Statement of the Problem: When confronted with non-infectious granulomatous inflammation from the oral cavity, as pathologists it is important to relay information to the clinician to ensure appropriate testing is performed to rule out various causes of OFG
Findings: Crohn disease should be considered if abnormalities in hemoglobin, serum iron, transferrin or ferritin, Vitamin B12/folate are identified. GI endoscopy to evaluate for bowel involvement may be considered. Abnormal erythrocyte sedimentation rate or C-reactive protein studies can be seen in Fig. 5 a Low power magnification of Crohn disease. There are numerous similarities to idiopathic orofacial granulomatosis including epithelial hyperplasia, stromal edema and loosely formed granulomas with mixed inflammation.
Conclusion & Significance: typical granuloma from the lip in a patient diagnosed with Crohn disease. The granuloma is composed of epithelioid histiocytes, multinucleated giant cells, plasma cells, lymphocytes, and occasionally eosinophils  Although not always present, sarcoid granulomas can have lymphocytes along the periphery and within the granuloma. Elevated angiotensin-converting enzyme can be associated with sarcoidosis. Abnormal chest X-rays may indicate sarcoidosis or tuberculosis