case_images: PMC10499291_01
case_images: Radiographic and imaging analysis. Serial OPGs revealing slowly progressive osteolysis of the mandible. OPG: Orthopantomogram
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case_images: Serial OPGs taken during this period revealed continued bone loss from condyle to angle, approaching the body of the mandible on the left side [Figure 1].
case_images: Radiographic and imaging analysis. CBCT with 3D reconstruction showing the extent of bone resorption in mandible. CBCT: Cone-beam computed tomography, 3D: Three dimensional
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case_images: Cone beam computed tomography (CBCT) with three-dimensional reconstruction disclosed the extent of involvement of the mandible [Figure 2].
case_images: Haematoxylin and eosin-stained histopathological and immunohistochemical analysis images. (a) Inflammatory infiltrate with abundant vascular channels (4x). (b) Dense plasma cell:rich inflammatory infiltrate (10x). (c) Mature, viable lamellated bone with fibrovascular tissue (10x). (d) CD38-positive plasma cells highlighted (10x). (e) D2-40 staining of endothelial cells, highlighting lymphatic vessels. (f) Ki-67 index less than 1% in most proliferative areas
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case_images: Plasma cell rich chronic inflammatory infiltrate [Figure 3a and b] was evident on histopathological examination. No osteoclastic activity was evident, and viable bone with osteoblastic rimming and osteocytes was evident on decalcified sections [Figure 3c]. Deep cut sections revealed numerous endothelium-lined vessels along with CD38-positive plasma cells [Figure 3d]. D2-40 or podoplanin marker confirmed proliferation of abundant slit-like lymphatic vessels [Figure 3e]. Histopathological examination was negative for any epithelial and mesenchymal malignancy, and Ki-67 marker was <1% in most proliferative areas [Figure 3f].
case_images: Follow-up OPG (6-month post-operative). OPG: Orthopantomogram
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case_images: The patient is disease free after six months of follow-up [Figure 4].