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International Poster Journal of Dentistry and Oral Medicine



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Int Poster J Dent Oral Med 8 (2006), No. 2     15. June 2006

Int Poster J Dent Oral Med 2006, Vol 8 No 02, Poster 311

Oral Manifestation of Acute Myeloid Leukemia

A Case Report

Language: English

Dr. med. dent. Priska Fischer, School of Dentistry, Department of Orthodontics, University of Freiburg
PD Dr. med. Joachim Böhm, Institute of Pathology, University of Freiburg
Prof. Dr. med. dent. Petra Ratka-Krüger, School of Dentistry, Department of Operative Dentistry and Periodontology, University of Freiburg
Prof. Dr. med. dent. Gisbert Krekeler, School of Dentistry, Department of Operative Dentistry and Periodontology, University of Freiburg

June 19-21. 2003
Europerio 4


Acute Myeloid Leukaemia
Leukaemiae are a group of neoplastic diseases, which are characterized by proliferation of immature white blood cells in the bone marrow and blood, with AML being the most frequent form of leukaemia in adults.


Oral manifestations of AML are featured by rapidly developing, in many cases massive and often painful enlargements of the gingiva. Sometimes they occur in combination with ulcerations of the papilla tips or colonization with Candida albicans. In some cases though the oral mucosa appears remarkably pale.

Material and Methods

Fig. 1: Generalized inflammation and hyperplasia of the gingiva

Fig. 2: Hyperplasia of the gingiva with necrotic papillae on the palatal side

Fig. 3-4: Histological evaluation of the biopsy with gingival infiltration

The Case
A 34 year old female patient with generalized gingival enlargement was referred to us by the medical clinic with the diagnosis of AML. Clinical findings were recorded photographically and a biopsy was taken from the palatal gingiva and prepared for histological evaluation. The patient passed away five weeks after consultation.


A covering, partly keratinized squamous epithelium is represented with the typical layering. Tightly lying blasts made of non-circular nuclei with partly prominent nucleoles infiltrate the squamous epithelium.


In case AML is suspected, an immediate haematological control is necessary. Dental treatment is limited to careful reduction of plaque. Before subgingival treatment an internistic consultation is highly recommended due to the risk of bacteriaemia. The histology corresponds to an infiltration of the gingiva in the course of AML.

This case report documents the association of gingivo-periodontal alterations with white blood cell diseases, i. e. Acute Myeloid Leukaemia. It shows, that a careful anamnesis of every patient is mandatory. By referring suspected patients for haematological investigation, the dentist may aid in the detection and early treatment of the systemic disease.



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Willman, C.L.; Leukemia 15: 690-694, 2001
Wu, J. et al.; J Periodontol 73(6): 664-668, 2002

This Poster was submitted by Dr. med. dent. Priska Fischer.

Correspondence address:
Dr. med. dent. Priska Fischer
School of Dentistry, Department of Orthodontics
University of Freiburg
Hugstetterstr. 55
D-79106 Freiburg