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LASER THERAPY AND CHAMOMILLA RECUTITA EXTRACT ON THE TREATMENT OF ORAL MUCOSITIS
ORAL AND MAXILLOFACIAL PATHOLOGY e106 Abstracts CPP263 - INJURY CENTRAL OF GIANT CELLS IN JAW: CASE REPORT. MIRIÃ LIMA NOGUEIRA, JEAN CARLOS DELLA GIUSTINA, CINTIA DE SOUZA ALFERES ARAÚJO. Leucoderma, female patient, 14 years old, sought medical care complaining of “ball in her mouth.” Extraoral physical examination showed a slight asymmetry in the left cheek and intraoral inspection detected swelling in the vestibule of background in the left jaw, painless and normal colored, wearing orthodontic braces. Palpation found a mollified tissue type “eggshell.” Radiography showed a destructive osteolytic lesion in the left maxilla with root divergence between teeth 22 and 23. During biopsy and trans-surgery, it was noticed the presence of fleshy lesion bleeding with minimum touch. Histopathologic results were conclusive for central injury of giant cell. Additional tests were requested that ruled out the diagnosis of brown tumor of hyperparathyroidism. Enucleation and curettage was performed in the jaw tumor in a hospital under general anesthesia. The patient remained under observation for 8 months; there was improvement of intra- and extraoral edema and panoramic radiograph showed bone formation in the area with no sign of relapse.
CPP264 - GORLIN-GOLTZ SYNDROME: CASE REPORT. MIRIÃ LIMA NOGUEIRA, JEAN CARLOS DELLA GIUSTINA, CINTIA DE SOUZA ALFERES ARAÚJO. Leucoderma, female patient, 49 years old, sought medical care complaining of “injury in the jaw.” She had a history of treatment of various squamous cell carcinoma (SCC) of the skin. In extraoral clinical examination noted papillomatous lesions on the face, suggestive clinical picture of CEC and intraoral examination revealed to be dentate upper and lower part without local changes. Radiographic examination detected 3 radiolucent lesions, well delineated with radiopaque halo body region, bilateral mandibular branch and left posterior maxilla. Biopsy was performed via fine-needle aspiration, which collected whitened liquid with keratin, suggesting keratocystic odontogenic tumor. Incisional biopsy of the lesions and chest and face radiographs were requested, which showed calcification of the falx cerebri, confirming the diagnosis of Gorli-Goltz syndrome. The patient had surgery under general anesthesia for enucleation and curettage of chemical injury and cauterized surgical site using Carnoy. The patient is currently under monitoring.
¨ GREN’S SYNDROME AND CPP265 - SJO POLYAUTOIMMUNITY: A CLOSE RELATION. THAYANARA SILVA MELO, GUILHERME SOARES GOMES DA SILVA, ALESSANDRA DE ALBUQUERQUE TAVARES CARVALHO, JAIR CARNEIRO LEÃO, LUIZ ALCINO MONTEIRO GUEIROS. Sjögren’s syndrome (SS) is commonly associated with other autoimmune diseases, representing a cluster of autoimmunity. A 59-year-old black female patient was referred with severe dry mouth for clinical evaluation of SS. Her medical history included systemic sclerosis, rheumatoid arthritis, and dermatomyositis. Extraoral evaluation showed marked features of systemic sclerosis, including microstomy, nose deformity, and paucity of wrinkles. Intraoral assessment revealed severe hyposalivation, with scarce and foamy saliva and depapillated tongue. Salivary glands scintigraphy showed lack of capture
OOOO August 2017 and elimination of the tracer, bilaterally. Sialometry results were negative and Schirmer test was intensely reduced; lip biopsy was compatible with focal lymphocytic sialoadenitis, rendering the diagnosis of SS. Systemic treatment was not modified and local measures were introduced to control the oral symptoms, with limited benefit. The patient has been kept in close followup for months because of the high risk of extraglandular involvement.
CPP266 - ATYPICAL FACIAL INVOLVEMENT OF WEGENER’S GRANULOMATOSIS. THAYANARA SILVA MELO, LILIANE DE ANDRADE CARVALHO, DANIEL GOMES, ALESSANDRA ALBUQUERQUE TAVARES CARVALHO, JAIR CARNEIRO LEÃO, LUIZ ALCINO MONTEIRO GUEIROS. Wegener’s granulomatosis is an uncommon vasculitis of small- and medium-sized vessels. A 23-year-old female patient was referred with a diffuse gingival swelling and extensive facial ulcers. She reported a 5-month lasting non-responsive retroauricular pustule-nodular lesion, initially diagnosed as acne. The injury progressed to numerous sharp-demarcated deep facial ulcerations. Skin biopsy was suggestive of pyoderma gangrenosum. The patient also presented with fever, diffuse pulmonary inflammation with cavitation, and gingival hyperplasia. Both pANCA and c-ANCA, as well as tuberculosis tests, were negative. A gingival biopsy was performed and microscopic analysis showed plenty of multinucleated cells and vascular structures with areas of clutter and infiltration of inflammatory cells, suggestive of Wegner’s granulomatosis. Based on the oral biopsy report, the patient was started on corticosteroid/cyclophosphamide pulse therapy and an adequate clinical response was noted. c-ANCA was tested again 1 month later and the result was positive. The patient is now on close follow-up with adequate clinical control.
CPP267 - OSTEONECROSIS OF THE JAW ASSOCIATED WITH HIV VIRUS. THAIS DA SILVA FONSECA, JOÃO MATEUS MENDES CERQUEIRA, LIGIA AKIKO NINOKATA MIYAHARA, DOUGLAS MAGNO GUIMARÃES, GIORDANNA PEREIRA CHEMELO, FLÁVIA SIROTHEAU CORREA PONTES, HÉLDER ANTÔNIO REBELO PONTES. Osteonecrosis is a terminology that refers to the death of the cells of 2 components of the bone: hematopoietic marrow and osteocytes. A 25-year-old male patient with a history of injury in the anterior region of the mouth with 2 months of evolution was transferred to the oral pathology department for evaluation. Physical examination revealed swelling of the left facial and bone necrosis in the maxilla, anterior to left posterior region, with fetid, putrid odor, involving the teeth 21, 22, 23, 26 and 27. Laboratory tests were requested for evaluation of case details. The patient was then diagnosed as HIV-positive carrier and Kaposi’s sarcoma secondary to the virus, confirmed respectively, through rapid HIV test and histopathology specimen in incisional biopsy. After being sent to the infectious diseases sector, it evolved into feverish and diarrheal episodes, culminating in death.
CPP268 - LASER THERAPY AND CHAMOMILLA RECUTITA EXTRACT ON THE TREATMENT OF ORAL MUCOSITIS. PAULO VICTOR MOURÃO MACHADO, CLEBER NUNES ALEXANDRE,
OOOO Volume 124, Number 2 LETÍCIA DÁVILA PORTUGAL, CINTHIA XEREZ DE ALBUQUERQUE, PAULA REGINA KIMURA QUEIROZ, EVILÁZIO CUNHA CARDOSO, LUZIANA BRASIL. Herein we present the case of a 17-years-old female patient with acute lymphocytic leukemia in the induction phase of chemotherapy. She presented severe grade IV (WHO) critical oral mucositis, distributed all over the oral mucosa, associated with severe pain, drooling, halitosis, dysphagia, severely compromising oral ingestion. Treatment begun with low-level laser therapy, 780 nm of wave length, with continuous light applied with 6.2 J/ cm2. Ad-MucÒ cream (Chamomilla recutita extract) was applied to the lesions after laser therapy. Four sessions were performed at 24-hour interval, allowing the observation of significant progress during the applications. Full recovery was achieved after the laser therapy, with considerable regression of the legions, expressive general condition recovery, and reestablishment of progressive swallowing, contributing to the improvement of her nutrition state. The low-level laser therapy associated with Ad-MucÒ cream was an efficient alternative to the treatment of oral mucositis, considered non-traumatic, with low cost and with satisfactory results.
CPP269 - ORAL BASALOID SQUAMOUS CELL CARCINOMA IN AN INDIGENOUS PATIENT. PRISCILLA BARBOSA DINIZ, NAYARA DA SILVA BARAÚNA, FILIPE TORRES AMORIM OLIVEIRA, CAROLINA CALEGARI, MICHELLE AGOSTINI, BRUNO AUGUSTO BENEVENUTO DE ANDRADE, MÁRIO JOSÉ ROMAÑACH. Basaloid squamous cell carcinoma (BSCC) is a variant of oral squamous cell carcinoma with aggressive clinical behavior, usually occurring in the tongue and floor of the mouth of older patients. A 70-year-old indigenous male patient presented an exuberant swelling on the anterior alveolar ridge. Medical history included habits of chewing tobacco since he was 6 years old and alcohol consumption. Intraoral examination revealed a 4-cm reddish swelling covered by irregular and vascular surface, located on the anterior alveolar ridge of the mandible. Panoramic radiograph showed extensive superficial bone resorption with irregular borders. Microscopic evaluation revealed infiltrative tumor islands composed of basaloid epithelial cells with hyperchromatic pleomorphic nuclei, comedonecrosis, and focal areas of squamous differentiation. Final diagnosis was of BSCC of the alveolar ridge. The patient denied treatment because of religious beliefs; currently he is alive with the disease 1 year after diagnosis. Oral BSCC rarely affects the alveolar ridge of indigenous patients.
CPP270 - WHITE SPONGE NEVUS. PRISCILLA BARBOSA DINIZ, ÚRSULLA VAZ VIEIRA CAMPOS, RUBEM COSTA ARAÚJO, MICHELLE AGOSTINI, BRUNO AUGUSTO BENEVENUTO DE ANDRADE, MÁRIO JOSÉ ROMAÑACHOMAÑACH. White sponge nevus (WSN) is a rare autosomal-dominant disorder characterized by white symmetric diffuse corrugated or velvety plaques on the oral, esophageal, or genital mucosae. Oral lesions are benign, usually appear at birth or during childhood, and no treatment is required. A 7-year-old female patient was referred for evaluation of diffuse white verrucous plaques of smooth surface on the buccal mucosa bilaterally. Her mother reported initial presentation when the patient was 6 months old
ABSTRACTS Abstracts e107 and previous history of incisional biopsy performed 2 years before first consultation. Microscopic review revealed hyperplasic stratified squamous epithelium and hyperparakeratosis with extensive hydropic degeneration and keratinocytes exhibiting perinuclear eosinophilic condensation. The final diagnosis was of WSN. Orientation was offered to the patient’s family about the benign nature of oral lesions. WSN is uncommon and should be considered as a differential diagnosis of oral white lesions in infants.
CPP271 - UNUSUAL EPIDERMOID CYST IN THE HARD PALATE. ONDINA KARLA MOUSINHO DA SILVA ROCHA, HUGO COSTA-NETO, ANDRÉIA FERREIRA DO CARMO, LUIZ ARTHUR BARBOSA DA SILVA, ÉRICKA JANINE DANTAS DA SILVEIRA, HÉBEL CAVALCANTI GALVÃO. Epidermoid cysts are ectoderm-derived benign malformations and represent approximately 7% of all head and neck cysts, although they are rare in the oral cavity, which represents less than 0.01% of all known cysts. They are usually located in the floor of the mouth’s middle line in children and young adults. Herein we report the case of a 56-year-old male patient, melanoderma, presenting with a lesion in the palate middle line, nodular, exophytic, sessile, staining slightly reddened, softened consistency, asymptomatic, with duration of 2 years. The radiographic data showed no alterations associated with the lesion. An excisional biopsy was performed and the histopathologic exam showed pathologic cavity coated with keratinized squamous stratified epithelium and subsequent capsule composed by dense fibrous connective tissue, not showing cutaneous annexes. In this case report, it is discussed the origin, the localization and the differential diagnosis for oral cavity epidermoid cysts.
CPP272 - PLASMABLASTIC LYMPHOMA IN THE ORAL CAVITY IN PATIENTS WITH SEROLOGIES UNKNOWN FOR HIV: CASE REPORT. ANDREZA MARIA DE OLIVEIRA FILGUEIRAS, THIAGO MOREIRA PESSÔA, GERALDO OLIVEIRA SILVA-JUNIOR, RUTH TRAMONTANI RAMOS, MARÍLIA HEFFER CANTISANO, FÁBIO RAMOA PIRES. Plasmablastic lymphoma (PL) is an unusual aggressive nonHodgkin’s lymphoma derived from B cells and mostly associated with human immunodeficiency virus (HIV) infection. The aim of this study was to report a case of PL involving the oral cavity in a 35-year-old male patient with unknown HIV serology. FMSJ, male, leucoderma, presented to the Stomatology Service with pain in the anterior maxilla, 5 months of evolution, with constant fever, weight loss, and lack of appetite. Intraoral exam noted an ulcerated lesion with hardened edges and with extensive necrotic areas, fetid odor, painful on palpation, located in the pre-maxilla extending to the upper lip mucosa. An incisional biopsy of the area was performed and submitted for histopathologic examination and later immunohistochemistry, which was conclusive for B lymphoma of high-grade plasmablastic type, with positive result for CD138, plasma cell, KI67 >90%, and negative for CD20, CD56, CD3, and CD68. Complementary exams revealed that the patient had HIV 1- and 2-positive serology. The patient was referred to Oncology and Infectology for treatment. Oral PL and large associated of HIV-positive patients is important information for the differential diagnosis. The importance of complementary exams, especially when the person with AIDS is unaware of HIV
CPP264 - GORLIN-GOLTZ SYNDROME: CASE REPORT. MIRIÃ LIMA NOGUEIRA, JEAN CARLOS DELLA GIUSTINA, CINTIA DE SOUZA ALFERES ARAÚJO. Leucoderma, female patient, 49 years old, sought medical care complaining of “injury in the jaw.” She had a history of treatment of various squamous cell carcinoma (SCC) of the skin. In extraoral clinical examination noted papillomatous lesions on the face, suggestive clinical picture of CEC and intraoral examination revealed to be dentate upper and lower part without local changes. Radiographic examination detected 3 radiolucent lesions, well delineated with radiopaque halo body region, bilateral mandibular branch and left posterior maxilla. Biopsy was performed via fine-needle aspiration, which collected whitened liquid with keratin, suggesting keratocystic odontogenic tumor. Incisional biopsy of the lesions and chest and face radiographs were requested, which showed calcification of the falx cerebri, confirming the diagnosis of Gorli-Goltz syndrome. The patient had surgery under general anesthesia for enucleation and curettage of chemical injury and cauterized surgical site using Carnoy. The patient is currently under monitoring.
¨ GREN’S SYNDROME AND CPP265 - SJO POLYAUTOIMMUNITY: A CLOSE RELATION. THAYANARA SILVA MELO, GUILHERME SOARES GOMES DA SILVA, ALESSANDRA DE ALBUQUERQUE TAVARES CARVALHO, JAIR CARNEIRO LEÃO, LUIZ ALCINO MONTEIRO GUEIROS. Sjögren’s syndrome (SS) is commonly associated with other autoimmune diseases, representing a cluster of autoimmunity. A 59-year-old black female patient was referred with severe dry mouth for clinical evaluation of SS. Her medical history included systemic sclerosis, rheumatoid arthritis, and dermatomyositis. Extraoral evaluation showed marked features of systemic sclerosis, including microstomy, nose deformity, and paucity of wrinkles. Intraoral assessment revealed severe hyposalivation, with scarce and foamy saliva and depapillated tongue. Salivary glands scintigraphy showed lack of capture
OOOO August 2017 and elimination of the tracer, bilaterally. Sialometry results were negative and Schirmer test was intensely reduced; lip biopsy was compatible with focal lymphocytic sialoadenitis, rendering the diagnosis of SS. Systemic treatment was not modified and local measures were introduced to control the oral symptoms, with limited benefit. The patient has been kept in close followup for months because of the high risk of extraglandular involvement.
CPP266 - ATYPICAL FACIAL INVOLVEMENT OF WEGENER’S GRANULOMATOSIS. THAYANARA SILVA MELO, LILIANE DE ANDRADE CARVALHO, DANIEL GOMES, ALESSANDRA ALBUQUERQUE TAVARES CARVALHO, JAIR CARNEIRO LEÃO, LUIZ ALCINO MONTEIRO GUEIROS. Wegener’s granulomatosis is an uncommon vasculitis of small- and medium-sized vessels. A 23-year-old female patient was referred with a diffuse gingival swelling and extensive facial ulcers. She reported a 5-month lasting non-responsive retroauricular pustule-nodular lesion, initially diagnosed as acne. The injury progressed to numerous sharp-demarcated deep facial ulcerations. Skin biopsy was suggestive of pyoderma gangrenosum. The patient also presented with fever, diffuse pulmonary inflammation with cavitation, and gingival hyperplasia. Both pANCA and c-ANCA, as well as tuberculosis tests, were negative. A gingival biopsy was performed and microscopic analysis showed plenty of multinucleated cells and vascular structures with areas of clutter and infiltration of inflammatory cells, suggestive of Wegner’s granulomatosis. Based on the oral biopsy report, the patient was started on corticosteroid/cyclophosphamide pulse therapy and an adequate clinical response was noted. c-ANCA was tested again 1 month later and the result was positive. The patient is now on close follow-up with adequate clinical control.
CPP267 - OSTEONECROSIS OF THE JAW ASSOCIATED WITH HIV VIRUS. THAIS DA SILVA FONSECA, JOÃO MATEUS MENDES CERQUEIRA, LIGIA AKIKO NINOKATA MIYAHARA, DOUGLAS MAGNO GUIMARÃES, GIORDANNA PEREIRA CHEMELO, FLÁVIA SIROTHEAU CORREA PONTES, HÉLDER ANTÔNIO REBELO PONTES. Osteonecrosis is a terminology that refers to the death of the cells of 2 components of the bone: hematopoietic marrow and osteocytes. A 25-year-old male patient with a history of injury in the anterior region of the mouth with 2 months of evolution was transferred to the oral pathology department for evaluation. Physical examination revealed swelling of the left facial and bone necrosis in the maxilla, anterior to left posterior region, with fetid, putrid odor, involving the teeth 21, 22, 23, 26 and 27. Laboratory tests were requested for evaluation of case details. The patient was then diagnosed as HIV-positive carrier and Kaposi’s sarcoma secondary to the virus, confirmed respectively, through rapid HIV test and histopathology specimen in incisional biopsy. After being sent to the infectious diseases sector, it evolved into feverish and diarrheal episodes, culminating in death.
CPP268 - LASER THERAPY AND CHAMOMILLA RECUTITA EXTRACT ON THE TREATMENT OF ORAL MUCOSITIS. PAULO VICTOR MOURÃO MACHADO, CLEBER NUNES ALEXANDRE,
OOOO Volume 124, Number 2 LETÍCIA DÁVILA PORTUGAL, CINTHIA XEREZ DE ALBUQUERQUE, PAULA REGINA KIMURA QUEIROZ, EVILÁZIO CUNHA CARDOSO, LUZIANA BRASIL. Herein we present the case of a 17-years-old female patient with acute lymphocytic leukemia in the induction phase of chemotherapy. She presented severe grade IV (WHO) critical oral mucositis, distributed all over the oral mucosa, associated with severe pain, drooling, halitosis, dysphagia, severely compromising oral ingestion. Treatment begun with low-level laser therapy, 780 nm of wave length, with continuous light applied with 6.2 J/ cm2. Ad-MucÒ cream (Chamomilla recutita extract) was applied to the lesions after laser therapy. Four sessions were performed at 24-hour interval, allowing the observation of significant progress during the applications. Full recovery was achieved after the laser therapy, with considerable regression of the legions, expressive general condition recovery, and reestablishment of progressive swallowing, contributing to the improvement of her nutrition state. The low-level laser therapy associated with Ad-MucÒ cream was an efficient alternative to the treatment of oral mucositis, considered non-traumatic, with low cost and with satisfactory results.
CPP269 - ORAL BASALOID SQUAMOUS CELL CARCINOMA IN AN INDIGENOUS PATIENT. PRISCILLA BARBOSA DINIZ, NAYARA DA SILVA BARAÚNA, FILIPE TORRES AMORIM OLIVEIRA, CAROLINA CALEGARI, MICHELLE AGOSTINI, BRUNO AUGUSTO BENEVENUTO DE ANDRADE, MÁRIO JOSÉ ROMAÑACH. Basaloid squamous cell carcinoma (BSCC) is a variant of oral squamous cell carcinoma with aggressive clinical behavior, usually occurring in the tongue and floor of the mouth of older patients. A 70-year-old indigenous male patient presented an exuberant swelling on the anterior alveolar ridge. Medical history included habits of chewing tobacco since he was 6 years old and alcohol consumption. Intraoral examination revealed a 4-cm reddish swelling covered by irregular and vascular surface, located on the anterior alveolar ridge of the mandible. Panoramic radiograph showed extensive superficial bone resorption with irregular borders. Microscopic evaluation revealed infiltrative tumor islands composed of basaloid epithelial cells with hyperchromatic pleomorphic nuclei, comedonecrosis, and focal areas of squamous differentiation. Final diagnosis was of BSCC of the alveolar ridge. The patient denied treatment because of religious beliefs; currently he is alive with the disease 1 year after diagnosis. Oral BSCC rarely affects the alveolar ridge of indigenous patients.
CPP270 - WHITE SPONGE NEVUS. PRISCILLA BARBOSA DINIZ, ÚRSULLA VAZ VIEIRA CAMPOS, RUBEM COSTA ARAÚJO, MICHELLE AGOSTINI, BRUNO AUGUSTO BENEVENUTO DE ANDRADE, MÁRIO JOSÉ ROMAÑACHOMAÑACH. White sponge nevus (WSN) is a rare autosomal-dominant disorder characterized by white symmetric diffuse corrugated or velvety plaques on the oral, esophageal, or genital mucosae. Oral lesions are benign, usually appear at birth or during childhood, and no treatment is required. A 7-year-old female patient was referred for evaluation of diffuse white verrucous plaques of smooth surface on the buccal mucosa bilaterally. Her mother reported initial presentation when the patient was 6 months old
ABSTRACTS Abstracts e107 and previous history of incisional biopsy performed 2 years before first consultation. Microscopic review revealed hyperplasic stratified squamous epithelium and hyperparakeratosis with extensive hydropic degeneration and keratinocytes exhibiting perinuclear eosinophilic condensation. The final diagnosis was of WSN. Orientation was offered to the patient’s family about the benign nature of oral lesions. WSN is uncommon and should be considered as a differential diagnosis of oral white lesions in infants.
CPP271 - UNUSUAL EPIDERMOID CYST IN THE HARD PALATE. ONDINA KARLA MOUSINHO DA SILVA ROCHA, HUGO COSTA-NETO, ANDRÉIA FERREIRA DO CARMO, LUIZ ARTHUR BARBOSA DA SILVA, ÉRICKA JANINE DANTAS DA SILVEIRA, HÉBEL CAVALCANTI GALVÃO. Epidermoid cysts are ectoderm-derived benign malformations and represent approximately 7% of all head and neck cysts, although they are rare in the oral cavity, which represents less than 0.01% of all known cysts. They are usually located in the floor of the mouth’s middle line in children and young adults. Herein we report the case of a 56-year-old male patient, melanoderma, presenting with a lesion in the palate middle line, nodular, exophytic, sessile, staining slightly reddened, softened consistency, asymptomatic, with duration of 2 years. The radiographic data showed no alterations associated with the lesion. An excisional biopsy was performed and the histopathologic exam showed pathologic cavity coated with keratinized squamous stratified epithelium and subsequent capsule composed by dense fibrous connective tissue, not showing cutaneous annexes. In this case report, it is discussed the origin, the localization and the differential diagnosis for oral cavity epidermoid cysts.
CPP272 - PLASMABLASTIC LYMPHOMA IN THE ORAL CAVITY IN PATIENTS WITH SEROLOGIES UNKNOWN FOR HIV: CASE REPORT. ANDREZA MARIA DE OLIVEIRA FILGUEIRAS, THIAGO MOREIRA PESSÔA, GERALDO OLIVEIRA SILVA-JUNIOR, RUTH TRAMONTANI RAMOS, MARÍLIA HEFFER CANTISANO, FÁBIO RAMOA PIRES. Plasmablastic lymphoma (PL) is an unusual aggressive nonHodgkin’s lymphoma derived from B cells and mostly associated with human immunodeficiency virus (HIV) infection. The aim of this study was to report a case of PL involving the oral cavity in a 35-year-old male patient with unknown HIV serology. FMSJ, male, leucoderma, presented to the Stomatology Service with pain in the anterior maxilla, 5 months of evolution, with constant fever, weight loss, and lack of appetite. Intraoral exam noted an ulcerated lesion with hardened edges and with extensive necrotic areas, fetid odor, painful on palpation, located in the pre-maxilla extending to the upper lip mucosa. An incisional biopsy of the area was performed and submitted for histopathologic examination and later immunohistochemistry, which was conclusive for B lymphoma of high-grade plasmablastic type, with positive result for CD138, plasma cell, KI67 >90%, and negative for CD20, CD56, CD3, and CD68. Complementary exams revealed that the patient had HIV 1- and 2-positive serology. The patient was referred to Oncology and Infectology for treatment. Oral PL and large associated of HIV-positive patients is important information for the differential diagnosis. The importance of complementary exams, especially when the person with AIDS is unaware of HIV