Pyogenic Granuloma: Understanding Your Pathology Report

Section Editor: Jason Wasserman MD PhD FRCPC
July 15, 2026

A pyogenic granuloma is a common, noncancerous (benign) growth made up of small blood vessels and inflammatory cells. It is usually round, and its surface often appears bright red because of the blood vessels inside. Another name for this growth is lobular capillary hemangioma, and you may see either name on your pathology report. Despite its name, a pyogenic granuloma is not an infection, does not produce pus, and is not a true granuloma; the name is a historical one that has stuck. It is not cancer, and the cells do not spread to other parts of the body. This article will help you understand the findings in your pathology report, what each term means, and why it matters for your care.

What causes a pyogenic granuloma?

Most pyogenic granulomas develop after a minor injury, such as a scratch, burn, or other irritation. This is especially true for growths that start inside the mouth (oral cavity) or nose (nasal cavity). For some people, no cause can be identified. Pregnancy also makes these growths more likely, particularly on the gums and lips, because of hormonal changes; when a pyogenic granuloma develops during pregnancy, it is sometimes called a granuloma gravidarum. Some medications have also been linked to their development.

Where are pyogenic granulomas found?

A pyogenic granuloma can develop almost anywhere in the body. The most common locations are the skin (especially the fingers and hands), the lips and inside of the mouth, and the nasal cavity. Growths that develop during pregnancy most often appear on the gums.

What are the symptoms?

A pyogenic granuloma often appears suddenly and may grow quickly at first, sometimes over just a few weeks, before slowing down. The most common symptom is bleeding, and the growth may bleed easily when touched, brushed, or bumped, sometimes disproportionate to its size. Some pyogenic granulomas are painful. Without treatment, some shrink gradually over weeks to months, and a few disappear entirely, although many persist and are removed.

How is the diagnosis made?

The diagnosis of a pyogenic granuloma is made after a pathologist examines the tissue under the microscope. This usually happens after the entire growth has been removed, although sometimes a small sample is taken first in a procedure called a biopsy.

Under the microscope, the cells on the outer surface of the tissue are often damaged or missing, a change pathologists call an ulcer. Beneath the surface, the growth consists of many small and medium-sized blood vessels. The smaller vessels tend to cluster around the medium-sized ones in rounded groups, a pattern pathologists describe as lobular, which is where the alternate name lobular capillary hemangioma comes from. The tissue between the blood vessels contains fluid and inflammatory cells, including neutrophils, plasma cells, and lymphocytes. This combination of blood vessels and inflammatory cells makes a pyogenic granuloma resemble granulation tissue, the tissue that normally forms during healing. For this reason, many doctors consider a pyogenic granuloma to be an overgrown healing reaction to an earlier injury rather than a true tumor. Because the diagnosis can usually be made from the microscopic appearance alone, additional tests are rarely needed.

Surgical margins

A surgical margin is the edge of the tissue that the surgeon cuts through when removing the growth. Margins are described in your report only after the entire pyogenic granuloma has been removed, not after a small biopsy. Because a pyogenic granuloma is noncancerous, the report may simply state that the growth was completely removed.

Negative margin — No abnormal tissue is present at the cut edge. This suggests the growth was completely removed.
Positive margin — Abnormal tissue is present at the cut edge. This is associated with a higher chance that the growth will come back in the same area.

What happens after the diagnosis?

A pyogenic granuloma is not a cancer, so no cancer treatment is needed. Many are treated simply by removing them completely, which also stops the bleeding that brought most people to the doctor in the first place. Removal may be done by shaving or cutting out the growth, and the base is sometimes treated to reduce the chance of it returning. Other approaches, such as laser treatment or freezing, are used in some situations.

Pyogenic granulomas can recur after removal, particularly if any of the growth is left behind, and may need to be treated again. Growths that develop during pregnancy often shrink or disappear on their own after delivery, so in some cases the care team may suggest simply watching them unless they bleed heavily or cause problems. Because a pyogenic granuloma can occasionally resemble other growths, having it examined by a pathologist helps confirm the diagnosis and rule out anything more serious.

Questions to ask your doctor

Was my growth completely removed?
Was the diagnosis confirmed by a pathologist under the microscope?
What is the chance that this will come back?
If it comes back, what are my options?
Is there anything I can do to reduce the chance of it returning?
My pyogenic granuloma developed during pregnancy. Is it likely to go away on its own after delivery?
What should I do if it starts bleeding again?
Do I need any follow-up appointments?
Could the growth have been caused by a medication I am taking?
Was there anything unexpected in my pathology report?