Case report: a unique pediatric case of a primary CD8 expressing ALK-1 positive anaplastic large cell lymphoma of skeletal muscle

Primary involvement of skeletal muscle is a very rare event in ALK-1 positive anaplastic large cell lymphoma (ALCL). We describe a case of a 10-year old boy presenting with a three week history of pain and a palpable firm swelling at the dorsal aspect of the left thigh. Histological examination of the lesion revealed a tumoral and diffuse polymorphic infiltration of the muscle by large lymphoid cells. Tumor cells displayed eccentric, lobulated "horse shoe" or "kidney-shape" nuclei. The cells showed immunohistochemical positivity for CD30, ALK-1, CD2, CD3, CD7, CD8, and Perforin. Fluorescence in situ hybridization analysis revealed a characteristic rearrangement of the ALK-1 gene in 2p23 leading to the diagnosis of ALK-1 positive ALCL. Chemotherapy according to the ALCL-99-NHL-BFM protocol was initiated and resulted in a complete remission after two cycles. This case illustrates the unusual presentation of a pediatric ALCL in soft tissue with a good response to chemotherapy

Influence of orthopedic treatment on hard and soft facial structures of individuals presenting with Class II, Division 1 malocclusion: a comparative study A influência do tratamento ortopédico nas estruturas faciais de indivíduos com má oclusão de Classe II, 1ª Divisão: um estudo comparativo

The purpose of this investigation was to comparatively evaluate the cephalometric changes in soft and hard tissues related to treatment of Class II, division 1 malocclusion with activator-headgear and Bionator appliances. Twenty-four individuals formed the activator-headgear group and twenty-five comprised the Bionator group, while other twenty-four presenting the same malocclusion did not receive any intervention and served as controls. Lateral headfilms were taken at the beginning and at the end of the observation period and were digitized with computerized cephalometrics; cephalometric analysis was performed and the results were submitted to statistical test. According to the methodology employed, our findings suggested that both appliances do not significantly alter the growth path, and also they were not able to modify the posterior inferior height and the sagittal and vertical position of the upper lip. The lower lip and the soft menton were only slightly modified by the orthopedic appliances, but the mentolabial sulcus showed a significant decrease in deepness compared to the control group. Of statistical significance, only the anterior inferior hard and soft facial heights and the lower lip height increased more in the treated groups.<br>Esta pesquisa teve por objetivo avaliar, comparativamente, as alterações cefalométricas tegumentares e esqueléticas, decorrentes do tratamento das más oclusões de classe II, 1a divisão, com o ativador combinado com a ancoragem extrabucal e com o bionator. O grupo tratado com o ativador combinado com a ancoragem extrabucal foi composto por 24 indivíduos e o grupo tratado com o bionator compreendeu 25 pacientes, enquanto que outros 24 indivíduos compuseram o grupo controle, apresentando a mesma má oclusão, porém sem terem sido submetidos a nenhuma terapia ortodôntica. Obteve-se telerradiografias laterais de todos os indivíduos no início e final do período de observação que foram digitalizadas e seus traçados cefalométricos computadorizados realizados e submetidos ao teste estatístico. De acordo com a metodologia empregada, os resultados sugerem que ambos os aparelhos não foram capazes de alterar, significaticamente, o padrão de crescimento facial assim como a altura facial posterior inferior e o posicionamento sagital e vertical do lábio superior. Os aparelhos ortopédicos alteraram ligeiramente o lábio inferior e o mento tegumentar, porém o sulco mentolabial foi signifivativamente reduzido nos grupos tratados em comparação com o grupo controle. As alturas faciais esquelética e tegumentar, bem como a altura do lábio inferior foram significativamente aumentadas com a terapia ortopédica, alcançando diferença estatística em relação ao grupo controle

Comparative study of dental arch width in plaster models, photocopies and digitized images

The aim of this study was to comparatively assess dental arch width, in the canine and molar regions, by means of direct measurements from plaster models, photocopies and digitized images of the models. The sample consisted of 130 pairs of plaster models, photocopies and digitized images of the models of white patients (n = 65), both genders, with Class I and Class II Division 1 malocclusions, treated by standard Edgewise mechanics and extraction of the four first premolars. Maxillary and mandibular intercanine and intermolar widths were measured by a calibrated examiner, prior to and after orthodontic treatment, using the three modes of reproduction of the dental arches. Dispersion of the data relative to pre- and posttreatment intra-arch linear measurements (mm) was represented as box plots. The three measuring methods were compared by one-way ANOVA for repeated measurements (&#945; = 0.05). Initial / final mean values varied as follows: 33.94 to 34.29 mm / 34.49 to 34.66 mm (maxillary intercanine width); 26.23 to 26.26 mm / 26.77 to 26.84 mm (mandibular intercanine width); 49.55 to 49.66 mm / 47.28 to 47.45 mm (maxillary intermolar width) and 43.28 to 43.41 mm / 40.29 to 40.46 mm (mandibular intermolar width). There were no statistically significant differences between mean dental arch widths estimated by the three studied methods, prior to and after orthodontic treatment. It may be concluded that photocopies and digitized images of the plaster models provided reliable reproductions of the dental arches for obtaining transversal intra-arch measurements

Avaliação comparativa do espaçamento anterior em nipo-brasileiros e leucodermas, na dentição decídua Comparative assessment of anterior spacing in Japanese-Brazilian and white children in the primary dentition

OBJETIVO: avaliar comparativamente a prevalência das características de espaçamento anterior em nipo-brasileiros e leucodermas, na dentição decídua. MÉTODOS: duas amostras de crianças com 2 a 6 anos de idade foram selecionadas: 405 nipo-brasileiros de 36 escolas do estado de São Paulo e 510 leucodermas de 11 instituições públicas da cidade de São Paulo. As variantes oclusais foram classificadas em quatro categorias, nas arcadas superior e inferior: espaçamento generalizado; somente espaços primatas; ausência de espaços; e apinhamento. Foi aplicada regressão logística para análise do efeito dos fatores idade, sexo e grupo étnico sobre a prevalência das características oclusais (&#945; = 0,05). RESULTADOS: em nipo-brasileiros, o espaçamento generalizado foi a característica mais prevalente nas arcadas superior (46,2%) e inferior (53,3%). A frequência dos espaços primatas foi maior na arcada superior (28,2% versus 15,3%). Para a ausência de espaços (21,7-26,4%) e o apinhamento (4,0-4,9%), a variação entre as arcadas foi relativamente pequena. Em leucodermas, a ausência de espaços e a presença exclusiva dos primatas evidenciaram distribuição similar à observada nos nipo-brasileiros. O espaçamento generalizado foi diagnosticado em aproximadamente 50% das arcadas. A prevalência de apinhamento foi maior na arcada inferior (12,8% versus 3,9%). O único modelo de regressão logística que apresentou algum fator significativo foi o ajustado para a prevalência de apinhamento. Apenas o fator racial foi significativo (p < 0,001). CONCLUSÃO: sugere-se que as características de espaçamento anterior, na dentição decídua, não estariam condicionadas à idade ou ao sexo. Contudo, leucodermas teriam chances 2,8 vezes maiores de apresentar apinhamento na arcada inferior, em comparação aos nipo-brasileiros.<br>OBJECTIVE: To carry out a comparative evaluation of the prevalence of anterior spacing characteristics in Japanese-Brazilian and white children in primary dentition. METHODS: Two selected samples of children aged 2-6 years were: 405 Japanese-Brazilians from 36 schools in the State of São Paulo and 510 white children from 11 public institutions in São Paulo city. The spacing features in the maxillary and mandibular arches were assigned to four categories: generalized spacing; only primate spaces; no spacing; and crowding. Logistic regression was used to analyze the effect of age, gender and ethnic group on the prevalence of the occlusal characteristics (&#945;=0.05). RESULTS: In Japanese-Brazilians, generalized spacing was the most prevalent trait in the maxillary (46.2%) and mandibular (53.3%) arches. The frequency of primate spaces was higher in the maxillary arch (28.2% versus 15.3%). Concerning no spacing (21.7-26.4%) and crowding (4.0-4.9%), the variation between arches was relatively small. In white children, no spacing and exclusive presence of primate spaces showed distributions similar to that observed in Japanese-Brazilians. Generalized spacing was diagnosed in approximately 50% of the arches. Crowding prevalence was higher in the mandibular arch (12.8% versus 3.9%). The regression model adjusted for crowding prevalence was the only significant one. Only racial factor was significant (p<0.001). CONCLUSION: It may be suggested that anterior spacing features in primary dentition would not be influenced by age or gender. Nevertheless, white children would have 2.8 times more chances of presenting crowding in the mandibular arch, in comparison with Japanese-Brazilians