Perception and utilization of oral histopathology services by general practice dentist in Southwest Nigeria

Background: Oral histopathology services are oral diagnostic procedures. General Dental Practitioners (GDPs) are routinely exposed to oral lesions that require biopsies. Hence, the study’s objective of assessing the perception and the utilization of oral histopathology services by GDPs.Methods: This was a cross-sectional study conducted at dental clinics distributed across Southwest Nigeria. A self-administered questionnaire consisting of sections addressing the socio-demographic/professional aspects; the beliefs of GDPs and their utilization of oral histopathology services was used to collect data. A modified 5-point Likert rating scale was used to indicate the extent of agreement or disagreement with statement constructs. Analysis was done using SPSS for windows version 20.0. Significance was assessed at 5%.Results: There were 56.1% males and 43.9% females. The peak age range was 30-39 years (35.4%), while 58.5% had < 10 years of practice and 79.3% work in government dental centres. Many of the respondents (61.0%) thought suspicious lesions should be biopsied, 47.6% thought that specialists’ skills were not required for biopsy. Furthermore, 53.7% had poor perception scores while 81.1% of those who had seen oral lesions that required biopsies, had poor utilization scores.Conclusion: The GDPs had a poor perception and utilization of oral histopathology services. Continuous medical education is needed to increase awareness amongst dentists.Keywords: Oral; Histopathology; General dental practice; Southwest Nigeri

Dysplastic Papilliferous Basaloid Ameloblastoma: Report of a Case

Papilliferous ameloblastoma is an uncommon histologic variant of ameloblastoma. About five cases have been reported in the English literature till date. All five showed squamous differentiation with keratin formation and were diagnosed as papilliferous keratoameloblastoma. The present lesionshows basaloid differentiation and mild dysplasia in addition to papilliferous projections, thus termed dysplastic papilliferous basaloid  ameloblastoma.  Ameloblastoma, the most common odostoma has not ceased to intrigue pathologists with its diverse histomorphological patterns. Therefore, we present this uncommon lesion in a 50 year old man with right mandibular swelling. Key words: Papilliferous, Basaloid, Ameloblastoma, Dysplastic, Nonhealing socket

Characterization of alveolar soft part sarcoma of the tongue: A clinico-pathologic study and scoping review

Background: Alveolar soft part sarcoma (ASPS) is a rare malignant soft tissue tumour. There is a dearth of literature analyzing its features on the tongue.Objectives: This study aims to conduct a scoping review to describe the essential clinico-pathologic features, treatment modalities and outcome of previously reported tongue ASPS (TASPS) and new cases at our center.Methods: A search of databases (PubMed, Medline, Cochrane and Google Scholar) and the internet for articles on TASPS written in English was conducted. Information extracted included clinico-pathological and demographic data. Descriptive statistics was used for analysis.Results: A total of 49 articles were eligible for this study. In all, 81 cases were utilized. Asian studies accounted for most cases 35(43.2%) and a slight female preponderance of 1.1 was seen. Most cases - 38 (46.9%), occurred in the 1st decade and the base of tongue was the most common location in 19 (39.6%) cases. Also, tumour metastasis was present in 14 (25.9%) cases. Transcription Factor E3 (TFE3) – 8 (24.2%) and Neuron Specific Enolase (NSE) – 8 (24.2%) were the most common immunohistochemical stains used and were both expressed 7 out of 8 cases (87.5%). Most common treatment modality was surgery and 42 (82.4%) cases managed by surgery alone were free of disease at < 5 years of follow up.Conclusions: TASPS slightly affected the female gender and tongue base more commonly. It occurred more in the first two decades of life. Use of standard investigative tools for management will allow for better appraisal of research findings. &nbsp

Kimura’s disease in a Nigerian: Case report

Kimura’s disease (KD) is a chronic inflammatory disease presenting as multiple  subcutaneous swellings within the head and neck region. Aetiology has been suggested to be due to allergy or an immune response and it’s predominantly seen in young and middle-aged males. Histopathologically, hyperplasia of lymphoid tissue, with well-developed lymphoid follicles and marked infiltration of eosinophils are seen. KD is a relatively rare disease previously reported to be endemic in Asians of Chinese decent. However, they can constitute a diagnostic challenge where there is low index of suspicion. Therefore, we report a case of KD in an adult male Nigerian

Clinical and histological diagnosis of oral pathologic lesions, any concordance?

Objective: This study aims to examine the concordance between clinical and histopathological diagnosis of surgical specimen of oral lesions using partial biopsy technique. Methods: This was a retrospective study that utilized the data obtained from the case notes and histology record of 433 patients that had biopsy done between 2008 and 2017. Information on patients' age, gender, type of biopsy, presumptive clinical diagnosis and histopathologic diagnosis were obtained. Concordance between presumptive clinical and histopathologic diagnosis (incisional and final surgical specimen as the case may apply) and rate of misdiagnosis were assessed.Results: Excisional biopsies were more often used for benign lesions while incisional biopsy with or without surgical specimen were more often used for malignant lesions. Benign lesions were more frequently diagnosed than malignant lesions. The presumptive clinical diagnosis was erroneous for 40.3% and 22.1% of lesions following incisional histopathology and surgical specimen histopathology report respectively. Lesions that were subjected to both incisional and surgical specimen biopsies had a misdiagnosis rate of 11.2%.Conclusion: Incisional biopsy and post-surgical specimen histopathology investigation are important tools in the effective management of oral pathologic lesions. Keywords: Clinical diagnosis, incisional biopsy, excisional biopsy,  concordance, misdiagnosi