Gossypiboma in the oral region: case report and literature review

Gossypiboma is an inflammatory reaction to a foreign body, specifically composed of a cotton matrix left behind after surgery. The present study aims to present a case report of gossypiboma 23 years after a dental surgery and to make a literature review of the English language cases published on the issue. A 42-year-old woman was attended to evaluate complaints of pain on the right side of the maxilla. The patient reported that dental extractions in this region had been performed over a period of nearly 23 years. The panoramic radiograph demonstrated an opacity in the right maxillary sinus, which presented a spongiform aspect, irregularly shaped radiopaque image, as well as a rupture of the maxillary sinus's lower cortical layer. A surgical excision was performed, and the histopathological diagnosis was of gossypiboma. Six similar cases have also reported of gossypiboma in the oral region; however, calcification was only identified in the present case report. The patient is currently undergoing follow-up and has presented no complaints of pain or recurrence

Diffuse large B-cell lymphoma, not otherwise specified of the palate: a case report

Diffuse large B-cell lymphoma (DLBCL) is the most frequent type of non-Hodgkin´s lymphoma found in oral and maxillofacial regions. A large number of cases may be biologically heterogeneous, which are commonly defined as DLBCL, not otherwise specified (NOS) by the World Health Organization (WHO-2008). The present case reports on an ulcer of raised and irregular edges, found on the border between the hard and soft palate, as the first and only manifestation of an extranodal non-Hodgkin lymphoma in an 85-year-old patient. Incisional biopsy was carried out, and the specimen revealed a proliferation of large lymphoid cells suggestive of diffuse large cell lymphoma. An immunohistochemical analysis was performed. EBV-RNA was assessed by in situ hybridization that also proved to be negative. Immunohistochemical and EBV analyses are important to avoid delays and inappropriate treatment strategies. Although advanced age is considered an adverse prognostic factor, early diagnosis did prove to be a key contributory factor in the cure of non-Hodgkin lymphoma

Desmoplastic fibroblastoma (collagenous fibroma) of the oral cavity

Desmoplastic fibroblastoma is benign soft tissue tumor, with fibroblastic or myofibroblastic origin, that rarely occurs in oral cavity. We reported the case of a 56-year-old man who presented a tumor in the left mandibular alveolar ridge, with slow and asymptomatic growth, with no osseous involvement. The tumor was sessile with lobulated surface, covered by healthy mucosa with erythematous areas. The lesion was excised and specimens sent to histopathology and immunohistochemistry. Histopathological exam showed a non-encapsulated fibroblastic proliferation, characterized by myofibroblasts, spindle and stellate fibroblasts with large or oval nuclei and bi or tri nucleation, immersed in an abundant hypocellular dense collagen stroma. Tumor cells were positive for vimentin, HHF35, α-smooth muscle actin and factor XIIIa. The diagnosis of desmoplastic fibroblastoma was based in the clinical history of absence of trauma related to the growth in the alveolar ridge, associated with macroscopic, microscopic and immunohistochemical features. The patient is free-diseases by eight month

Immunohistochemical analysis for CD21, CD35, Caldesmon and S100 protein on dendritic cells types in oral lymphomas

OBJECTIVE: Follicular dendritic cells (FDCs) and interdigitating dendritic cells (IDCs) are dendritic cells found in lymphoid follicles, reactive follicles and in lymphomas. The goal of this study was to evaluate the presence and distribution of FDCs and IDCs in oral lymphomas. MATERIAL AND METHODS: Immunohistochemistry reactions were applied to 50 oral lymphomas using the antibodies anti-CD21, anti-CD35 and anti-caldesmon to FDCs, and anti-S100 protein to IDCs. Caldesmon+/FDCs and S100+/IDCs were quantified in Imagelab® software. RESULTS: FDCs revealed by CD21 and CD35 were positively stained in two cases of diffuse large B-cell lymphoma, one MALT lymphoma, and in one case of mantle cell lymphoma. FDCs were immunopositive to caldesmon in all cases, as well as IDCs to S100 protein. Burkitt lymphoma presented a lower amount of caldesmon+/FDCs and S100+/IDCs than diffuse large B-cell lymphoma and plasmablastic lymphoma of the oral mucosa type. CONCLUSIONS: The microenvironment determined by neoplastic lymphoid cells in oral lymphomas is responsible by the development and expression of dendritic cells types

Lingual Lymphangioma Ablation With High Power Diode Laser: A Case Report

Introduction: Lymphangioma is a rare vascular anomaly that affects the lymphatic vessels. Its etiology is not yet clear and it usually occurs in the head and neck region. This pathology is commonly diagnosed in childhood and there is no consensus about the most effective treatment of it.Case Report: We report a case of lymphangioma located on the dorsum of the tongue in a 9-year-old boy, with the clinical appearance of small transparent vesicles similar to “frog-eggs”. The diagnosis was defined according to the clinical aspect and ultrasound images. The treatment performed consisted of two sessions of ablation with a high-power diode laser.Conclusion: High-intensity diode laser ablation was a safe and effective tool for the treatment of this lesion in the tongue, which provided the patient with a faster, efficient transoperative period and a more comfortable postoperative period.

CONSTRUÇÃO E VALIDAÇÃO DE INSTRUMENTO DE CONSULTA DE ENFERMAGEM PARA PESSOAS COM HEMOFILIA

Objetivo: construir e validar um instrumento de consulta de enfermagem para pessoas com hemofilia.Método: estudo metodológico realizado de fevereiro de 2017 a fevereiro de 2018, em um serviço referência de hematologia do Nordeste do Brasil. Utilizou-se a técnica Delphi para validação, por três grupos de enfermeiras juízas (n=29): Especialistas em hemofilia (n=nove) de nove hemocentros do país; Residência em Hematologia (n=oito); Enfermeiras do Serviço (n=12). A concordância entre as juízas foi verificada por escala Likert e teste exato de Fisher.Resultados: 89,6% não apresentaram dificuldade para compreender o instrumento. Quanto ao grau de relevância, as características ‘credibilidade’ e ‘cientificidade’ apresentaram maiores percentuais de extremamente relevante (90%). O teste exato de Fisher foi significativo no grau de satisfação de ‘clareza das afirmações’ (p<0,05).Conclusão: o instrumento foi considerado válido, proporcionando autonomia, apoio técnico e respaldo ético ao enfermeiro, contribuindo na melhoria da qualidade da assistência.Objective: to construct and validate a nursing consultation instrument for people with hemophilia.Method: methodological study conducted from February 2017 to February 2018, in a hematology reference service in Northeast Brazil. The Delphi technique was used for validation, by three groups of nurse judges (n=29): hemophilia specialists (n=nine) from nine blood centers in the country; Hematology Residency (n=eight); Service Nurses (n=12). Inter-rater agreement was checked by Likert scale and Fisher’s exact test.Results: 89.6% had no difficulty in understanding the instrument. As for the degree of relevance, the characteristics ‘credibility’ and ‘scientificity’ showed higher percentages of extremely relevant (90%). Fisher’s exact test was significant in the degree of satisfaction of ‘clarity of statements’ (p<0.05). Conclusion: the instrument was considered valid, providing autonomy, technical support, and ethical support to the nurse, contributing to the improvement of the quality of care.Objetivo: construir y validar un instrumento de consulta de enfermería para personas con hemofilia. Método: estudio metodológico realizado de febrero de 2017 a febrero de 2018, en un servicio de referencia de hematología del Nordeste de Brasil. Para la validación se utilizó la técnica Delphi, por parte de tres grupos de enfermeras jueces (n=29): Especialistas en hemofilia (n=nueve) de nove hemocentros del país; Residencia en Hematología (n=ocho); Enfermeras del Servicio (n=12). La concordancia entre las jueces se verificó mediante la escala Likert y la prueba exacto de Fisher. Resultados: 89,6% não apresentaram dificuldade para compreender o instrumento. Quanto ao grau de relevância, as características ‘credibilidade’ e ‘cientificidade’ apresentaram maiores percentuais de extremamente relevante (90%). O teste exato de Fisher foi significativo no grau de satisfação de ‘clareza das afirmações’ (p<0,05). Conclusão: o instrumento foi considerado válido, proporcionando autonomia, apoio técnico e respaldo ético ao enfermeiro, contribuindo na melhoria da qualidade da assistência

A retrospective analysis of oral and maxillofacial lesions in children and adolescents reported in two different services

Most epidemiological studies involving oral and maxillofacial lesions assess only data from histopathological analysis. This may lead to a poor notification of diseases whose diagnosis is predominantly clinical. Aim: To evaluate and to compare the freque

Oral and maxillofacial lesions in older individuals and associated factors : a retrospective analysis of cases retrieved in two different services

Studies on the oral and maxillofacial lesions (OMLs) in older people usually assess data of laboratory services and data from oral medicine clinic have been poorly described. The aim of this study was to describe and to compare OMLs in older individuals considering two data sources, besides to assess associated factors with the three most frequent lesions. A retrospective study was conducted with individuals aged 60 years or older. Data of individuals and lesions reported in both services were collected. Univariate analysis was used to test the association between the occurrence of the lesion and the independent variables. The level of significance was set at 5%. A total of 1,695 (37.3%) records were from the Oral Medicine clinic and 2,848 (62.7%) from the Laboratory service. Inflammatory/reactive lesion group was the most frequent in both services (40.4% in Oral Medicine Clinic and in 44.2% Laboratory). The second and third groups of lesions in the Oral Medicine clinic were infectious diseases (18.5%), and variations of normality (10.8%), while in the laboratorial service were the malignant neoplasms (17.6%) and potentially malignant disorders (13.3%). Differences between services regarding the frequency of lesion groups occurred (p<0.05), except for pigmented (p=0.054) and infectious (p=0.054) groups. Females (OR: 2.08; CI: 1.81?2.39) and individuals who wore a removable prosthesis (OR: 3.99; CI: 2.83?5.62) were also likely to have inflammatory fibrous hyperplasia. Old?old individuals (OR: 1.70; CI: 1.30?2.21), male (OR: 3.63; CI: 3.00?4.39), smoking (OR: 6.05; CI: 4.84?7.56) or alcohol use (OR: 3.95; CI: 3.12?5.01) were likely to have squamous cell carcinoma. The results showed different frequencies of OMLs in older individuals according to the data sources and age group. The findings are important to direct public policies for this age group

What is the preferred concentration of ethanolamine oleate for sclerotherapy of oral vascular anomalies?

This study compared three different concentrations of EO (1.25%, 2.5% and 5%) for the treatment of oral vascular anomalies (OVAs). This was a retrospective comparative analysis of patients with OVAs treated with EO. Anomalies smaller than 20 mm were included. The patients were treated with 1.25% (G1), 2.5% (G2), and 5% (G3) and clinical data were obtained. The number of sessions, the final volume and dose of EO were statistically analyzed to verify effectiveness and safety of the treatment. The different concentrations of EO were compared considering the number of sessions, the final volume and total dose of EO. Analysis of covariance (ANCOVA) was used to evaluate the influence of covariates on the outcomes. A p-value < 0.05 was considered significant. Nineteen women and 11 men with a median age of 54 years were included. The OVAs were most frequent in the lip (n=14) and cheek (n=9). All lesions exhibited complete clinical healing within 28 days. Patients of G3 required fewer sessions than those of G2 (p=0.017), a lower final volume compared to the other groups (p<0.001), and a lower total dose than G1 (p<0.001). Patients of G1 used a lower total dose than G2 (p=0.003). The concentration of 5% EO performed better than 1.25% and 2.5% for sclerotherapy of OVAs measuring up to 20 mm. This preliminary result should be the preferred concentration of EO to provide an effective and safe treatment of OVAs