Oral Surgery Oral Medicine Oral Pathology Oral Radiology最新文献

{"title":"Interobserver agreement in histopathologic diagnosis of oral lichen planus","authors":"Leen AlQudah,&nbsp;Si On Lim,&nbsp;Valerie Murrah,&nbsp;Ricardo Padilla","doi":"10.1016/j.oooo.2025.04.058","DOIUrl":"10.1016/j.oooo.2025.04.058","url":null,"abstract":"<div><h3>Introduction</h3><div>Oral lichen planus (OLP) is a chronic immune-mediated disorder with unknown etiology. Optimal OLP diagnosis takes both histopathological and clinical aspects into consideration. Diagnostic criteria for OLP have varied over the years. This study aimed to evaluate interobserver agreement using the 2016 American Academy of Oral and Maxillofacial Pathology (AAOMP) diagnostic criteria.</div></div><div><h3>Methods</h3><div>This retrospective observational cohort study included 102 archived tissue samples received at the UNC Oral and Maxillofacial Pathology Laboratory and diagnosed as OLP or oral epithelial dysplasia (OED). Seventy-four OLP and 28 OED cases were retrieved. Three board certified oral and maxillofacial pathologists assessed the blinded cases individually. Each observer (observer A, B, C) was provided with the following clinical information: anatomic location, number of lesions (multiple vs solitary), sex, and age. Statistical analyses were conducted using SAS (SAS Institute Inc.) version 9.4 with unweighted Cohen’s kappa (k) test utilized to measure interobserver agreement in pairs.</div></div><div><h3>Results</h3><div>Responses were categorized as OLP vs OED. This study demonstrated a concordance with signout diagnosis of OLP using the 2016 AAOMP criteria of 77%, 43%, 91% for observers A, B, and C, respectively; whereas the concordance with signout diagnosis of OED for all observers was 93%. Interobserver agreement using Cohen’s categories of k grading were as follows: Observers A and B: 0.42 (moderate), Observers B and C: 0.35 (fair), Observers A and C: 0.71 (substantial).</div></div><div><h3>Conclusion</h3><div>This study illustrates the range of variation that can occur between pathologists in the histopathologic diagnosis of OLP. Although some variation in interobserver agreement in OLP diagnosis was shown to occur in the study, the overall moderate agreement supports the use of 2016 AAOMP criteria. Importantly, the congruency of observers concerning the diagnosis of mild OED is significant as it supports the reliability of adequate existing histopathologic criteria for a premalignant condition.</div></div>","PeriodicalId":49010,"journal":{"name":"Oral Surgery Oral Medicine Oral Pathology Oral Radiology","volume":"140 3","pages":"Page e85"},"PeriodicalIF":2.0,"publicationDate":"2025-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144670555","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Phosphaturic mesenchymal tumor of the mandible presenting with an epithelial component in a patient with kidney dysfunction and tumor-induced osteomalacia","authors":"Jesse Bissell ,&nbsp;Carter Bruett ,&nbsp;Bryan Trump ,&nbsp;Mason Borsch ,&nbsp;David Adams ,&nbsp;Leslie Halpern","doi":"10.1016/j.oooo.2025.04.075","DOIUrl":"10.1016/j.oooo.2025.04.075","url":null,"abstract":"<div><div>Phosphaturic mesenchymal tumor (PMT) is a benign neoplasm that causes tumor-induced osteomalacia via secretion of fibroblast growth factor-23 (FGF-23). The FGF-23 secreted by osteocytes acts on the renal tubules causing phosphaturia. Patients exhibit hypophosphatemia and bone demineralization and endure significant loss of function and pain as a result. The patients have abnormal lab values before tumor resection such as an elevation in FGF-23 and serum alkaline phosphatase, low phosphorus, and low or unusually normal 1-25 dihydroxyvitamin D. However, in some cases, osteomalacia may not be apparent at the time of biopsy. Histologically, most PMTs present as nonspecific masses with difficult to discern features. The tumor contains a rich vascular supply which is often hemangiopericytoma-like and features a “grungy” calcifying matrix. Fibrohistiocytic spindled cells proliferate and can produce areas reminiscent of giant cell tumors of bone. Histological subtypes have been identified but appear to be minor morphologic variants. The diagnosis is challenging, and it can take years due to symptomatology, tumor localization, and diagnostic challenges. It is rarely reported in the head and neck, and when it involves the jaws, it can contain a variable epithelial component which complicates the diagnostic process. Here we report a case of a phosphaturic mesenchymal tumor presenting in the mandible with an epithelial component. We discuss the diagnostic challenges and the clinical outcome.</div></div>","PeriodicalId":49010,"journal":{"name":"Oral Surgery Oral Medicine Oral Pathology Oral Radiology","volume":"140 3","pages":"Page e91"},"PeriodicalIF":2.0,"publicationDate":"2025-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144670562","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Recreational drugs induced pemphigus: an atypical clinical and histologic presentation","authors":"Anwar AlMuzaini ,&nbsp;Jassem Bastaki","doi":"10.1016/j.oooo.2025.04.035","DOIUrl":"10.1016/j.oooo.2025.04.035","url":null,"abstract":"<div><h3>Introduction</h3><div>Pemphigus is a group of autoimmune blistering disease processes affecting the skin and mucosal surfaces. Pemphigus vulgaris is the most common form of pemphigus encountered in the oral cavity. Many causes have been attributed to the initiation of the disease process including drug use. Herein, we present a case of recreational Drug-Induced Pemphigus with atypical clinical and histologic features.</div></div><div><h3>Case Report</h3><div>A 39-year-old Kuwaiti male presented with a 2-year history of multiple recreational drug abuse, including hashish, ethanol, methamphetamine, and chemical, that triggered schizophrenia. Prior to admission to the psychiatric hospital, he developed oral ulcerations of 1-year onset. ELISA showed elevated DSG-3 and indirect immunofluorescence testing was “suggestive of pemphigus.” On exam, the patient had 2 small deep ulcers in the left buccal mucosa, white keratotic, and rough mucosal changes, and crusted labial verrucous lesions not typical of pemphigus. Multiple lesional samples were examined histologically and showed acantholysis, focal suprabasal epithelial clefting, focal superficial epithelial separation, and dyskeratosis. Focally, there was extensive dyskeratosis and tier keratosis, reminiscent of Darier disease. Direct immunofluorescence (DIF) testing was negative. Additional biopsies were performed from recently developing lesions with less hyperplasia and crusting to further asses the disease process and progression. Dyskeratosis was not as prominent and the diagnosis rendered was suggestive of Pemphigus with clinical and histologic features of Pemphigus vegetans and foliaceous. Systemic corticosteroid therapy was commenced and the patient started showing improvements a week later.</div></div><div><h3>Conclusions</h3><div>Recreational drug-induced pemphigus can pose a diagnostic challenge when the lesions clinically are not typical of pemphigus. Thorough history-taking and appropriate diagnostic modalities can facilitate early diagnosis and management.</div></div>","PeriodicalId":49010,"journal":{"name":"Oral Surgery Oral Medicine Oral Pathology Oral Radiology","volume":"140 3","pages":"Page e78"},"PeriodicalIF":2.0,"publicationDate":"2025-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144670632","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"DEK::AFF2 fusion-associated papillary nonkeratinizing squamous cell carcinoma of the sinonasal tract and middle ear: a case report and review of the literature","authors":"Sara Sternbach ,&nbsp;Elizabeth Knott ,&nbsp;Sarah Franklin ,&nbsp;Stephen Roth ,&nbsp;Jian Yi Li ,&nbsp;Judd Fastenberg","doi":"10.1016/j.oooo.2025.04.025","DOIUrl":"10.1016/j.oooo.2025.04.025","url":null,"abstract":"<div><h3>Introduction</h3><div>Nonkeratinizing squamous cell carcinoma (NKSCC) with the <em>DEK::AFF2</em> fusion is a new entity that was recently added to the 2022 5th edition of the WHO Classification of Tumors of the Head and Neck. This rare malignancy of the sinonasal tract, skull base, and middle ear can be deceptively bland and potentially mistaken as a sinonasal papilloma. We describe a case characterized by multifocal disease, that was initially interpreted as benign.</div></div><div><h3>Materials and Methods</h3><div>A 22-year-old female with no significant past medical history presented in January 2022 with right-sided nasal congestion and epistaxis. Initial biopsy and subsequent resection resulted in an initial diagnosis of inverted sinonasal papilloma. Three months post-op, the patient returned with continued nasal epistaxis, left-side hearing impairment with otalgia, and left facial weakness. CT scan demonstrated rapid recurrence of the tumor with a new finding of involvement of the middle ear and temporal bone.</div></div><div><h3>Results</h3><div>Microscopic examination of the recurrence revealed a nonkeratinizing basaloid epithelial process, exhibiting a papillary morphology with acute and chronic inflammation, and necrosis. Lesional epithelium was positive for cytokeratins AE1/AE3, CAM5.2, p63, SMARCB1/INI1 (retained), SMARCA4/BGR1 (retained), but negative for high-risk HPV. PD-L1 combined positive score was 5. Molecular analysis identified a <em>DEK::AFF2</em> fusion transcript. A diagnosis of <em>DEK::AFF2</em> fusion-associated papillary NKSCC of the sinonasal tract and middle ear was rendered.</div></div><div><h3>Conclusion</h3><div>This case exhibited the characteristic bland morphology that commonly leads to a misdiagnosis of a benign process. Immunohistochemical stains and molecular characterization resulted in the final diagnosis of <em>DEK::AFF2</em> fusion NKSCC, a rare and aggressive neoplasm with potential for locoregional nodal and distant metastasis. Currently, consistent effective therapeutic modalities have not been identified. However, an isolated case report suggested response to treatment with an immune checkpoint inhibitor.</div></div>","PeriodicalId":49010,"journal":{"name":"Oral Surgery Oral Medicine Oral Pathology Oral Radiology","volume":"140 3","pages":"Page e75"},"PeriodicalIF":2.0,"publicationDate":"2025-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144670741","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Visualizing trends in sign-out diagnoses at the LSU oral pathology biopsy service from 2012 to 2022","authors":"John Frazier,&nbsp;Molly Rosebush,&nbsp;Kitrina Cordell","doi":"10.1016/j.oooo.2025.04.027","DOIUrl":"10.1016/j.oooo.2025.04.027","url":null,"abstract":"<div><h3>Introduction</h3><div>Data visualization is a powerful tool to examine large datasets for trends over time. Unlike tabulated data, visualization techniques allow large amounts of data to be comprehended more easily using the power of the human visual system. In this presentation, data visualization will be used to assesses trends in oral biopsy sign-out diagnoses over the years 2012-2022.</div></div><div><h3>Methods</h3><div>The sign-out diagnoses for 31,100 specimens were obtained from the LSU oral pathology biopsy service database. This study has IRB approval. The data was cleaned and grouped by year into: Benign vs malignant, Benign soft tissue neoplasm, Bone lesions, Epithelial dysplasia, Epithelial lesions, Foreign bodies, Odontogenic cysts, Odontogenic neoplasms, Malignancies, Nonodontogenic cysts, Pigmented lesions, Salivary gland lesions, Salivary gland neoplasms, and Vascular lesions. Within each group, the most common diagnoses were kept as distinct entities. Less common diagnoses were then grouped as “Other.” For each group, stacked bar graphs by year and diagnosis were generated. Visualizations were done using R.</div></div><div><h3>Results</h3><div>The most common diagnosis and trends across years by group: Benign vs malignant: Benign—slight decrease. Benign soft tissue neoplasm: Fibroma-stable. Bone lesions: Viable bone-mild fluctuation. Epithelial dysplasia: Mild epithelial dysplasia-mild fluctuation. Epithelial lesions: Squamous papilloma-mild fluctuation. Foreign bodies: Amalgam tattoo-mild fluctuation. Odontogenic cysts: Dentigerous cyst-mild fluctuation. Odontogenic neoplasms: Odontoma-decrease. Malignancies: SCC-mild fluctuation. Nonodontogenic cysts: Nasopalatine duct cyst-significant fluctuation. Pigmented lesions: Melanotic macule-moderate fluctuation. Salivary gland lesions: Mucocele-stable. Salivary gland neoplasms: Pleomorphic adenoma-significant fluctuation. Vascular lesions: Pyogenic granuloma-stable.</div></div><div><h3>Conclusion</h3><div>A slight increase in total number of sign-outs was observed, however, the overall trends in sign-out diagnoses have remained relatively stable over the years.</div></div>","PeriodicalId":49010,"journal":{"name":"Oral Surgery Oral Medicine Oral Pathology Oral Radiology","volume":"140 3","pages":"Pages e75-e76"},"PeriodicalIF":2.0,"publicationDate":"2025-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144670743","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Massive intraosseous salivary gland choristoma—radiographically visible cluster of five mucous glands in mandibular marrow","authors":"Lakshmi Garladinne,&nbsp;Hiba Qari,&nbsp;Jerry Bouquot","doi":"10.1016/j.oooo.2025.04.014","DOIUrl":"10.1016/j.oooo.2025.04.014","url":null,"abstract":"<div><h3>Introduction</h3><div>Since first described in 1994, ectopic salivary glands (choristomas) have been reported in jawbone marrow in 19 patients, 14 in a single 2000 paper. Such entities, once described, provided for the first time a very logical nonodontogenic tissue of origin for intraosseous salivary neoplasms and cysts. Two reported choristomas were large enough to be radiographically visible. We present herein the largest, most “mature” example yet of this phenomenon.</div></div><div><h3>Methods and Materials</h3><div>Case report.</div></div><div><h3>Results</h3><div>An 18-year-old male had his impacted mandibular third molars removed, along with pericoronal cysts. An incidental finding just distal to the left third molar presented as an oval radiolucency with a faint, hazy, reticulated opacity and well-demarcated, scalloped borders. The area was asymptomatic, and the cortex was not expanded. Microscopic examination demonstrated a cyst lining of thin, atrophic stratified squamous epithelium consistent with dentigerous (eruption) cyst. Slightly separated from the cyst was a tight cluster of five independent (as per cut levels) mucous glands without serous demilunes, identical to minor salivary glands except for a lack of excretory ducts. The largest gland was 1.3 × 0.6 × 0.3 cm in size, more than twice as large as any previously described. The glands appeared histologically normal and even contained mucus (mucicarmine positive) in some ducts, something not previously reported. Serial sectioning showed no ducts traversing between glands. The glands were embedded within a mature fibrous stroma, with no true encapsulation noted; inflammation was not seen.</div></div><div><h3>Conclusion</h3><div>We report the largest yet example of the rare entity, intraosseous salivary choristoma (normal tissue in an abnormal location). This is only the second example to contain multiple glands, the third to show radiographically and the most “normal” gland yet, with ducts and mucus production, as demonstrated by secretions in some ducts. Glands were embedded in fibrous tissue.</div></div>","PeriodicalId":49010,"journal":{"name":"Oral Surgery Oral Medicine Oral Pathology Oral Radiology","volume":"140 3","pages":"Page e71"},"PeriodicalIF":2.0,"publicationDate":"2025-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144670849","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The profile of chronic hyperplastic candidiasis—long-term follow-up demonstrating low risk for malignant transformation","authors":"Orit Winocur-Arias ,&nbsp;Ayelet Zlotogorski-Hurvitz ,&nbsp;Marilena Vered ,&nbsp;Yehonatan Ben-Zvi ,&nbsp;Gavriel Chaushu ,&nbsp;Jeremy Edel ,&nbsp;Ilana Kaplan","doi":"10.1016/j.oooo.2025.04.018","DOIUrl":"10.1016/j.oooo.2025.04.018","url":null,"abstract":"<div><h3>Introduction</h3><div>Chronic Hyperplastic Candidiasis (CHC) is a rare lesion, recently removed by WHO from the list of potentially malignant disorders, although its differentiation from leukoplakia is controversial. The aims of this study were investigation of clinical presentation, systemic factors, and long-term malignant transformation rate in CHC vs leukoplakia without dysplasia (LKP).</div></div><div><h3>Material and Methods</h3><div>Retrospective case-controlled study of CHC and LKP without dysplasia, diagnosed between 2000 and 2013. A database was created, and additional biopsies from the same patients were searched for records of oral malignancy up to 2022.</div></div><div><h3>Results</h3><div>The study included 116 patients, 62 CHC, 54 LKP, matched for age, gender, and location with the CHC group; all biopsies were negative for dysplasia. The tongue and buccal mucosa were most frequently involved. In CHC, significantly fewer patients presented white lesions, more lesions were ulcerated or exophytic (<em>P</em> = .006 and <em>P</em> = .003, respectively). History of head and neck (H&amp;N) malignancy was significantly more frequent in CHC (<em>P</em> = .001), as were chemotherapy (<em>P</em> = .019), radiotherapy <em>P</em> = .026), and immune-related conditions (<em>P</em> = .03). No significant differences were found in the frequency of non-H&amp;N malignancy and other systemic condition evaluated. Within the follow-up period, in CHC 2 (3.2%) patients had a malignant transformation at the original site of CHC, of which one was a recurrence of previous OSCC. In addition, 2 (3.2%) patients were newly diagnosed with OSCC and 3 (4.8%) had a recurrence of OSCC at other locations. In LKP, 2 (3.7%) had newly diagnosed OSCC, 1 (1.7%) at the site of the original biopsy. No significant differences were found between groups.</div></div><div><h3>Conclusions</h3><div>Medical background of immune-related conditions, H&amp;N malignancy, radiotherapy to H&amp;N, and chemotherapy may play a role in predisposing for CHC. Malignant transformation rate in CHC lesions was low, similar to LKP without dysplasia, and represented a lower transformation rate than expected.</div></div>","PeriodicalId":49010,"journal":{"name":"Oral Surgery Oral Medicine Oral Pathology Oral Radiology","volume":"140 3","pages":"Pages e72-e73"},"PeriodicalIF":2.0,"publicationDate":"2025-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144670782","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Multifocal follicular adenomas of thyroid discovers PTEN-hamartoma tumor syndrome in children","authors":"John Hicks ,&nbsp;Catherine Flaitz","doi":"10.1016/j.oooo.2025.04.011","DOIUrl":"10.1016/j.oooo.2025.04.011","url":null,"abstract":"<div><h3>Introduction</h3><div>PTEN-hamartoma tumor syndrome (PHTS) is due to phosphatase and tensin homolog gene (PTEN, located on 10q23.3) deletion or mutation. This results in the loss of function of PTEN tumor suppressor inhibitory effects and regulation of cell proliferation, leading to the development of hamartomas and benign and malignant tumors.</div></div><div><h3>Methods and Materials</h3><div>Two preadolescent females presented with markedly enlarged thyroids, which upon ultrasound examination demonstrated multiple nodules of variable sizes. Thyroid function tests were not abnormal. Fine needle aspirations of the thyroid nodules demonstrated benign follicular lesions. Total thyroidectomies identified numerous multifocal follicular adenomas ranging from macroscopic to microscopic in size, with no malignant features.</div></div><div><h3>Results</h3><div>Molecular testing identified PTEN mutation with thyroid tissue, and subsequently identified germline PTEN mutation in both patients. Upon follow-up screening examination, a benign lipoma and hamartomatous ductal hyperplasia with PASH (pseudoangiomatous stromal hyperplasia) were identified in one patient; while the other patient had a breast intraductal papilloma and PTEN hamartoma of soft tissue (PHOST) involving an extremity. Both patients will be followed long-term for the development of other lesions.</div></div><div><h3>Conclusion</h3><div>PTEN-hamartoma tumor syndrome (PHTS) is primarily comprised of Cowden Syndrome and Bannayan–Riley–Ruvalcaba syndrome, and less often by Proteus-like syndrome, autism with macrocephaly, and other syndromes. A variety of thyroid diseases occurs in at least 75% of children with PHTS, with multiple adenomatous nodules being the hallmark, as in the present cases. Other thyroid diseases include lymphocytic thyroiditis, multinodular hyperplasia, and C-cell hyperplasia. The major long-term concern is the development of malignant tumors. Lifetime risk of cancer in individuals with PTEN mutations is significant and involves many organ systems (85% breast, 35% thyroid, 30% endometrium, 30% kidney, 12% colorectum, 5% melanoma). Multiple adenomatous nodules in a child may lead to the discovery of PHTS and reinforce the need for tumoral genetic testing in such instances.</div></div>","PeriodicalId":49010,"journal":{"name":"Oral Surgery Oral Medicine Oral Pathology Oral Radiology","volume":"140 3","pages":"Page e70"},"PeriodicalIF":2.0,"publicationDate":"2025-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144672099","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A clinical imaging study using a smartphone point-of-care autofluorescence device to facilitate the early detection of oral cancer in primary and community health clinical settings","authors":"Safia Durab ,&nbsp;Ruchika Mitbander ,&nbsp;Jackson Coole ,&nbsp;Alex Kortum ,&nbsp;Imran Vohra ,&nbsp;Jennifer Carns ,&nbsp;Richard Schwarz ,&nbsp;Ida Varghese ,&nbsp;Sean Anderson ,&nbsp;Hawraa Badaoui ,&nbsp;Loganayaki Anandasivam ,&nbsp;Rachel Giese ,&nbsp;Ann Gillenwater ,&nbsp;Rebecca Richards-Kortum ,&nbsp;Nadarajah Vigneswaran","doi":"10.1016/j.oooo.2025.04.081","DOIUrl":"10.1016/j.oooo.2025.04.081","url":null,"abstract":"<div><h3>Introduction</h3><div>Early diagnosis of oral cancer is key to improving prognosis and patient outcomes. Suspicious oral lesions are often encountered by front-line dental and medical practitioners who must decide whether to refer the patient to a specialist for biopsy and histopathology, which is the gold standard for diagnosis. The development of objective tools for screening of oral mucosal lesions that enable clinical risk stratification is imperative for improving early detection of oral cancer, especially in resource-limited primary care settings.</div></div><div><h3>Methods and Materials</h3><div>The mobile Detection of Oral Cancer (mDOC) device is a smartphone autofluorescence imaging system that captures wide field white light and autofluorescence images of the oral mucosa using optics in a custom 3D printed case. A custom Android application was developed to collect patient demographic information and to guide the clinician to collect widefield images in the oral cavity. Lesion specific characteristics are also recorded in the app. This study enrolled patients presenting to the UTHealth School of Dentistry and MD Anderson Cancer Center clinics for clinical evaluation. Referral decisions were determined by expert clinicians.</div></div><div><h3>Results</h3><div>Preliminary results consist of white light and autofluorescence image data from a total of 223 anatomic sites in 111 patients. Of these 223 sites, 174 sites prompted referral for further evaluation and 49 sites did not prompt referral for further evaluation based on expert clinical impression. This dataset is being used to develop an automated algorithm to generate a referral decision at the point of care.</div></div><div><h3>Conclusion</h3><div>The mDOC device serves as a simple tool to image the oral mucosa for objective screening, with the potential to enable earlier detection of oral lesions in primary care settings. Future work involves the implementation of diagnostic algorithms to inform site-level and patient-level referral decisions to determine whether a patient requires further evaluation.</div></div>","PeriodicalId":49010,"journal":{"name":"Oral Surgery Oral Medicine Oral Pathology Oral Radiology","volume":"140 3","pages":"Page e93"},"PeriodicalIF":2.0,"publicationDate":"2025-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144670564","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Oral manifestations of syphilis: an alarming trend in Kuwait","authors":"Anwar AlMuzaini ,&nbsp;Dalal Alomar ,&nbsp;Tareq Mohammad ,&nbsp;Jassem Bastaki","doi":"10.1016/j.oooo.2025.04.034","DOIUrl":"10.1016/j.oooo.2025.04.034","url":null,"abstract":"<div><h3>Introduction</h3><div>Syphilis, a sexually transmitted bacterial disease, is caused by <em>Treponema pallidum</em> (<em>T. pallidum</em>). The diagnosis of syphilis can be difficult without suspicion, and it’s made through serologic testing or direct detection of (<em>T. pallidum</em>) in biopsies<em>.</em> The stage at diagnosis and neurologic involvement determine the treatment.</div></div><div><h3>Case Series</h3><div>Eleven patients presented to different governmental clinics in Kuwait. Ten were males, and the patients ranged in age from 21 to 39.5 years old. While one patient had only a peri-anal lesion, the remainder presented with generalized oral/oropharyngeal painful lesions. The oral manifestations consisted of red/violaceous macules that progress into “waxy” mucosal thickening, “Mucus Patches.” Exophytic rough/papillary growth, “condylomata lata,” can develop. Less frequently, mucosal nodularity and “cobble-stoning,” similar to those seen in granulomatous processes, is observed. One peri-anal lesion from a male patient was only examined histologically in consultation and was clinically ulcerated pyogenic granuloma-like. Treponema IHC testing confirmed the diagnoses, while Warthin starry histochemical testing done on at least 5 cases was negative. Histologically, the lesions exhibited certain general diagnostically helpful features with different degree of manifestation across all biopsies. They are the presence of plasmacytic infiltrate submucosally, combined with the presence of neutrophils in the mucosal lining. Hyperplasia of the mucosa is helpful as well and can range from slight elongation of the rete ridges to a papillary/exophytic hyperplasia. The submucosal plasmacytic infiltrate also varies in the percentage of lymphocytes present and may extended deeper and with a perivascular pattern.</div></div><div><h3>Conclusion</h3><div>Syphilis can present a diagnostic challenge to unsuspecting diagnosticians. Oral lesions may be the first sign; thus dentists are on the frontline and must be familiar with it. Pathologists must be quick to test with Treponema IHC when certain histologic signs are observed in the biopsies. If misdiagnosed, or left untreated, the consequences can be a public health catastrophe.</div></div>","PeriodicalId":49010,"journal":{"name":"Oral Surgery Oral Medicine Oral Pathology Oral Radiology","volume":"140 3","pages":"Page e78"},"PeriodicalIF":2.0,"publicationDate":"2025-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144670631","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}