodontic origin such as lymphangioma, which might be in the area
of the tooth apex, should be included in the differential diagnosis of apical periodontitis.
Histopathologic examination is mandatory for their diagnosis and treatment.
Key Words
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Article info
Publication history
Published online: October 15, 2010
Identification
Copyright
© 2011 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.
