Comparison of p16ink4a immunostaining in benign and malignant HPV-related lesion

Objective: We aim to analyze the difference between p16inka immunostaining in normal epithelium, two benign HPV-related lesions (papilloma and condyloma acuminatum) and one malignant HPV-related lesion (oropharynx carcinoma).Methods: Five normal oral mucosas, fifteen papiloma, fifteen condyloma acuminatum and fifteen HPV-positive OSCC were included in the present study. Histological sections were stained anti-p16ink4a by immunohistochemistry. For the positive stain, score was based on a scale of - to 3+, as follows: - negative stain; 1+ less than 25% of positivity and focal distribution; 2+ 26-50% positivity and focal distribution; and 3+ 50-75% of positive cells and diffuse distribution. As for the evaluation of the intensity score was based on: - negative; 1- low intensity; 2- moderate intensity; 3- intensive.Results: The results showed no significant differences between the scores (positive x intensity) of p16ink4a in normal epithelium, papilloma and condyloma acuminatum. All these 3 lesions showed significant differences when compared with the oropharynx squamous cell carcinoma.Relevance: There are differences in the expression of p16ink4a between benign HPV-lesions and malignant HPV-lesions. Also, it is not possible to identify the presence of HPV by the detection of p16ink4a using IHC in benign lesions, as has been used in OSCC.

Oral lipoma of unusual size and location: a case report

A lipoma is a slow-growth benign tumor of the adipocytes. In the oral cavity, it is more commonly observed in the buccal mucosa; other sites less affected are the tongue, floor of the mouth, and lips. The objective of this report is to describe an extensive tumor affecting the dorsum of the tongue and the therapeutic maneuver performed. A 63-year-old man was referred to our clinic for evaluation of a tumor in the dorsum of the tongue with 6 months of duration. The physical examination revealed an extensive nodule, asymptomatic, submucosal, in the dorsum of the tongue at the left that measured approximately 4 cm. On palpation, the lesion was mobile and had rubbery consistency. According to these findings, the diagnostic hypotheses were lipoma and neurofibroma. Hence, surgical excision was performed and during the procedure a yellowish and well-delimited lesion was observed. The surgical specimen floated in 10% formalin. The histopathological examination confirmed the diagnosis of lipoma. The patient is asymptomatic after 40 months of follow-up. This report describes an unusual presentation of lipoma on the dorsum of the tongue and demonstrates that this lesion can reach large proportions.

Genes homeobox: uma relação molecular entre o desenvolvimento e o câncer

Homeobox genes are regulatory genes encoding nuclear proteins that act as transcription factors, regulating aspects of morphogenesis and cell differentiation during normal embryonic development of several animals. Vertebrate homeobox genes can be divided in two subfamilies: clustered, or HOX genes, and nonclustered, or divergent, homeobox genes. During the last decades, several homeobox genes, clustered and nonclustered ones, were identified in normal tissue, in malignant cells, and in different diseases and metabolic alterations. Homeobox genes are involved in the normal teeth development and in familial teeth agenesis. Normal development and cancer have a great deal in common, as both processes involve shifts between cell proliferation and differentiation. The literature is accumulating evidences that homeobox genes play an important role in oncogenesis. Many cancers exhibit expression of or alteration in homeobox genes. Those include leukemias, colon, skin, prostate, breast and ovarian cancers, among others. This review is aimed at introducing readers to some of the homeobox family functions in normal tissues and especially in cancer.Os genes homeobox são genes reguladores que codificam proteínas nucleares as quais atuam como fatores de transcrição, regulando vários aspectos da morfogênese e da diferenciação celular durante o desenvolvimento embrionário normal de diversos animais. Os genes homeobox de vertebrados podem ser subdivididos em duas famílias: os agrupados, ou HOX, e os não agrupados, ou divergentes. Durante as últimas décadas, vários genes homeobox, agrupados e não agrupados, foram identificados em tecidos normais, em células malignas e em diferentes doenças e condições metabólicas. Os genes homeobox estão envolvidos, por exemplo, no desenvolvimento normal do dente e em agenesias dentárias de ocorrência familiar. O desenvolvimento normal e o câncer têm muito em comum, já que ambos envolvem proliferação celular e diferenciação. A literatura tem mostrado um número cada vez maior de trabalhos relacionando os genes homeobox à oncogênese. Muitos tipos de câncer exibem expressão ou alteração nos genes homeobox. Eles incluem leucemias, câncer de cólon, pele, próstata, mama e ovário, entre outros. Esta revisão objetiva levar os leitores a conhecer algumas das funções da família homeobox nos tecidos normais e especialmente no câncer

Oral focal mucinosis of the hard palate and gingiva

Oral focal mucinosis (OFM) is an uncommon, asymptomatic, submucosal, slow-growing nodule representing a counterpart of the cutaneous focal mucinosis (CFM). OFM has a female predilection with the highest prevalence in the fifth decade of life. About 68% of OFMs occur in the gingiva and 14% in the palate. We present the case of a 41-year-old woman presenting a progressively growing mass on the palate, since the last 8 months. The diagnostic workup led to the diagnosis of an unusual OFM with the clinical presentation involving the gingiva and hard palate. This case report discusses the clinical and histopathological differential diagnosis

Expression of PCNA, p53 and Ki-67 in dentinogenic ghost cell tumors and calcifying cystic odontogenic tumors

O objetivo deste estudo foi avaliar a expressão dos antígenos PCNA, p53 e Ki-67 (marcadores de proliferação), em três casos diagnosticados como tumor dentinogênico de células fantasma (TDCF) e dez casos como tumor odontogênico císticos, calcifi cante unicístico (TOCCU) obtidos dos arquivos do Serviço de Patologia Oral e Cirúrgica da Universidade de São Paulo, Brasil. Foram realizadas reações de imunohistoquímica em espécimes de tecido parafi nado. Apenas a marcação nuclear foi considerada específi ca para os três anticorpos. A imunoexpressão das proteínas PCNA, p53 e Ki-67 foi analisada semi-quantitativamente e quantitativamente. Os resultados mostraram que o PCNA foi expresso em ambas as lesões, principalmente na camada basal, e que p53 também mostrou positividade em todos os casos. O TOCCU mostrou um aumento estatisticamente signifi cante na expressão do Ki-67 em relação ao TDCF. Em conclusão, nossos resultados não mostraram correlação entre a atividade proliferativa e o comportamento biológico desses tumores.The aim of this study was to compare the proliferative pattern of dentinogenic ghost cell tumors (DGCT) and unicystic calcifying cystic odontogenic tumors (UCCOT) using antibodies against PCNA, p53 and Ki- 67. Three cases diagnosed as DGCT and ten as UCCOT were retrieved from the fi les of the Surgical Oral Pathology Service at the University of São Paulo, Brazil. Immunohistochemistry was performed in formalin- fi xed and paraffi n-embedded tissue specimens. Only nuclear staining was considered specifi c for the three antibodies. Immunoexpression of PCNA, Ki-67 and p53 was analyzed semi-quantitatively and quantitatively. The results showed that PCNA was positive in both lesions, mainly in the basal cells, and p53 showed positivity in all cases. UCCOT showed statistically signifi cantly higher Ki-67 labeling indices than did DGCT. In conclusion, our results do not support the correlation between proliferative activity as shown by these proteins and reported biologic behavior

Oral leukoplakia manifests differently in smokers and non-smokers

Oral leukoplakias (OL) are potentially malignant lesions that are typically white in color. Smoking is considered a risk factor for developing OL, and dysplastic lesions are more prone to malignant transformation. The aim of this study was to describe the clinical features observed in dysplastic and non-dysplastic OL in both smokers and nonsmokers. A total of 315 cases of OL were retrieved and separated into either dysplastic or non-dysplastic lesions, and these cases were further categorized as originating in either smokers or non-smokers. Frequencies of the type of OL lesion, with respect to whether the patients smoked, were established. The results demonstrated that 131 cases of OL were dysplastic (74 smokers and 57 non-smokers), and 184 were non-dysplastic (96 smokers and 88 non-smokers). For OL cases in smokers for which information about alcohol consumption was also available (84 cases), the results revealed no significant difference in the amount of dysplastic and non-dysplastic lesions. Dysplastic lesions were more frequent in male smokers and in non-smoking females. The median age of smokers with cases of OL was significantly lower than in non-smokers; the lowest median ages were observed for female smokers with dysplastic OL. The most frequent anatomical sites of dysplastic lesions were the floor of the mouth in smokers and the tongue in non-smokers. Dysplastic lesions in smokers were significantly smaller than non-dysplastic lesions in non-smokers. Being a male smoker, being female, being younger, and having smaller lesions were associated with dysplastic features in OL. These clinical data may be important for predicting OL malignant transformation

PCC13 - Potenciais dificuldades no diagnóstico da sífilis secundária

Dentre as doenças sexualmente transmissíveis com manifestação oral, a sífilis destaca-se por sua incidência que tem se tornado cada vez maior na população brasileira com significativo aumento de casos nos últimos anos. O presente trabalho relata o caso de paciente do sexo feminino, 22 anos, leucoderma, fumante e etilista, apresentando lesões multifocais em mucosa oral e pele com 02 mesesde evolução. A paciente relatava ainda perda de peso e tosse

Oral focal mucinosis of the hard palate and gingiva

Oral focal mucinosis (OFM) is an uncommon, asymptomatic, submucosal, slow-growing nodule representing a counterpart of the cutaneous focal mucinosis (CFM). OFM has a female predilection with the highest prevalence in the fifth decade of life. About 68% of OFMs occur in the gingiva and 14% in the palate. We present the case of a 41-year-old woman presenting a progressively growing mass on the palate, since the last 8 months. The diagnostic workup led to the diagnosis of an unusual OFM with the clinical presentation involving the gingiva and hard palate. This case report discusses the clinical and histopathological differential diagnosis

PCC12 - Histoquímica e imuno-histoquímica no diagnóstico da mucinose oral focal

A mucinose oral focal (MOF) é uma lesão rara de tecidos molesque apresenta etiologia desconhecida, entretanto, sabe-se que ela está relacionada a uma produção exagerada de ácido hialurônico por fibroblastos. Clinicamente, a lesão se apresenta na cavidade oral como um nódulo, que pode ser de base séssil ou pediculada, indolor e sem alteração de cor.É apontada ainda como manifestação oral da mucinose cutânea

Adenocarcinoma polimorfo de baixo grau: relato de caso clínico

O adenocarcinoma polimorfo de baixo grau (APBG) é uma neoplasia maligna incomum em região de cabeça e pescoço e que ocorre quase exclusivamente em glândulas salivares menores. Esta lesão apresenta baixo potencial biológico de malignidade e tem como principais diagnósticos diferenciais tanto clínico quanto histológico o adenoma pleomórfico e o carcinoma adenoide cístico. Descrevemos um caso de APBG em um paciente do sexo masculino com 59 anos de idade, leucoderma e que apresentava um nódulo assintomático de aproximadamente 10 dias de evolução em palato mole. Foi realizada uma biópsia incisional e o exame microscópico confirmou o diagnóstico de APBG. O tratamento dessas lesões envolve a completa excisão cirúrgica e raramente há recorrência ou desenvolvimento de doença metastática. Após três meses da excisão cirúrgica, o paciente não apresentou recorrências