Oral Surgery Oral Medicine Oral Pathology Oral Radiology最新文献

{"title":"Mesenchymal chondrosarcoma: three cases of the jaws and skull, each with variant histopathology; all confirmed with identification of the Hey1::NCOA2 fusion","authors":"Dr. Elizabeth Campbell ,&nbsp;Dr. Robert Kelsch ,&nbsp;Dr. Morris Edelman ,&nbsp;Dr. John Fantasia Zucker","doi":"10.1016/j.oooo.2024.04.066","DOIUrl":"https://doi.org/10.1016/j.oooo.2024.04.066","url":null,"abstract":"<div><h3>Introduction</h3><p>Mesenchymal chondrosarcoma is a high grade biphasic primitive tumor with foci of hyaline cartilage. The tumors may occur in bone or soft tissue and are common in the craniofacial region. Microscopically this neoplasm can be difficult to diagnosis. Identification of the Hey1::NCOA2 fusion confirms the diagnosis. Two cases involving the jaws and one of the skull are reported.</p></div><div><h3>Case Findings</h3><p>Case 1: A 44-year-old male with right jaw pain and facial asymmetry presented for evaluation. Imaging revealed a 7 cm destructive intraosseous mixed radiolucent-radiopaque lesion. Case 2: An 11-year-old male presented with swelling of left temporal region of two weeks duration. Imaging revealed a 5 cm destructive lesion with a mixed radiographic appearance. Case 3: An 11-year-old male presented with a 2 month post-traumatic unresolved reddish-blue soft tissue swelling of upper anterior labial mucosa. Imaging revealed minimal bony surface destruction of the anterior maxilla.</p></div><div><h3>Results</h3><p>Microscopic variability characterized the three cases. Case 1 exhibited classic histopathological presentation of nodules of cartilage surrounded by spindle cells. Case 2 predominately exhibited spindle cells with a pericytomatous vascular growth pattern without a cartilage component. Osseous components were identified; it was unclear whether the bone was native or neoplastic. Case 3 exhibited a monotonous spindle cell lesion suggestive of monophasic synovial sarcoma, but minute osteochondroid foci led to molecular interrogation. Molecular analysis in all three cases identified a Hey1::NCOA2, confirming the mesenchymal chondrosarcoma diagnoses.</p></div><div><h3>Conclusion</h3><p>Aggressive clinical behavior characterized all three cases. Histologically, the biphasic presentation was best represented in Case 1. Case 2 and 3 showed the characteristic primitive cells with minimal to no atypia; a minimal cartilaginous component was noted on extensive sampling of case 3. Mesenchymal chondrosarcoma was confirmed in each case by identifying the Hey1::NCOA2 fusion.</p></div>","PeriodicalId":49010,"journal":{"name":"Oral Surgery Oral Medicine Oral Pathology Oral Radiology","volume":"138 2","pages":"Pages e51-e52"},"PeriodicalIF":2.0,"publicationDate":"2024-07-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141605742","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":"Atypical spindle cell proliferation of indeterminate biological potential","authors":"Dr. Najwa Yousef ,&nbsp;Dr. Shahd Alajaji ,&nbsp;Dr. John Basile ,&nbsp;Dr. Ivan Stojanov Robert J. Tomsich ,&nbsp;Dr. Ahmed Sultan","doi":"10.1016/j.oooo.2024.04.077","DOIUrl":"https://doi.org/10.1016/j.oooo.2024.04.077","url":null,"abstract":"<div><h3>Case Presentation</h3><p>A 39-year-old female with unremarkable medical history presented with severe, generalized gingival enlargement of all quadrants. The gingival swelling was present for six years but only recently caused discomfort in addition to increasing tooth mobility. The patient denied any constitutional symptoms and was not taking any medications. She did not have any cutaneous, ocular, or genital lesions. She has had three miscarriages in the past and of note, the patient's symptoms worsen during pregnancy. On clinical examination all four quadrants demonstrated diffuse maxillary and mandibular buccal and lingual erythematous gingival enlargement associated with displacement of teeth and associated mobility. Radiographs showed generalized horizontal bone loss in both the maxilla and mandible. The clinical differential diagnosis of the severe gingival swelling included acute leukemia, lymphoma, inflammatory bowel disease, plasma cell gingivitis, and drug-induced gingival overgrowth. An incisional biopsy demonstrated a densely cellular proliferation of spindle cells arranged in a storiform pattern of short fascicles suggestive of a mesenchymal proliferation. The connective tissue stroma also showed areas of atypical metaplastic osteoid and chondroid deposition. Small islands of clear cells reminiscent of odontogenic islands were found encased within the osteoid deposits. There were also aggregates of granular cells noted. A comprehensive IHC panel included SATB2 (diffusely positive), CD56 (+ve), SSTR2A (focal +ve), CK19 (-ve but highlighted odontogenic epithelial nests), and the following stains were negative: AFB/ZN, TLE-1, MUC-4, ERG, CK7, CK20, Desmin, STAT-6, S-100, SOX-10, CD34, CD99, CD68, CD45, Kappa/Lambda (polytypic), and Ki67 (low). Molecular work-up for phosphaturic mesenchymal tumor was performed and CISH for fibroblast growth factor 23 (FGF23) was negative.</p></div><div><h3>Conclusion</h3><p>The features are most likely to represent multifocal peripheral ossifying/odontogenic fibromatosis supported by diffuse SATB2 expression which suggests origin from the periodontal ligament. Additionally, the findings may be in part related to an underlying undiagnosed genetic/hereditary etiology.</p></div>","PeriodicalId":49010,"journal":{"name":"Oral Surgery Oral Medicine Oral Pathology Oral Radiology","volume":"138 2","pages":"Pages e56-e57"},"PeriodicalIF":2.0,"publicationDate":"2024-07-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141605775","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":"Systemic associations of oral lichen planus and oral lichenoid lesions, a retrospective case-control study of 301 patients","authors":"Dr. Mari Vehviläinen,&nbsp;Prof. Tuula Salo,&nbsp;Dr. Maria Siponen","doi":"10.1016/j.oooo.2024.04.025","DOIUrl":"https://doi.org/10.1016/j.oooo.2024.04.025","url":null,"abstract":"<div><h3>Objective</h3><p>The objective of this study was to evaluate the association between oral lichen planus (OLP)/oral lichenoid lesions (OLL) and other comorbidities, especially thyroid gland diseases and in addition, the risk of oral squamous cell carcinoma (OSCC).</p></div><div><h3>Material and methods</h3><p>We performed a retrospective case-control study by using medical data of 301 OLP/OLL patients and 301 age- and sex-matched controls who had visited Kuopio University Hospital (KUH), Finland between years 1996 and 2017. The medical history, the use of regular medications, allergies, presence of LP elsewhere in the body and clinical features of OLP/OLL lesions were registered. In addition, we studied how many of OLP/OLL patients developed a OSCC after at least a 6-year follow up time.</p></div><div><h3>Results</h3><p>The prevalence of autoimmune hypothyroidism (HT) was 12.2% in OLP group, 18.8.% in OLL group and 9% (n=27) in the control group; the estimated odds ratios being 1.425 [95% CI 0.793 to 2.562] for OLP and 2.292 [95%CI 1.175 to 4.47] for OLL. Patients with HT had more often erosive mucosal lesions compared to patients without HT. Allergies were seen in 32.9% (n=99) of OLP/OLL cases and in 22.9% (69) of controls; the estimated odd ratio being 1.726 (1.184 to 2.516) for OLP/OLL. 6 of 205 OLP patients (3%) and 5 of 96 OLL patients (5.2%) developed OSCC. Most of the OSCCs (4/6) were located in the tongue in OLP group and in OLL group the cancers were randomly distributed.</p></div><div><h3>Conclusions</h3><p>This study confirms the previously seen association of OLP/OLL and thyroid diseases, especially hypothyroidism. In this study OLL was more strongly associated with HT than OLP. In addition, an association was seen between OLP/OLL and allergies. OLP and especially OLL increase the risk of OSCC.</p></div>","PeriodicalId":49010,"journal":{"name":"Oral Surgery Oral Medicine Oral Pathology Oral Radiology","volume":"138 2","pages":"Page e36"},"PeriodicalIF":2.0,"publicationDate":"2024-07-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141605856","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":"Incidence of Squamous Cell Carcinoma In Patients Under the Age of 45yo from 2003-2023","authors":"Dr. Jayinee Adhvaryu ,&nbsp;Dr. Rachelle Cadet ,&nbsp;Dr. Paul Freedman ,&nbsp;Dr. Renee Reich","doi":"10.1016/j.oooo.2024.04.026","DOIUrl":"https://doi.org/10.1016/j.oooo.2024.04.026","url":null,"abstract":"<div><h3>Introduction</h3><p>Squamous Cell Carcinoma (SCC) is the most common malignant tumor in the oral cavity and has been reported to be more common in older men. It has been associated with smoking, smokeless tobacco and alcohol. Recent studies have posited an increase in incidence of oral SCC in younger populations. The objective of this study is to examine incidence of oral SCC in different age groups, stratified by sex and site.</p></div><div><h3>Materials and Methods</h3><p>Demographic information was collected by searching the Oral Pathology Laboratory, Inc/ NYPQ database from 2003-2023. Data was collected for all SCCs and separated into 5 year age brackets (&lt;45, &lt;40, &lt;35 and &lt;30) and by decade (2003-2010, 2011-2020 and 2021-2023) This was further subcategorized by location and by gender.</p></div><div><h3>Results</h3><p>The incidence of SCC decreased in the &lt;40 and &lt;45 yo age brackets from 2003-2023 by 1.1% and 1.54%, respectively. The incidence of SCC increased in the &lt;30 and &lt;35 yo age brackets from 2003-2023 by 0.7% and 0.4%, respectively. While the incidence of SCC amongst females decreased from 2003-2023, the incidence of SCC on the tongue in females in the &lt;40, &lt;35 and &lt;30 yo age brackets increased from 2003-2023 by 17.1%, 20% and 33.3%, respectively. For men, the incidence of SCC varied over the years and across age brackets, with the highest incidence occurring in 2011-2020. The incidence of tongue SCC in men increased as age decreased. From 2003 to 2023, its incidence increased in all age groups except the &lt;30 age group where it decreased by 16.9%.</p></div><div><h3>Conclusion</h3><p>This study shows a slight increasing trend in SCC in all patients &lt;35. There's a marked increase in females with SCC of the tongue. Further demographic information is needed to better understand the etiology of these trends.</p></div>","PeriodicalId":49010,"journal":{"name":"Oral Surgery Oral Medicine Oral Pathology Oral Radiology","volume":"138 2","pages":"Page e37"},"PeriodicalIF":2.0,"publicationDate":"2024-07-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141605857","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":"Sensitizing oral squamous cell carcinoma to chemotherapy by targeted disruption of cancer stem cells using an NFκB inhibitor","authors":"Prof Pablo Agustin Vargas ,&nbsp;Dr. Luan César da Silva ,&nbsp;Prof. Rogério Moraes Castilho","doi":"10.1016/j.oooo.2024.04.048","DOIUrl":"https://doi.org/10.1016/j.oooo.2024.04.048","url":null,"abstract":"<div><h3>Introduction</h3><p>Oral squamous cell carcinoma (OSCC) shows a limited response to current systemic treatments, and this resistance could be associated with cancer stem cells (CSC). NFκB is an activated pathway in several malignancies, including head and neck cancer. Here we evaluated the role of NFκB inhibitor on the behavior of CSC derived from OSCC.</p></div><div><h3>Material and methods</h3><p>Emetine was used as an NFκB inhibitor. CSC presence was assessed by tumorspheres, and the emetine IC&lt;sub&gt;50&lt;/sub&gt; was determined in this specific cell population. Also, the CSC was quantified by the enzymatic activity of aldehyde dehydrogenases (ALDH) using flow cytometry. Immunofluorescence staining for phosphorylated protein p65 was used to identify the NFκB levels of tumor cells. Finally, OSCC cells were sensitized with emetine for 24 hours followed by administration of cisplatin (IC&lt;sub&gt;50&lt;/sub&gt;).</p></div><div><h3>Results</h3><p>The IC&lt;sub&gt;50&lt;/sub&gt; of emetine in CSC OSCC was 0.5μM. We then treated the OSCC cells with the emetine IC&lt;sub&gt;50&lt;/sub&gt;, which showed a significant reduction of the ALDH population, while the NFκB pathway was inhibited. Further, emetine sensitized OSCC cells to cisplatin, resulting in a reduction of the IC&lt;sub&gt;50&lt;/sub&gt; from 3.9μM to 1.3μM for SCC9.</p></div><div><h3>Conclusion</h3><p>Our results suggested that CSCs play an important role in tumor resistance to chemotherapy and highlight the disruption of these cells by the NFκB inhibition as a promisor target therapy.</p></div>","PeriodicalId":49010,"journal":{"name":"Oral Surgery Oral Medicine Oral Pathology Oral Radiology","volume":"138 2","pages":"Pages e44-e45"},"PeriodicalIF":2.0,"publicationDate":"2024-07-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141605870","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":"Medication-Associated Osteonecrosis: Exploring the Efficacy of Sonodynamic Therapy in a Series of Cases","authors":"Ms. Larissa Agatti ,&nbsp;Dr. Paulo Moraes ,&nbsp;Dr. Aguinaldo Garcez ,&nbsp;Ms. Luiza Hellmeister ,&nbsp;Dr. Daniela Prata Tacchelli ,&nbsp;Dr. Marcelo Sperandio ,&nbsp;Dr. Victor Montalli","doi":"10.1016/j.oooo.2024.04.032","DOIUrl":"https://doi.org/10.1016/j.oooo.2024.04.032","url":null,"abstract":"<div><p>This study presents a series of six cases involving patients who underwent previous cancer treatments and utilized bisphosphonates, monoclonal antibodies, and high-dose corticosteroids, subsequently experiencing osteonecrosis in the oral cavity. The associated challenges included pain, recurrent infections, diminished quality of life—especially in terms of food intake—and social discomfort due to characteristic lesion odor. Medication-associated osteonecrosis (OAM) is identified as an injury leading to the temporary or permanent loss of blood supply to bones, with diverse causal factors. Patients underwent thorough anamnesis, substantiating medication use via medical prescriptions, clinical examinations by qualified Dental Surgeons, and imaging assessments including panoramic radiography, periapical radiographs during follow-up, and, in specific cases, computed tomography. The treatment involved weekly monitoring, adjusting consultation frequencies as the condition stabilized, and implementing Sonodynamic Therapy (SDT). SDT, an innovative approach, utilizes low-frequency, high-intensity ultrasound to stimulate sonosensitizers, inducing the formation of reactive oxygen species (ROS). A non-invasive treatment, SDT offers site-specific cytotoxicity by generating ROS in response to sonic/ultrasonic sources, potentially treating bacterial infections. All six patients treated with SDT experienced improved quality of life, as documented through visual evidence. The adaptability of SDT to equipment emitting sonic/ultrasonic waves envisions broader applications, particularly in resource-limited regions, rendering it a potentially accessible method for both professionals and patients. This research underscores the promising outcomes of SDT in managing medication-associated osteonecrosis, paving the way for further exploration and potential integration into broader clinical practices.</p></div>","PeriodicalId":49010,"journal":{"name":"Oral Surgery Oral Medicine Oral Pathology Oral Radiology","volume":"138 2","pages":"Page e39"},"PeriodicalIF":2.0,"publicationDate":"2024-07-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141605872","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":"Idiopathic gingival papillokeratosis with crypt formation: a report of 7 additional cases of an uncommon entity","authors":"Dr. Ana Luiza Roza ,&nbsp;Dr. Alberto Peraza Labrador ,&nbsp;Dr. Spencer Armuth ,&nbsp;Dr. Victoria Woo ,&nbsp;Dr. John Wright ,&nbsp;Dr. Aline Abrahão ,&nbsp;Dr. Letícia Cabido ,&nbsp;Dr. Aline Romañach","doi":"10.1016/j.oooo.2024.04.050","DOIUrl":"https://doi.org/10.1016/j.oooo.2024.04.050","url":null,"abstract":"<div><h3>Introduction</h3><p>Idiopathic gingival papillokeratosis with crypt formation (IGPCF) is an uncommon condition of unknown etiology, characterized by keratotic plaques in the upper labial attached gingiva of young patients. No treatment is required, although periodic follow-up is recommended as some lesions persist. Despite the limited number of published cases, the diagnosis of IGPCF is highly suggestive based on the distinctive clinical features, and biopsy is usually unnecessary. We aim to report seven additional patients with IGPCF from Brazil and the United States.</p></div><div><h3>Material and Methods</h3><p>Seven IGPCF cases were retrieved from the archives of the Oral Pathology Laboratories from the Federal University of Rio de Janeiro, Brazil, and Texas A&amp;M University, USA, between 2017 and 2023.</p></div><div><h3>Results</h3><p>Six patients were male, and one patient was female, with an average age of 15.8 years (ranging from 12 to 21). All patients presented with asymptomatic bilateral papillary white plaques located exclusively in the attached anterior gingiva with a duration ranging from 4 to 12 months. Six cases presented in the maxillary labial gingiva, whereas a single case was located in the mandibular labial gingiva. Clinically, the lesions appeared as well-demarcated symmetric white plaques with an irregular surface, stopping abruptly at the mucogingival junction. Incisional biopsies were performed on six patients with exuberant lesions, while an exclusively clinical diagnosis was established in a single patient with discrete plaques. Microscopic analysis revealed gingival mucosa showing overlying parakeratosis with papillary architecture and multifocal epithelial crypt-like invaginations with parakeratin plugging. Mild pseudoepitheliomatous hyperplasia was noticed, with no signs of epithelial atypia.</p></div><div><h3>Conclusion</h3><p>Clinicians should be aware of IGPCF and differentiate it from other papillary keratotic oral lesions. Reporting additional cases may provide further characterization of this unusual entity and improve understanding as it relates to etiology and prognosis.</p></div>","PeriodicalId":49010,"journal":{"name":"Oral Surgery Oral Medicine Oral Pathology Oral Radiology","volume":"138 2","pages":"Page e45"},"PeriodicalIF":2.0,"publicationDate":"2024-07-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141604918","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":"MAML2 Positive Nodular Hidradenoma Presenting as a Subcutaneous Submental Mass – The Importance of Clinical Correlation","authors":"Dr. Julia Price ,&nbsp;Dr. Stephen Roth ,&nbsp;Dr. Sheldon Genack ,&nbsp;Dr. Sadaf Sheikh ,&nbsp;Dr. John Fantasia","doi":"10.1016/j.oooo.2024.04.068","DOIUrl":"https://doi.org/10.1016/j.oooo.2024.04.068","url":null,"abstract":"<div><h3>Introduction</h3><p>Nodular hidradenomas are benign adnexal neoplasms presenting as solitary asymptomatic intradermal nodules, often on facial skin. Tumors are covered by normal skin, but superficial ulcers may occur. Hidradenomas often exhibit cuboidal cells with pink cytoplasm, but clear cell, squamoid, plasmacytoid, and mucinous variants have been described. Malignant counterpart of hidradenoma exists. There is morphologic and molecular overlap between cutaneous adnexal tumors and salivary gland tumors, for example, hidradenoma and mucoepidermoid carcinoma (MEC).</p></div><div><h3>Case Findings</h3><p>A 64-year-old male patient presented with a submental subcutaneous mass for six months. A fine needle aspiration (FNA) was performed, based on the clinical suspicion for a granulomatous process and to rule out malignancy. FNA cytology was interpreted as positive for malignant cells, suspicious for squamous cell carcinoma (SCC). Constituent cells were p40 positive and negative for p16, androgen receptor (AR), and CD163. AFB staining negative for acid fast bacilli. Excision of the lesion was performed.</p></div><div><h3>Results</h3><p>Microscopic examination reveals a fragmented epithelioid tumor with squamoid, clear cell, glandular, and papillary features favoring a benign adnexal skin tumor. The proliferative index was &lt; 5%. Included in the differential diagnosis was MEC. Positive MAML2 gene rearrangement was identified on fluorescent in-situ hybridization (FISH). Upon consultation with dermatopathology, a diagnosis of benign nodular hidradenoma was rendered.</p></div><div><h3>Conclusions</h3><p>Clinical presentation, discussed with the surgeon, excluded association with salivary glands, emphasizing the subcutaneous location. Although there is morphologic and molecular overlap between nodular hidradenoma and MEC, clinical location supports the final diagnosis of a benign adnexal tumor, specifically benign nodular hidradenoma. In addition, MAML2 interrogation can help distinguish hidradenoma from other sweat gland neoplasms.</p></div>","PeriodicalId":49010,"journal":{"name":"Oral Surgery Oral Medicine Oral Pathology Oral Radiology","volume":"138 2","pages":"Pages e52-e53"},"PeriodicalIF":2.0,"publicationDate":"2024-07-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141605097","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 Correlation of p53, CK13, CK17, and Ki67 Immunostaining Patterns in Assisting the Histopathologic Grading of Oral Epithelial Dysplasia","authors":"Dr. Julia Yu-Fong Chang ,&nbsp;Dr. Yi-Ping Wang","doi":"10.1016/j.oooo.2024.04.070","DOIUrl":"https://doi.org/10.1016/j.oooo.2024.04.070","url":null,"abstract":"<div><h3>Introduction</h3><p>Different markers, such as p53, CK13, CK17, and Ki67, have been used to assist in the histopathologic grading of oral epithelial dysplasia (OED). This study aims to evaluate the correlation between these markers and histopathologic grading.</p></div><div><h3>Materials and Methods</h3><p>This retrospective study included 65 OED cases: 15 with mild dysplasia, 31 with moderate dysplasia, and 19 with severe dysplasia. Patient age, gender, lesion location, histopathologic grading, and expression patterns of p53, CK13, CK17, and Ki67 immunohistochemical studies were reviewed and analyzed.</p></div><div><h3>Results</h3><p>In our cases, half of the mild dysplasia and all of the moderate and severe dysplasia cases showed a reverse CK13/CK17 staining pattern. An increased number of Ki67-positive cells, located upward, were frequently associated with moderate and severe dysplasia cases. However, mutated p53 staining patterns were correlated with severe dysplasia (16/19; 84.2%). All our mild dysplasia cases showed a wild-type p53 staining pattern, and fewer than one-third (7/31; 22.6%) of moderate dysplasia cases revealed a mutated p53 staining pattern. The staining patterns were not associated with patient age and gender. Lesions at the ventral and lateral border of the tongue and soft palate were mainly associated with a mutated p53 staining pattern (12/14; 85.7% and 3/3; 100%, respectively). Only 17.5% (7/40) of the lesions on the buccal mucosa were associated with mutated p53.</p></div><div><h3>Conclusions</h3><p>The alteration in the CK13/17 staining pattern can be used to detect differentiation changes in early OED. Mutation of p53 is most likely a later event and is associated with more advanced OED.</p></div>","PeriodicalId":49010,"journal":{"name":"Oral Surgery Oral Medicine Oral Pathology Oral Radiology","volume":"138 2","pages":"Page e53"},"PeriodicalIF":2.0,"publicationDate":"2024-07-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141605099","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":"Cellular spindled histiocytic pseudotumor. A lesion previously undescribed in the oral cavity. A diagnostic trap.","authors":"Dr. Yeshwant Rawal","doi":"10.1016/j.oooo.2024.04.080","DOIUrl":"https://doi.org/10.1016/j.oooo.2024.04.080","url":null,"abstract":"<div><h3>Introduction</h3><p>The cellular spindled histiocytic pseudotumor is a rare, benign, and reactive mass-producing lesion that clinically and histopathologically mimics spindle cell neoplasms. There is only one previous report of twenty cases, all arising in the breast in association with fat necrosis. This is the first description of oral involvement.</p></div><div><h3>Materials and Method</h3><p>A 70-year-old male presented with a few month history of a painful swelling of the anterior maxilla. Teeth 8 and 9 were extracted approximately three years ago. A CBCT showed a mass partially covered by a thin rim of bone. Clinical suspicion for a neoplastic process was high and an incisional biopsy was submitted for histopathological evaluation.</p></div><div><h3>Results</h3><p>The lesion consisted of cohesive and compact fascicles of spindle cells with scattered lymphocytes. One focus of necrotic bone and degenerating fat was seen. Two pieces of likely graft foreign material were embedded among lesional cells towards one margin of the submitted tissue. Lesional cells were seen infiltrating surrounding skeletal muscle fibers. Mitotic figures were not obvious. Lesional cells expressed CD68 and CD163 strongly but were negative to AE1/AE3, S100, SMA, desmin, CD34 and CD21. A working diagnosis of reactive proliferation with features like a cellular spindled histiocytic pseudotumor was given. Thorough curettage and follow-up were recommended. Following a thorough curettage, healing was uneventful with no recorded recurrence.</p></div><div><h3>Conclusions</h3><p>The cellular spindled histiocytic pseudotumor is an exaggerated reactive response to degenerating fat and foreign material. The clinical and histopathological presentation is worrisome for benign and malignant spindle cell tumors. Incisional biopsies may not show degenerating fat or other foreign material. This is the first report of oral involvement. Awareness of this entity will prevent misadventures in its diagnosis and management.</p></div>","PeriodicalId":49010,"journal":{"name":"Oral Surgery Oral Medicine Oral Pathology Oral Radiology","volume":"138 2","pages":"Page e58"},"PeriodicalIF":2.0,"publicationDate":"2024-07-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141605106","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}