Pyogenic granuloma of the larynx and trachea. A causal and pathologic misnomer for granulation tissue.

Pyogenic granuloma has a diagnostic, lobular arrangement of capillaries that clearly distinguishes it, histologically, from granulation tissue. Recently, the accurate term, "lobular capillary hemangioma" (LCH), has been introduced to emphasize this characteristic appearance. A review of 639 vascular lesions of the oral cavity, upper respiratory tract, larynx, and trachea yielded 73 LCHs. All were located in nasal or oral mucous membranes. Conversely, every one of 62 vascular lesions from the trachea or larynx consisted of granulation tissue, without evidence of LCHs. There were clinical as well as pathologic differences. The LCHs arose spontaneously, whereas each patient with laryngeal or tracheal granulation tissue had a specific history of trauma. Pyogenic granuloma (ie, LCH) does not occur in the larynx or trachea.