Treatment

Under intravenous anesthetic an incision was made over an intact buccal cortex. An incisional biopsy was performed and the tissue submitted for microscopic evaluation.

Incisional Biopsy

Histological examination revealed sheets and clusters of large cells with abundant cytoplasm and folded, grooved or bean-shaped nuclei intermixed with eosinophils and many multinucleated giant cells (Figures 2-4). The immunohistochemistry stain showed strong membrane expression with CD1a antibody (Figure 5). Mitotic figures were identified.

Figure 2 Low power (x40) H & E histology shows sheets of large round cells with abundant cytoplasm and many eosinophils.

Figure 3 High power (x100) H & E histology shows sheets of large cells with abundant cytoplasm and folded nuclei intermixed with many eosinophils and multinucleated giant cells.

Figure 4 High power (x200) H & E histology shows many multinucleated giant cells surrounded by sheets of large cells with abundant cytoplasm and many eosinophils.

Figure 5 High power (x200) immunohistochemistry stain with CD1a antibody. Note the uniform and strong cell membrane positive stain.