Adına benzemeyen bir patoloji: Piyojenik granülom

Piyojenik granülom, isminde yer alan piyojenik ifadesine bakarak enfeksiyonla ilişkili bir patoloji olarak düşünüle- bilse de gerçekte, hatırlanan veya hatırlanamayan travmaları takiben ortaya çıkan edinsel bir hemanjiyomdur. Pratikte, maling melanom ile karışabilmesi ve kanamaya yol açabilmesi nedeni ile önem taşır. Bu çalışmada 17 yıllık arşivimizde yer alan olguları geriye doğru değerlendirdik. Toplam 21 hasta sunduk. Bunların 12 tanesinde lezyon elde, 14 tanesinde baş boyun bölgesinde ve 3 tanesinde de gövde ve alt ekstremitelerde yerleşikti. Tedavide eksizyonu takiben flep ile onarım (n:3), deri grefti ile onarım (n:2), primer onarım (n:15), geriye kalan 9 olguda da bipolar koter ile koterizasyon yöntemini seçtik. Piyojenik granülom, her ne kadar genellikle boyutları küçük ve patolojik olarak iyi huylu bir tümör olsa da yerleştiği yer itibarı ile rezeksiyon sonrası oluşacak defektin onarımı ciddi rekonstrüktif teknikleri gerekli kılabilir. Büyük boyutlara ulaşmış piyojenik granülom kit-leleri daima saplıdır ve rezeksiyon mutlaka sap görülerek yapılmalıdır değilse gereksiz yere fazla sağlam doku çıkarılmış olur ki bu da rekonstrüksiyonu zorlaştırabilir. Tanınmaması halinde gereksiz yere biyopsi yapılması, kanamaları durdurmak için sütür konulması gibi işlemler yapılmakta olduğundan bu konuda yazılmış bunun gibi basit makaleleri okuyup fotoğraflarına bakılması yararlı olabilir.

A pathological diagnosis that does not resemble its name: Pyogenic granuloma

Pyogenic granuloma as its name implies may be considered as a purulent infection associated with granuloma but in fact it has no relationship with any infection. It is an acquired hemangioma that follows both known or unknown traumas to the region. The lesion occasionally resembles melanoma and it is of importance for differential diagnosis from it and also since it bleeds easily. In this study, we presented our experience on pyogenic granuloma by evaluating our archives including 27 patients. Eleven pyogenic granulomas were located on the hand, 17 cases were located on head and neck, and in 3 patients it was located on the lower extremity. To reconstruct the defect following its excision we used primary closure technique (n:15), bipolar coauterization (n:9), skin grafting (n:2), and local flap (n:3). Although it is usually small in size and benign in its pathologic nature, depending its localization, the defect following its resection may require serious reconstructive techniqual attempts. Regarding the correlation between the preoperative and post-operative pathological diagnoses, we can say that it is not difficult to diagnose a pyogenic granuloma by naked eye.

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