Abstract
Here, we discuss the pathophysiology of leukemia-associated gingival enlargement based on a case of acute myelomonocytic leukemia (AML-M4) with typical gingival enlargement. Uniquely, this patient was well enough to allow full periodontal examination and incisional gingival biopsy to be performed both before and after chemotherapy. The patient was a 39-year-old Japanese woman with AML-M4 showing gingival enlargement. Histological and immunohistochemical features of gingiva and bacterial counts in the periodontal pockets were examined before and after chemotherapy. The results were as follows: (1) infiltration of myelomonocytic blasts in enlarged gingiva; (2) resolution of gingival enlargement with complete remission of AML by anticancer chemotherapy; and (3) the numbers of bacteria in the periodontal pockets were not high and were not altered before or after chemotherapy. In patients with AML-M4, remarkable mucosal enlargement is not generally observed in the body except in the gingiva. We hypothesized that antigens derived from periodontal bacteria, even if they are not present in large numbers, could act as chemoattractants for myelomonocytic leukemic cells.
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Acknowledgments
We thank Ms. Mutsumi Okabe (Technical staff, Department of Pathology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences) for pathological diagnosis. We also thank Drs. Chieko Kudo, Aya Hisaeda, Noriko Kanda, Naoko Koide-Namba, Mayumi Ishii, Shoichi Hongo (All staff belong to the Department of Patho-physiology-Periodontal Science, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences), and Ms. Yuko Sugiura for daily dental clinical support, and Drs. Katsuyuki Kubo, Atsushi Ikeda, and Daisuke Yamamoto for bacterial data analysis. This study was supported by a Grant-in-Aid for Young Scientists (B) (22791836 to Y.S.) from the Japan Society for the Promotion of Science.
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Sonoi, N., Soga, Y., Maeda, H. et al. Histological and immunohistochemical features of gingival enlargement in a patient with AML. Odontology 100, 254–257 (2012). https://doi.org/10.1007/s10266-011-0051-0
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DOI: https://doi.org/10.1007/s10266-011-0051-0