: Juvenile Xanthogranuloma of the Oral Cavity in Children: A Clinico-pathologic study.

Department of Pediatric Dentistry
Lutheran Medical Center

Resident’s Name: Craig Elice Date: 7/17/2009
Article title: Juvenile Xanthogranuloma of the Oral Cavity in Children: A Clinico-pathologic study.
Author(s): Flaitz C., Allen C., Neville B., et al
Journal: Oral Surg Oral Med Oral pathol Oral Radiol Endod
Volume (number): 345-52
Date: Sept 2002
Major topic: Clinical and Histochemical evaluation of JXG
Type of Article: Case Reports
Main Purpose: This article reviews 5 cases of oral JXG in children
Review of Cases: JXG is a benign reactive self-healing disorder of children which is classified as a normolipenic, non Langerhans cell disease caused by the proliferation of phagocytoid monocytes. It most commonly affects infants less than 1 year of age with a male predilection. The cutaneous type is most commonly associated with the head and neck region of the skin and occurs as single or multiple lesions in a cluster. The lesion is papulonodular with a color varying from yellow to red to red brown to normal skin color. The lesions are usually asymptomatic and the lesions undergo spontaneous regression after several months leaving a permanent scar.
Systemic JXG can affect several different organ systems, and skin lesions are associated with it in 40-50% of cases. Treatment includes surgical excision. If left untreated, this disorder may be life threatening
Five cases of Oral JXG were studied ranging in age from 5 months to 10 years with a mean age of 6.3 years. Most lesions were solitary affecting the gingival, dorsum of tongue, and buccal mucosa and none were associated with cutaneous lesions. Histopathological examination indicated an increase in histiocytes and dendritic cells in the lesions. Extensive histological evaluation was discussed in the article.
Differential diagnosis with Langherhan cell disease (LCD0 is necessary. Other diseases linked to JXG are neurofibromatosis type I, juvenile chronic myeloid leukemia, ALL, LCD, Diabetes Mellitus, etc.
Key points/Summary : Oral JXG tends to occur in an older age group than the other types of JXG. Cellular analysis of a biopsy is necessary to differentiate it from LCD
Assessment of article: Good article. Too much information about the ultrastuctural and immunocytochemical studies of the lesions.