Giant Cell Fibroma of Tongue: Understanding the Nature of an Unusual Histopathological Entity
Table 1
Illustrating comparison between giant cell fibroma, irritation fibroma, retrocuspid papilla, and papilloma.
Giant cell fibroma
Irritation fibroma
Retrocuspid papilla
Papilloma
Etiology
Unknown
Chronic irritation
Developmental
Human papilloma virus
Age
1st–3rd decade
4th–6th decade
Children and young adult
30–50 years
Sex
Slight female predilection
Slight male predilection
Female predilection
Equal sex distribution
Common site
Gingiva, tongue
Buccal, labial, and tongue mucosa
lingual gingiva adjacent to mandibular cuspids. Frequently bilateral
Tongue, lips, and soft palate
Histopathology
Moderate to dense fibrous connective tissue stroma containing numerous giant cells, concentrated mostly beneath the epithelium; giant cells are stellate fibroblasts with enlarged nuclei and few containing multiple nuclei; surface epithelium typically has very elongated, thin rete processes
Dense, minimally cellular stroma of collagen fibers; stromal cells are bipolar fibroblasts with plump nuclei and fibrocytes with thin, elongated nuclei with minimal cytoplasm; surface epithelium is usually atrophic and may show signs of continued trauma
Connective tissue stroma may exhibit large stellate fibroblasts and occasional epithelial rests.
Keratinized stratified squamous epithelium arrayed in finger-like projections with thin fibrovascular connective tissue cores; koilocytes (virus altered epithelial cells) are sometimes seen high in the prickle cell layer