Table 6.

Summary of clinical presentation, histological features, common locations, radiographic features, and key differential points of different oral lesions

Lesion type	Clinical presentation	Histological features	Common location	Radiographic features	Key differential points
Fibrous epulis	Pink, smooth, sessile or pedunculated mass	Dense collagen fibre bundles	Interdental papilla	Usually no significant features	Firm texture, slow growth
Vascular epulis (PG)	Red or purple-red, easily bleeding	Capillary proliferation, inflammatory cell infiltration	Gingiva, often in anterior region	Usually no bone changes	Easy bleeding, rapid growth
Giant cell epulis	Red-purple or blue-brown, may be ulcerated	Multinucleated giant cells and mononuclear cells	Mandibular anterior region common	May show superficial bone resorption	May cause bone resorption
Gingival cyst	Blue or blue-grey translucent swelling	Cyst cavity lined with squamous epithelium	Free gingiva	No bone changes	Cystic characteristics, fluctuant on palpation
Gingival hyperplasia/Inflammatory hyperplasia	Diffuse enlargement of gingiva	Hyperplastic epithelium, increased connective tissue	Generalised or localised gingiva	No bone changes	Often drug-induced or associated with systemic conditions
Peripheral odontogenic fibroma	Firm, smooth-surfaced pink mass	Odontogenic epithelium in fibrous stroma	Attached gingiva	May show superficial bone erosion	Contains odontogenic epithelial rests
Peripheral ossifying fibroma	Pink, may be ulcerated	Fibrous tissue with osteoid or calcified material	Anterior and premolar gingiva	May show calcifications	Often has calcified or osseous tissue
Haemangioma	Purple-red, blanches on pressure	Endothelial cell proliferation, vascular space formation	Any oral site	Usually no bone changes	Blanches on pressure, deep-seated lesion
Bacillary angiomatosis	Red papules or nodules	Lobular proliferation of blood vessels, bacilli present	Any oral site	No specific features	Associated with immunosuppression, especially HIV
Conventional granulation tissue	Red, soft, granular surface	Newly formed capillaries, fibroblasts, inflammatory cells	Any site of wound healing	No specific features	Associated with healing process, resolves with time
Metastatic cancer	Irregular mass, may be ulcerated	Cancer cells similar to primary tumour	Any oral site	May show bone destruction	Rapid growth, history of primary tumour
Non-Hodgkin’s lymphoma	Firm, painless swelling	Monomorphic lymphoid cell infiltrate	Gingiva, palate common	May show bone destruction	Often part of systemic disease
Angiosarcoma	Poorly defined, purplish swelling	Malignant endothelial cell proliferation	Any oral site, palate common	May show bone destruction	Aggressive growth, poor prognosis
Kaposi’s sarcoma	Purple-red or brown patches or nodules	Spindle cells and atypical vessels	Hard palate common	May show bone erosion	Often in HIV-positive patients