Oral lichen planus

O líquen plano da mucosa oral (LPO) é afecção relativamente comum, que pode aparecer isolado ou associado ao líquen plano cutâneo, havendo, no entanto, significantes diferenças clínicoevolutivas: o LPO tende a ser crônico, recidivante e de difícil tratamento, levando a importante morbidade, principalmente em sua forma erosiva. Novas formas clínicas agressivas têm sido salientadas na literatura, como a forma gingivo-vulvar. Este artigo revisa a etiopatogenia, as formas clínicas, a diagnose diferencial e laboratorial, a prognose e o tratamento do LPO, além de mencionar, brevemente, a experiência dos autores com esta enfermidade, vivida no Ambulatório de Estomatologia da Divisão de Dermatologia do Hospital das Clínicas da Faculdade de Medicina da Universidade de São PauloOral lichen planus (OLP) is a relatively common mucosal disease that can present isolated or associated with cutaneous lichen planus. Contrarily to its cutaneous counterpart, though, OLP tends to be chronic, relapsing, and difficult to treat. Severe morbidity is related to erosive forms, and more aggressive presentations have been described, such as the "gingivo-vulvar syndrome". This article reviews the current knowledge about the pathogenesis, clinical picture, differential and laboratorial diagnosis, prognosis, and treatment of OL

Head and Neck: Primary oral mucosal melanoma

Primary Oral Mucosal Melanoma (POMM) is an aggressive and rare disease that involves mostly the hard palate and upper gingiva, followed by mandibular gingiva, lip mucosa, and other oral sites. POMM develops primarily between the 5th and 8th decades of life and most studies report a similar distribution between males and females. In contrast to cutaneous melanomas, the risk factors and pathogenesis are poorly understood. However, genetic profiling of mucosal melanomas have identified a number of altered genes, such as KIT, BRAF and N-RAS, suggesting that molecular pathways like the mitogen activated protein kinase (MAPK) pathway (RAS/MEK/ERK) and the phosphotidylinositol-3-kinase-PTEN pathway (PI3K/AKT/PTEN/mTOR) might be used for potential targeted therapy

Ameloblastoma with distinctive granular cell pattern: an 8 case study

Ameloblastoma with granular cell pattern (AGC) is classified as an unusual histological subtype of solid/multicystic ameloblastoma, characterized by granular changes in stellate-like cells located within the inner portion of the epithelial follicles. Studies have revealed that lysosomal overload causes cytoplasmic granularity; however, the mechanism involved remains poorly understood. Here we report on eight cases of granular cell ameloblastoma, in the posterior region of the mandible. The age of the patients included in this case series ranged from 35 -64 years old and 87.5% of cases occurred in non-Caucasians, with a slight gender predilection for men (62.5%). There was no evidence of recurrence, and the majority of the cases were treated with surgical resection (87.5%). All tumors displayed histopathological features consistent with the diagnosis of ameloblastoma with granular cell pattern

Cytokeratin immunoprofile of primary and metastatic adenoid cystic carcinoma of salivary glands: a report of two cases

Distant metastases from salivary gland tumors are considered infrequent: the incidence of distant metastases ranges from 24% to 61% according to different histotypes and to the site of the primary mass. The most common site of distant metastases due to salivary gland malignancies is the lung. From the pathology point of view, cytokeratins (CK) are important differentiation markers in salivary gland tumors, which are often used for the diagnostic process. Their employment also may be useful to identify and confirm the diagnosis of their distant metastases. We report the expression of CK in two cases of primary and metastatic adenoid cystic carcinoma (ACC) and their CK profiles of the primary and metastatic masses. Both patients—one male and one female—were diagnosed with an ACC cribriform and tubular, respectively, with lung metastases. In case 1, the metastatic mass presented the same histotype and CK profile of the primary tumor. For case 2, the metastatic lung mass was distinct from the primary mass (a solid ACC) and presented a different CK profile. Although salivary gland metastatic disease presents a poor prognosis, both patients reported herein are alive despite the presence of the disease in long-term follow-up. Therefore, the modifications seen in the CK profiles do not appear to be predictive of tumor behavior and outcome. The use of a CK profile seems to be useful to identify the nature of a distant mass and its possible correlations with a primary salivary gland tumo

Relevant proteins for the monitoring of engraftment phases after allogeneic hematopoietic stem cell transplantation

Introduction: Hematopoietic Stem Cell Transplant (HSCT) has been successfully used as standard therapy for hematological disorders. After conditioning therapy, patients undergoing allogeneic HSCT, present three different phases of engraftment: early pre-engraftment, early post-engraftment, and late engraftment. Severe complications are associated with morbidity, mortality, and malignancies in these phases, which include effects on the oral cavity. Objectives: The changes in the salivary composition after HSCT may contribute to identifying relevant proteins that could map differences among the phases of diseases, driven for personalized diagnostics and therapy. Methods: Unstimulated whole saliva was collected from patients submitted to HSCT. The samples were submitted to trypsin digestion for a Mass spectrometry analysis. MaxQuant processed the Data analysis, and the relevant expressed proteins were subjected to pathway and network analyses. Results: Differences were observed in the most identified proteins, specifically in proteins involved with the regulation of body fluid levels and the mucosal immune response. The heatmap showed a list of proteins exclusively expressed during the different phases of HSCT: HBB, KNG1, HSPA, FGB, APOA1, PFN1, PRTN3, TMSB4X, YWHAZ, CAP1, ACTN1, CLU and ALDOA. Bioinformatics analysis implicated pathways involved in protein processing in the endoplasmic reticulum, complement and coagulation cascades, apoptosis signaling, and cholesterol metabolism. Conclusion: The compositional changes in saliva reflected the three phases of HSCT and demonstrated the usefulness of proteomics and computational approaches as a revolutionary field in diagnostic methods

Ameloblastoma with distinctive granular cell pattern

Ameloblastoma with granular cell pattern (AGC) is classified as an unusual histological subtype of solid/multicystic ameloblastoma, characterized by granular changes in stellate-like cells located within the inner portion of the epithelial follicles. Studies have revealed that lysosomal overload causes cytoplasmic granularity; however, the mechanism involved remains poorly understood. Here we report on eight cases of granular cell ameloblastoma, in the posterior region of the mandible. The age of the patients included in this case series ranged from 35 -64 years old and 87.5% of cases occurred in non-Caucasians, with a slight gender predilection for men (62.5%). There was no evidence of recurrence, and the majority of the cases were treated with surgical resection (87.5%). All tumors displayed histopathological features consistent with the diagnosis of ameloblastoma with granular cell pattern

Cytokeratin immunoprofile of primary and metastatic adenoid cystic carcinoma of salivary glands: a report of two cases

Distant metastases from salivary gland tumors are considered infrequent: the incidence of distant metastases ranges from 24% to 61% according to different histotypes and to the site of the primary mass. The most common site of distant metastases due to salivary gland malignancies is the lung. From the pathology point of view, cytokeratins (CK) are important differentiation markers in salivary gland tumors, which are often used for the diagnostic process. Their employment also may be useful to identify and confirm the diagnosis of their distant metastases. We report the expression of CK in two cases of primary and metastatic adenoid cystic carcinoma (ACC) and their CK profiles of the primary and metastatic masses. Both patients—one male and one female—were diagnosed with an ACC cribriform and tubular, respectively, with lung metastases. In case 1, the metastatic mass presented the same histotype and CK profile of the primary tumor. For case 2, the metastatic lung mass was distinct from the primary mass (a solid ACC) and presented a different CK profile. Although salivary gland metastatic disease presents a poor prognosis, both patients reported herein are alive despite the presence of the disease in long-term follow-up. Therefore, the modifications seen in the CK profiles do not appear to be predictive of tumor behavior and outcome. The use of a CK profile seems to be useful to identify the nature of a distant mass and its possible correlations with a primary salivary gland tumo

Invasión ósea del carcinoma de células escamosas de la cavidad oral, análisis clínico-patológico de 62 casos

Prognosis for patients with squamous cell carcinoma (SCC) in oral cavity with bone invasion presence is concerning. Bone invasion patterns can be used to indicate aggressiveness and can be correlated with tumor clinical behavior. Objective: To evaluate bone invasion histopathological patterns in patients with oral cavity SCC and correlate them with the survival rate. Materials and methods: 62 patients with presence of SCC in the oral cavity as well as bone invasion were recruited for this study. Epidemiological and histopathological characteristics were tabulated and analyzed. Fischer's Square and Exact Tests were used to verify any statistical associations between the data. Results: More men were affected, especially in the fifth decade of life, and a strong association with smoking and chronic alcoholism was observed. Deaths were reported in 58% of patients, over a period of 5 years. The most prevalent histological pattern was the infiltrative, associated with lower survival rates. Conclusion: An analysis of the histopathological patterns of oral cavity SCC can be used as a prognostic factor thereby assisting with the decision of which oncological treatment approach to use.El pronóstico de pacientes con carcinoma de células escamosas (CEC) de la cavidad oral con presencia de invasión ósea continua sombrío. El patrón de invasión ósea puede ser usado como indicador de agresividad y correlacionado con el comportamiento clínico del tumor. Objetivo: Evaluar los patrones histopatológicos de invasión ósea en pacientes con CEC de la cavidad oral y correlacionarlos con la tasa de sobrevida. Material y métodos: La muestra fue constituida por 62 pacientes con presencia de CEC en la cavidad oral e invasión ósea. Las características epidemiológicas e histopatológicas fueron tabuladas y analizadas. Los Test Chi- cuadrado y exacto de Fischer fueron empleados para verificar las asociaciones estadísticas entre los datos. Resultados: Fueron afectados más hombres en la quinta década de vida y observada una fuerte asociación con tabaquismo y etilismo crónico. Fueron relatadas muertes en 58% de los pacientes, en un periodo de 5 años. El patrón histológico más prevalente fue el infiltrativo, asociado a menores tasas de sobrevida. Conclusión: El análisis del patrón histopatológico de los CEC de la cavidad oral, puede ser usado como factor pronóstico auxiliando en la decisión del abordaje del tratamiento oncológico.   &nbsp

miR-22 and miR-205 Drive Tumor Aggressiveness of Mucoepidermoid Carcinomas of Salivary Glands

Publisher Copyright: Copyright © 2022 Naakka, Barros-Filho, Adnan-Awad, Al-Samadi, Marchi, Kuasne, Korelin, Suleymanova, Brown, Scapulatempo-Neto, Lourenço, Castilho, Kowalski, Mäkitie, Araújo, Leivo, Rogatto, Salo and Passador-Santos.Objectives: To integrate mRNA and miRNA expression profiles of mucoepidermoid carcinomas (MECs) and normal salivary gland (NSGs) tissue samples and identify potential drivers. Material and Methods: Gene and miRNA expression arrays were performed in 35 MECs and six NSGs. Results: We found 46 differentially expressed (DE) miRNAs and 3,162 DE mRNAs. Supervised hierarchical clustering analysis of the DE transcripts revealed two clusters in both miRNA and mRNA profiles, which distinguished MEC from NSG samples. The integrative miRNA-mRNA analysis revealed a network comprising 696 negatively correlated interactions (44 miRNAs and 444 mRNAs) involving cell signaling, cell cycle, and cancer-related pathways. Increased expression levels of miR-205-5p and miR-224-5p and decreased expression levels of miR-139-3p, miR-145-3p, miR-148a-3p, miR-186-5p, miR-338-3p, miR-363-3p, and miR-4324 were significantly related to worse overall survival in MEC patients. Two overexpressed miRNAs in MEC (miR-22 and miR-205) were selected for inhibition by the CRISPR-Cas9 method. Cell viability, migration, and invasion assays were performed using an intermediate grade MEC cell line. Knockout of miR-205 reduced cell viability and enhanced ZEB2 expression, while miR-22 knockout reduced cell migration and invasion and enhanced ESR1 expression. Our results indicate a distinct transcriptomic profile of MEC compared to NSG, and the integrative analysis highlighted miRNA-mRNA interactions involving cancer-related pathways, including PTEN and PI3K/AKT. Conclusion: The in vitro functional studies revealed that miR-22 and miR-205 deficiencies reduced the viability, migration, and invasion of the MEC cells suggesting they are potential oncogenic drivers in MEC.Peer reviewe

Síndrome de Sjögren primária: aspectos relevantes para os dentistas

Objetivo: Esta revisão de literatura tem o propósito de oferecer aos cirurgiões-dentistas entendimento sobre os principais achados clínico-epidemiológicos da síndrome de Sjögren primária (SSp), bem como ressaltar os principais aspectos etiopatogênicos e histopatológicos da doença. Métodos: Buscou-se na base de dados Pubmed/Medline e ScienceDirect os descritores “síndrome de Sjögren”, “glândulas salivares”, “xerostomia”, “diagnóstico”, “glândula salivar menor”, “etiologia”, “biopsia” entre os anos de 1991 a 2017. Discussão: A SSp é uma exocrinopatia autoimune que tem como substrato, em especial, as glândulas lacrimais e salivares, culminando com os sintomas de xeroftalmia e xerostomia. Seu principal achado morfológico é a presença de agregados de leucócitos mononucleares ao redor dos ductos e ácinos. Outras manifestações sistêmicas podem estar presentes, acarretando considerável morbidade nos pacientes acometidos. Atualmente, foi publicado o mais novo conjunto de critérios diagnósticos da doença, sendo um marco histórico no diagnóstico precoce da enfermidade, fundamental para diminuir os altos números de subdiagnósticos e otimizar a conduta clínica. Conclusão: Esta revisão abordou os aspectos clínicos-epidemiológicos, histopatológicos e etiopatogênicos da SSp, objetivando melhor compreensão dessa doença multifatorial e, portanto, a necessidade de uma conduta multidisciplinar e do papel fundamental do cirurgião-dentista no manejo dos pacientes acometidos por essa síndrome.Objective: The aim of this present review is to provide dentists a better understanding of Primary Sjögren’s syndrome (SSp), clinical and epidemiological findings, also the etiopathogenic and histopathological features of the disease. Methods: The search was based on Pubmed/Medline and ScienceDirect database from 1991 to 2017. It was used keywords: “Sjögren’s syndrome”, “salivary gland”, “xerostomia”, “pathogenesis”, “diagnosis”, “minor salivary gland”, “ethiology”, “biopsy”. Discussion: Primary Sjögren’s syndrome (SSp) is an autoimmune exocrinopathy involving mainly the lacrimal and salivary glands, resulting in reduced secretory functions and classical sicca symptoms, such as dry eyes and dry mouth. The hallmark of the histopathological features is the presence of aggregates of mononuclear leukocytes surrounding ducts and acini. Others systemic manifestations can also be present, leading to considerable morbidity in the affected patients. The lastest diagnosis criteria of SSp was published in 2017, becoming a historical landmark in the early diagnosis of the disease, reducing the high number of underdiagnosis and improving therapeutic intervention. Conclusion: This review approached the clinical-epidemiological and histopathological features, and etiopathogenic factors of SSp, supporting a better comprehension of this multifactorial disease and needing a multidisciplinary approach and the role of the dentist in the clinical conduct of the patients affected by this syndrome