( EBER-ISH) will be positive. [ 7 ] Although EBV-MCU does not have an standardized treatment, many lesions resolve with reduction or cessation of the immunosuppressive agents.
[ 7 ]
Although the patient in this case report was previously treated with systemic steroids and has type 2 diabetes, there was no clinical evidence that indicated the patient was immunocompromised.
D. Traumatic Ulcerative Granuloma with Stromal Eosinophilia( TUGSE)
TUGSE is a reactive, self-limiting lesion of the oral mucosa, most often affecting the tongue. [ 8 ] TUGSEs may also involve the buccal mucosa, floor of the mouth, labial mucosa, and the retromolar mucosa. [ 8 ] Given its name, TUGSEs are thought to be a result of trauma to the oral mucosa; however, a reported subset of cases has been associated with a proliferation of atypical CD30 + cells, which is potentially indicative of an underlying lymphoproliferative disorder.[ 8, 9 ] Clinically, TUGSEs present as white-yellow pseudomembranous ulcers with rolled, red, indurated borders. TUGSEs may be painful or asymptomatic, are typically well-defined, and occasionally exhibit a fibrotic, white border. Histopathologically, TUGSEs consist of ulcerated oral mucosa overlying granulation tissue that is rich in capillary vessels lined by plump endothelial cells. A mix of eosinophils, lymphocytes, and neutrophils are seen permeating through the lesional stroma. [ 8 ] In some instances, degenerated muscle cells are seen at the base of the specimen with associated, interspersed eosinophils.[ 8 ] In a subset of cases with CD30 + atypical cells, these atypical cells are mononuclear and comparatively large relative to accompanying inflammatory cells.[ 8 ] In the case of our patient, there was no prior history of trauma or reports of pain. Further, on histopathologic examination of the incisional biopsy, no features of TUGSE were identified, ruling out this diagnosis.
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JANUARY / FEBRUARY 2026 | PENNSYLVANIA DENTAL JOURNAL 21