Tophaceous Pseudogout in the Temporomandibular Joint: A Case Report

Nano Biomedicine

Tophaceous Pseudogout in the Temporomandibular Joint: A Case Report

Kazuma HARADA1, Susumu TANAKA1, Toshihiro UCHIHASHI1,
Kaori OYA2, Hiroyuki OHARA3, Jiro MIURA4,
and Mikihiko KOGO1

1The 1st Department of Oral and Maxillofacial Surgery, Osaka University Graduate School of Dentistry, Osaka, Japan
2Division for Clinical Laboratory, Osaka University Dental Hospital, Osaka, Japan
3Department of Dentistry, Oral Maxillofacial Surgery, Kyoto Renaiss Hospital, Kyoto, Japan
4Division for Interdisciplinary Dentistry, Osaka University Dental Hospital, Osaka, Japan

Nano Biomed 2020; 12(2):115-119, (Dec 30, Nano Biomedicine)

We report an unusual case of tophaceous pseudogout that appeared in the right temporomandibular joint (TMJ) accompanied with painless swelling at periauricular region of a Japanese elderly man. Radiographic examination including computed tomographic images revealed an exophytic radiopaque lesion with clear boundaries in the right peri-condylar region. Surgical resection was employed, and a microscopic examination of the surgical specimen showed the deposition of basophilic rhomboidal crystals around which foreign body reactions including multinucleated giant cells and chondrogenicity were localized. Aggregates of rhomboid crystalline deposits were exposed under polarized light. Further elemental analysis confirmed the involvements of Ca and P and positive birefringence under a polarizing microscope, which helped in the histopathological diagnosis of tophaceous pseudogout.

Key words: tophaceous pseudogout; calcium pyrophosphate dihydrate; pseudogout

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