Multicentric clinicopathologic study of adenomatoid odontogenic tumors

Orientador: Pablo Agustin VargasDissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Odontologia de PiracicabaResumo: O tumor odontogênico adenomatoide (TOA) é um tumor benigno incomum que ocorre principalmente na região anterior da maxila de pacientes jovens como uma imagem radiolúcida unilocular bem delimitada em posição pericoronária a um canino incluso, podendo conter focos radiopacos no seu interior. O objetivo deste estudo foi relatar as características clínicopatológicas de 105 novos casos de TOA do Brasil, Guatemala, México e África do Sul. Os dados clínicos e radiográficos foram coletados das fichas clínicas dos arquivos de cinco Laboratórios de Patologia Oral e todos os casos foram revisados microscopicamente. A série incluiu 36 casos (34,2%) da África do Sul, 33 casos (31,4%) do Brasil, 23 casos (21,9%) do México e 13 casos (12,3%) da Guatemala. Setenta e dois pacientes (68,5%) eram do sexo feminino e 33 (31,4%) do sexo masculino, com idade média de 19,2 anos. Os tumores afetaram predominantemente a maxila anterior (48,5%), seguida pela mandíbula anterior (29,5%), mandíbula posterior (15,2%) e maxila posterior (6,6%). Sessenta e três tumores (63,6%) eram foliculares, trinta e quatro (34,3%) eram extra-foliculares e dois (2%) eram periféricos. A maioria dos casos causou expansão de corticais ósseas, com tamanho médio de 3,4 cm. Microscopicamente, a maioria dos casos mostrou estruturas semelhantes a rosetas e a pseudo-ductos. Esta é uma das maiores séries de TOA relatadas na literatura, o primeiro estudo multicêntrico envolvendo populações da América Latina e África do Sul. Um quinto dos casos atuais afetou as regiões posteriores dos ossos gnáticos, demonstrando maior tamanho quando comparado a outras populaçõesAbstract: Adenomatoid odontogenic tumor (AOT) is an uncommon benign tumor that commonly appears pericoronally related to an unerupted maxillary canine in female patients in the second decade of life, containing radiopaque foci. The aim of this study was to report the clinicopathologic features of 105 new cases of adenomatoid odontogenic tumor (AOT) from Brazil, Guatemala, Mexico, and South Africa. Clinical and radiographic data were collected from records of five Oral Pathology Laboratories and all cases were microscopically reviewed. The series included 36 cases (34.2%) from South Africa, 33 cases (31.4%) from Brazil, 23 cases (21.9%) from Mexico, and 13 cases (12.3%) from Guatemala. Seventy-two patients (68.5%) were female and 33 patients (31.4%) were male, with an average age of 19.2 years. Tumors predominantly affected the anterior maxilla (48.5%), followed by the anterior mandible (29.5%), posterior mandible (15.2%), and posterior maxilla (6.6%). Sixty-three tumors (63.6%) were follicular, thirty-four (34.3%) were extra-follicular, and two (2%) were peripheral. Most cases caused considerable cortical expansion, with average size of 3.4 cm. Microscopically, most cases showed rosette-like and duct-like structures. This is one of the largest series of AOT reported in the literature, the first multicenter study involving populations from Latin America and South Africa. A fifth of the present cases affected the posterior regions of the gnathic bones, demonstrating larger size when compared to other populationsMestradoPatologiaMestra em Estomatopatologia2019/02539-0FAPES

Oral pigmented lesions:a retrospective analysis from Brazil

Pigmented lesions are uncommon in the oral mucosa, and studies investigating the incidence and types of these lesions are desired to improve the diagnostic knowledge of clinicians. The aim of this study was to analyze the distribution of oral pigmented lesions in a Brazilian population. A retrospective descriptive cross-sectional study was performed. Oral pigmented lesions were retrieved from the files of two oral and maxillofacial pathology services from Brazil over a 45-year period (1974-2019). The clinical data and the diagnoses of each case were retrieved and included in a Microsoft Excel® database. From 77.074 lesions diagnosed in this period, 761 (0.99%) represented pigmented lesions of the oral mucosa, including 351 (46.1%) melanocytic and 410 (53.9%) non-melanocytic lesions, with a higher incidence in females (73.2%) between the fourth and seventh decades of life. Amalgam tattoo (53.6%) represented the most common lesion, followed by melanotic macule (18.3%) and racial pigmentation (10.8%). Other pigmented lesions included nevus (9.9%), post-inflammatory pigmentation (3%), melanoma (2.1%), melanoacanthoma (1.4%), smoker's melanosis (0.4%), drug-induced pigmentation (0.3%), and melanotic neuroectodermal tumor of infancy (0.1%). The buccal mucosa was the most commonly affected site (25.2%), followed by the alveolar ridge (14.5%), and gingiva (11.8%). The current findings were similar to previous studies with minor differences due methodology and characteristics of the services from where lesions were retrieved. The knowledge of these data may contribute to a better understanding of oral pigmented lesions and assist clinicians to better recognize and manage them

Anaplastic large cell lymphoma with oral manifestation : a series of four cases and literature review

The aim of this study was to describe the clinicopathological and immunohistochemical features of four cases of anaplastic large cell lymphoma (ALCL) diagnosed through oral manifestations. Clinical data were collected from charts of a single oral pathology laboratory over a 5-year period (2014–2019) and all cases were evaluated by conventional hematoxylin and eosin staining and an extended immunohistochemical panel comprising CD45, CD20, CD3, CD4, CD7, CD30, CD99, CD138, cytokeratin AE1/AE3, EMA, ALK, MUM-1 and Ki-67. The study included 3 male (75%) and 1 female (25%) patients, with a median age of 44 years. The most common intraoral affected site was the alveolar ridge (50%). Clinically, all cases were characterized as an ulcerated bleeding mass. Microscopically, proliferation of anaplastic large lymphoid cells with medium to large-sized, abundant amphophilic to eosinophilic cytoplasm and eccentric nuclei were observed. All cases were positive for CD30, while two cases strongly express ALK. Two patients died of the disease. Careful correlation of clinical, morphological and immunohistochemical data are necessary to establish the diagnosis of oral manifestation of ALCL since its microscopical features may mimic other malignant tumors. Clinicians and pathologists should consider ALCL in the differential diagnosis when evaluating oral ulcerated swellings exhibiting large lymphoid cells in patients with lymphadenopathy14991100