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Question: After my surgery on my right side tongue which states mucosa nueroma associated with MEN Type III, I took the specimens in slides to other hospitals and pathologists for 2nd diagnosis and result shows chronic inflammation instead, but only with 1 pc h&e slide. A government hospital which I gave 1pc H&E and 9 pcs unstained lost all the unstained ones except the H&E slides which they claimed is 100% mine. With this H&E slides, 4 pathologist confirmed that it is not mucosa neuroma, but instead is same as the other side of my tongue, chronic foliate pappilitis. I went thro endocrine cancer tests immediately after my first surgery in Sept 2006 and another test in June 2007, all tests did not indicate any risk to endocrine cancer.

But on right side of my tongue a week ago, I saw some tiny red spots which will change to to look like papillae after a day or two. It is on the right side of my tongue position next to where the teeth is and not on top of the tongue. It looks more red than the normal papillae, doctors says it is actually capilaries (blood vessels), he explained that sometimes due to heat these capilaries may looks dilated (more buldging). Is this correct? They dont seems any bigger except looks a bit more buldging (papillae like). It has been a week now. Dr advised to go and see him again if it is bigger or lesion like. What is chronic inflammation or foliate pappilitis? Is it dangerous and why does it occur? How long normally before it subside, the inflammation which I had which was cut out didnt subside after 3 months. Can you provide me with more information on chronic inflammation of the papilae or foliate papilitis maybe with pictures.

Appreciate your advise.

Thank you. AL


 

 

Answer:

Dear AL,

Your doctor is correct , sometimes due to heat these capillaries (blood vessels), may looks dilated (more bulging).

Foliate papillitis is a inflamed vestigial foliate papillae on the posterior lateral tongue.

Foliate papillae is a group of numerous projections arranged in several transverse folds on the lateral margins of the tongue just anterior to the palatoglossal fold.

The foliate papillae is formed when a parallel mucosal folds on the margins of the tongue at the junction of its body and root.

Small bumps (papillae) cover the upper surface of the tongue.

Minor infections or irritations are the most common cause of foliate papillitis but
diabetic neuropathy, oral cancer, mouth ulcers, and leukoplakia (a complication of AIDS) may also be causes. Dental problems can be also a cause.

For patients with foliate papillitis, Shaduolika (a traditional Chinese herb), and dexamethasone (for pain relief) are safe and effective.

Foliate papillitis cab be dangerous if it is no treated .

Foliate papillitis may occur on the tongue for no apparent reason. While it is not medically proven some doctors believe that an allergic reaction to food or medication or dehydration, oral sex, or antibiotic side effects can cause Foliate papillitis.

Because Foliate papillae recognize bitter flavors try to recognize lemon and vinegar (two bitter flavors) in order to check the current condition of your foliate papillae.

You can see more information on chronic inflammation of the papilae or foliate papillitis with the following pictures:

Foliate Papillitis

Foliate Papillitis

Tongue and foliate papillae:

Foliate papillae:

Foliate papillae:

 

 

 

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