Bilateral jaws involvement of Burkitt?s lymphoma in a pediatric patient

A case of Burkitt?s lymphoma with bilateral jaws involvement in a 5-year-old boy is reported discussing the dentist?s role in the diagnosis and management of this disease. The initial clinical diagnosis established of maxillary swelling causing trismus w

Oral peripheral nerve sheath tumors : a clinicopathological and immunohistochemical study of 32 cases in a Brazilian population

Oral peripheral nerve sheath tumors (OPNSTs) are reactive or neoplastic diseases that develop from proliferation of the nerve itself or their limiting sheaths. Here we describe the clinicopathologic data of OPNSTs observed in a sample of the Brazilian population and evaluate the expression of molecules associated with neural biology to determine their usefulness in the diagnosis. Descriptive study of cases diagnosed as OPNSTs, from the Pathology Laboratory at the School of Dentistry/ Federal University of Uberlandia, followed by an immunohistochemical study of S-100, CD57, neurofilament protein (NFP) and epithelial membrane antigen (EMA). OPNSTs comprised 0.27% of all biopsies. There were eight patients with neurofibromas, eight with traumatic neuromas, seven with schwannomas, five with granular cell tumor (GCT), and four with palisaded encapsulated neuromas (PEN). Women were more frequently affected (60.6% of the cases). Tongue and lips prevailed as the most frequent sites. S-100 was reactive in 100% of the cases. Neural fibers evidenced by CD57 reactivity of their Schwann cells were always nested in bundles within neurofibromas and GCT, absent within schwannomas and dispersed within PEN. Reactivity for NFP was limited to axons and then followed the same pattern of CD57, though much less evident. Reactivity for EMA was observed in the capsular tissues and perineurium of nerve fascicles, and absent in parenchymal cells of GCT. This study showed that OPNSTs are rare, widely benign and often found in tongue and lips. OPNSTs evolve from a common origin to distinct histological patterns, with eventual overlapping in their clinical and morphologic features. The arrangement of reactive residual neural fibers for CD57 can be a useful staining in the differential diagnosis of OPNSTs

Segmental resection vs. partial resection on treating solid multicystic ameloblastomas of the jaws – recurrence rates: a systematic review and meta-analysis

The aim of the present study was to compare the recurrence rates of solid multicystic ameloblastomas after segmental resection or marginal resection.PubMed, ScienceDirect, Web of Science, Scopus, Embase were searched for studies published up to July 2022. The gray literature was also searched. Meta-analysis was performed using OpenMeta Software, p< 0.05 considered significant.Among the search, 8 studies met all eligibility criteria. The group that underwent marginal resection was 1.1 times more likely to present recurrence of the lesion compared to the group that underwent segmental resection. There was no statistically significant difference between the two groups (segmental resection and marginal resection) in all eight studies regarding reducing ND (95% Confidence interval, 0.339 – 3.705; heterogeneity: Q value= 3.105; I2= 0%).The results showed that there was no statistically significant difference between segmental and marginal resection for the treatment of solid multicystic ameloblastomas; however, prospective studies with more rigorous methodological procedures are needed to better compare the surgical techniques

Simple bone cyst : description of 60 cases seen at a Brazilian School of Dentistry and review of international literature

The aim of this study was to describe the relative frequency and the main demographic and clinic-radiographic features related to patients diagnosed with Simple bone cyst (SBC) in an Oral Diagnosis Service in Southeast Brazil and present a review and discussion of international literature on this topic. SBC cases from our service encompassing the period between 1978 and 2017 were selected. In addition, a literature search was performed in the Pubmed/MEDLINE online electronic database published between 1951 and 2019. A total of 2,459 cystic lesions were documented in our service, thus 60 patients were diagnosed with the SBC representing 2.4% of all jaw cystic. Most of cases were asymptomatic. Multiple SBC lesions were seen in two patients (3.4%) and association with cemento-osseous dysplasia was seen in one female patient (1.7%). A total of 793 cases were enrolled in this literature review. The SBC is an asymptomatic lesion often discovered in routine image exams in young patients. The unilocular, well defined margin with scalloped appearance is characteristic and helps the definition of diagnosis. This review suggests a different epidemiologic trend concerning to the sex and it confirms the posterior region of mandible as the more frequent location. The conservative treatment with limited exploration and curettage remains as the gold-standard treatment

Avaliação das modificações de histonas H3K36me3, H3K9ac, H4K12ac e H3S10ph em queilite actínica e carcinoma epidermóide de lábio

The actinic cheilitis (AC) and lip squamous cell carcinoma (LSCC) are caused by prolonged exposure to the ultraviolet radiation in sunlight. Histone modifications are epigenetic deregulation that are associated with diverse cellular processes such as, for example, transcription, replication, repair, and present in pathological processes such as cancer. The aim of this study was to investigate the expression of antigens related to histone modifications in AC and LSCC compared to normal tissue by immunohistochemistry. Were evaluated 33 samples of AC, 27 cases of LSCC and nine cases of normal mucosa lip, diagnosed in the Pathology Laboratory of the School of Dentistry, Federal University of Uberlandia, between 1978 and 2013. After histopathological review, immunohistochemical was performed with antibodies against H3K36me3, H3K9ac, H4K12ac and H3S10ph. The proportion of reactive cells and the intensity were evaluated through the Quickscore index. There was a significant reduction (p <0.05) of the immunohistochemical reactivity of H3S10ph and H3K36me3 in ACs and LSCCs when compared to normal mucosa lip. A statistically significant decrease was found for immunohistochemical reactivity of H3K9ac and H4K12ac compared to normal tissue, there was not differences between the normal mucosa lip and LSCC. There was a statistically significant association between H3K9ac and gender in patients with carcinomas. There was not a statistically significant result when comparing AC with mild to moderate/intense dysplasia, or between well-differentiated compared to moderately/poorly differentiated carcinomas. The variations in histone modifications evaluated are relevant to begin in the process of carcinogenesis, but not to tumor progression in actinic aggression lip.Coordenação de Aperfeiçoamento de Pessoal de Nível SuperiorMestre em Biologia Celular e Estrutural AplicadasA queilite actínica e o carcinoma epidermóide de lábio são doenças causadas por exposição prolongada à radiação ultravioleta da luz solar. As modificações de histonas são desregulações epigenéticas que estão associadas a diversos processos celulares, como, por exemplo, transcrição, replicação, reparo e presentes em processos patológicos, como o câncer. O objetivo do presente estudo foi investigar a expressão de antígenos relacionados às modificações histonas em amostras de queilite actínica (QA) e carcinoma epidermóide de lábio (CEL) em comparação com o tecido normal (TN), através da técnica de imunoistoquímica. Para tanto, foram avaliados 33 casos de QA, 27 de CEL e de nove amostras de mucosa de lábio normal, diagnosticados pelo Laboratório de Patologia da Faculdade de Odontologia da Universidade Federal de Uberlândia, entre os anos 1978 e 2013. Após revisão histopatológica foram realizadas as reações imunoistoquímicas com os anticorpos contra H3K36me3, H3K9ac, H4K12ac e H3S10ph. A proporção de células reativas e a intensidade da reação foram avaliadas com o método de Quickscore. Houve diminuição significativa (p< 0,05) da reatividade imunoistoquímica para H3K36me3 e H3S10ph nos grupos de QA e CEL quando comparados ao grupo tecido de lábio normal. O grupo de QA apresentou diminuição significativa da reatividade imunoistoquímica para H3K9ac e H4K12ac comparado ao tecido normal, não havendo diferenças entre os grupos de tecido normal e CEL. Associação estatisticamente significante foi observada entre H3K9ac e o gênero em portadores de carcinomas. Não houve qualquer resultado significante na comparação entre casos de QA com displasia leve e moderada/intensa, tampouco entre carcinomas bem diferenciados comparados aos moderadamente/pouco diferenciados. Conclui-se que variação nas modificações de histonas avaliadas são relevantes para o início do processo de carcinogênese, mas não para a progressão tumoral na agressão actínica ao lábio

Immunoexpression of cancer stem cell markers in subtypes of oral squamous cell carcinomas

O objetivo do presente estudo foi investigar o significado clínico e o valor prognóstico da imunoexpressão dos marcadores de células-tronco tumorais, ALDH1 e Notch1 em câncer de boca. Foram avaliados por meio da técnica de imuno-histoquímica a expressão de ALDH1 e Notch1 em 63 pacientes com carcinomas espinocelulares de boca e seus subtipos, o carcinoma verrucoso e o carcinoma escamoso basalóide. A análise semi-quantitativa da imunoexpressão de ALDH1 e Notch1 no front de invasão tumoral foi realizada e associada com as variáveis clinicopatológicas pelo teste qui-quadrado ou teste exato de Fisher. As probabilidades de sobrevivência global e livre de doença, em cinco anos, foram estimadas pelo método de Kaplan-Meier sendo as curvas comparadas pelo teste log-rank. O modelo de regressão de Cox foi aplicado para verificar a influência das variáveis clinicopatológicas significativas no prognóstico. O nível de significância de 5% foi considerado em todos os testes estatísticos. Os resultados mostraram que a forte expressão para ALDH1 foi observada em 16 carcinomas espinocelulares de boca (25,4%) e para Notch1 em 27 carcinomas espinocelulares de boca (42,9%). A maioria dos tumores com forte imunoexpressão de ALDH1 foi carcinoma escamoso basalóide (56,3%). Associações estatisticamente significativas foram observadas entre a forte imunoexpressão de Notch1 em carcinomas espinocelulares pouco diferenciados com infiltração perineural (p=0,011) e comprometimento linfonodal histopatológico (pN+) (p=0,034). A imunoexpressão de Notch1 não foi fator de prognóstico significativo, entretanto a forte imunoexpressão de ALDH1 foi fator de prognóstico associado com pior sobrevivência global (p=0,040) para os pacientes com câncer de boca. Conclui-se que a forte imunoexpressão de Notch1 pode contribuir com a identificação de pacientes com carcinomas espinocelulares pouco diferenciados de boca que apresentam infiltração perineural e metástases linfonodais. Além disso, a forte imunoexpressão de ALDH1 pode ajudar a identificar um pior prognóstico nos pacientes com carcinomas espinocelulares de boca e seus subtipos.The present study aimed to investigate the clinical significance and prognostic value of the immunoexpression of cancer stem cell markers, ALDH1 and Notch1, in oral cancer. The expression of ALDH1 and Notch1 in 63 patients with oral squamous cell carcinomas and their subtypes, verrucous carcinoma and basaloid squamous cell carcinoma were evaluated by immunohistochemistry. The semi-quantitative analysis of the immunoexpression of ALDH1 and Notch1 at the invasive tumor front was performed and associated with clinicopathological variables using the chi-square test or Fisher\'s exact test. The probabilities of global and disease-free survival in five years were estimated using the Kaplan-Meier method and the curves were compared using the log-rank test. The Cox\'s regression model was applied to verify the influence of significant clinicopathological variables on the prognosis. The significance level of 5% was considered in all statistical tests. The results showed that the strong expression for ALDH1 was observed in 16 oral squamous cell carcinomas (25.4%) and for Notch1 in 27 oral squamous cell carcinomas (42.9%). Most tumors with strong immunoexpression of ALDH1 were basaloid squamous cell carcinoma (56.3%). Statistically significant associations were observed between the strong immunoexpression of Notch1 in poorly differentiated oral squamous cell carcinomas with perineural infiltration (p=0.011) and lymph node involvement (pN+) (p=0.034). The immunoexpression of Notch1 was not a significant prognostic factor, however, the strong immunoexpression of ALDH1 was a prognostic factor associated with worse overall survival (p=0.040) for patients with oral cancer. In conclusion, the strong immunoexpression of Notch1 can contribute to the identification of patients with poorly differentiated oral squamous cell carcinomas who have perineural infiltration and lymph node metastasis. Moreover, the strong immunoexpression of ALDH1 may help to identify an unfavorable prognosis in patients with oral squamous cell carcinomas and their subtypes

Cholesterol Granuloma in the Maxillary Sinus: Are Endodontically Treated Teeth Involved in Its Etiopathogenesis?

Cholesterol granuloma (CG) is a tissue reaction in response to the accumulation of cholesterol crystals rarely found in the maxillary sinus. The etiopathogenesis of maxillary sinus CG remains unclear. We reviewed the literature and added two new reports of cholesterol granuloma in maxillary sinus related to endodontically treated maxillary posterior teeth. The first report refers to a 45-year-old woman diagnosed with rhinitis, who was submitted to endodontic retreatment of maxillary molar, and subsequently showed maxillary sinus opacity with cystic appearance. The second case describes a young adult woman, who presented a cystic mass in maxillary sinus after endodontic treatment, in close association with the apex of the maxillary right second premolar. Both patients were treated by a classic Caldwell-Luc surgery and the microscopic analyses revealed maxillary sinus CG. In the following, the authors discuss the probable involvement of endodontically treated maxillary posterior teeth in the etiopathogenesis of maxillary sinus CG

A Case of Oral Histoplasmosis Concomitant with Pulmonary Tuberculosis

The superficial intraoral lesions of histoplasmosis occurring concomitant to tuberculosis, in a 46-year-old man, are reported. The human immunodeficiency virus (HIV) infection test was negative. The immunosuppression caused by tuberculosis in our patient probably had an important role in the development of intraoral lesions of histoplasmosis. Here, we discussed the role of the dentist in the diagnosis of these infectious diseases, highlighting the importance of anamnesis and the histopathology/immunohistochemistry exams

A Rare Case of Intraductal Papilloma Arising from Minor Salivary Gland in the Floor of the Mouth

A 77-year-old woman with a rare oral intraductal papilloma arising from the minor salivary gland located on the floor of the mouth and causing the mucus retention is reported. Microscopically, the lesion was characterized by unicystic cavity exhibiting the lumen partially filled by papillary projections of the ductal epithelium with varying degree of oncocytic metaplasia. Based on the histopathological analysis, the differential diagnosis of oral intraductal papillomas and other ductal neoplasms of salivary origin are discussed