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Histopathological, Immunohistochemical and Exfoliative Cytological Studies of Oral Verruciform Xanthoma  [PDF]
Tadahiko Utsunomiya, Takashi Matsumoto, Miyuki Morikawa, Masaaki Suemitsu, Hidekuni Tanaka, Yasuto Ota, Takaaki Saito, Hirotsugu Yamamoto, Kayo Kuyama
Open Journal of Stomatology (OJST) , 2014, DOI: 10.4236/ojst.2014.49058
Abstract: Verruciform xanthoma is a rare tumor-like lesion, predominantly affecting the oral mucosa. Although several studies of verruciform xanthoma have been reported, the characteristic features and pathogenesis have not been fully clarified. The purpose of the present study is to perform immunohistochemical analysis using markers of proliferative cell activity and cytokeratins, and to perform comparative analysis between cytological and histological features in order to clarify the characteristic features of verruciform xanthomas. Histological findings showed exophitic proliferation of stratified squamous epithelium and accumulation of foamy macrophages between epithelial processes. Immunohistochemically, accumulated foamy cells showed positive immuno-reactivity for CD68, and positive cells were also present in the epithelium. Expression of pancy-tokeratin was observed in most layers of the epithelium, whereas cytokeratin 13 was also detected in prickle cell layers. Positive reactivity for Ki-67 was observed in epithelial cell nuclei. Positive reactivity was largely distributed in basal and/or parabasal cell layers, and the positive cell rate was 20%. In addition, exfoliative cytological findings showed hyperkeratotic epithelial cells with picnosis, thus suggesting the characteristics of hyperplastic epithelium in verruciforma, although foamy cells were not observed in the cytological specimens. These results suggest that benign morphological characteristics with local cellular immune response of verruciform xanthoma may be evaluated based on immunohistochemical expression of cytokeratin and Ki-67, as well as exfoliative cytological findings.
Oral focal mucinosis: report of two cases
Madhusudhan, AS;Nagarajappa, Das;Manjunatha, BS;Swati, Saawarn;Charan Babu, HS;
Revista Odonto Ciência , 2010, DOI: 10.1590/S1980-65232010000300018
Abstract: purpose: oral focal mucinosis (ofm), an oral counterpart of cutaneous focal mucinosis, is a rare disease of unknown etiology. its pathogenesis may be due to overproduction of hyaluronic acid by fibroblast at the expense of collagen production, resulting in focal myxoid degeneration of connective tissue primarily affecting the mucosa overlying bone. it has no distinctive clinical features, since the diagnosis is solely based on histopathological features. this paper reports two cases and discusses clinicopathological, immunohistochemical features and differential diagnosis of myxomatous lesions of the oral cavity. case description: the two cases of ofm lesions were present in a 50 year-old patient on the hard palate and in a 26 year-old female patient in the mandible, which seem to be the first report in the indian population. conclusion: the histopathological and immunohistochemical analysis of vimentin and s-100 protein may play a vital role in the correct diagnosis of ofm.
Immunohistochemical Expression of Mast Cells Using c-Kit in Various Grades of Oral Submucous Fibrosis  [PDF]
Musarrat J. Khatri,Rajiv S. Desai,G. S. Mamatha,Meena Kulkarni,Jay Khatri
ISRN Pathology , 2013, DOI: 10.1155/2013/543976
Abstract: Oral submucous fibrosis (OSF) is a high risk precancerous condition characterized by changes in the connective tissue fibers of lamina propria and deeper parts of mucosa. Mast cells are local residents of connective tissue and have been identified to participate in fibrotic process. These cells produce pharmacologically active substances necessary for the physiological function of our body in response to various stimuli as and when required and also play a significant role in the pathogenesis of oral diseases. Ten healthy volunteers and 30 clinically diagnosed OSF cases with histopathological confirmation were included in the study. Immunohistochemical (c-kit) as well as acidified toluidine blue staining techniques were used to evaluate density and expression of mast cells. The mast cell density assessed using c-kit and toluidine blue showed significant difference in various stages of OSF. In general the mean number of mast cells obtained using c-kit was found to be more than that obtained using toluidine blue in various stages of OSF. The comparison of mast cell densities using immunohistochemistry (c-kit) and toluidine blue stain confirmed that c-kit is a more reliable technique to assess mast cell density in OSF. 1. Introduction Oral submucous fibrosis (OSF) is a chronic, progressive, and devastating disease which is prevalent in South East Asia. This is known to affect most parts of oral cavity, pharynx, and upper third of oesophagus. Although the pathogenesis of the disease is considered as multifactorial with areca nut chewing, ingestion of chilies, genetic and immunological processes, and nutritional deficiencies, areca nut is found to be the main aetiological factor for developing OSF [1]. In the initial stages, the disease is expressed clinically with burning sensation of mouth, blister formation, ulceration, excessive salivation, and defective gustatory sensation. As the disease progresses, the mucosa becomes blanched and fibrous bands appear vertically leading to difficulty in mouth opening [2]. Characteristic histopathological features of this disease include atrophic epithelium with an intercellular edema and moderate epithelial hyperplasia associated with progression of the disease. Many studies have revealed that mast cells play an important role in OSF as they have been identified to participate in fibrotic process. The pathogenic mechanism in OSF begins in the connective tissue region and mast cells are the local residents of the connective tissue. Studies on mast cells in normal and various pathological conditions have revealed them to
Leptin Promotes Wound Healing in the Oral Mucosa  [PDF]
Hirochika Umeki, Reiko Tokuyama, Shinji Ide, Mitsuru Okubo, Susumu Tadokoro, Mitsuki Tezuka, Seiko Tatehara, Kazuhito Satomura
PLOS ONE , 2014, DOI: 10.1371/journal.pone.0101984
Abstract: Introduction Leptin, a 16 kDa circulating anti-obesity hormone, exhibits many physiological properties. Recently, leptin was isolated from saliva; however, its function in the oral cavity is still unclear. In this study, we investigated the physiological role of leptin in the oral cavity by focusing on its effect on wound healing in the oral mucosa. Methods Immunohistochemical analysis was used to examine the expression of the leptin receptor (Ob-R) in human/rabbit oral mucosa. To investigate the effect of leptin on wound healing in the oral mucosa, chemical wounds were created in rabbit oral mucosa, and leptin was topically administered to the wound. The process of wound repair was histologically observed and quantitatively analyzed by measuring the area of ulceration and the duration required for complete healing. The effect of leptin on the proliferation, differentiation and migration of human oral mucosal epithelial cells (RT7 cells) was investigated using crystal violet staining, reverse transcription polymerase chain reaction (RT-PCR) and a wound healing assay, respectively. Results Ob-R was expressed in spinous/granular cells in the epithelial tissue and vascular endothelial cells in the subepithelial connective tissue of the oral mucosa. Topical administration of leptin significantly promoted wound healing and shortened the duration required for complete healing. Histological analysis of gingival tissue beneath the ulceration showed a denser distribution of blood vessels in the leptin-treated group. Although the proliferation and differentiation of RT7 cells were not affected by leptin, the migration of these cells was accelerated in the presence of leptin. Conclusion Topically administered leptin was shown to promote wound healing in the oral mucosa by accelerating epithelial cell migration and enhancing angiogenesis around the wounded area. These results strongly suggest that topical administration of leptin may be useful as a treatment to promote wound healing in the oral mucosa.
Spindle Cell Carcinoma of the Head and Neck: A Clinicopathological and Immunohistochemical Study of 40 Cases  [PDF]
Anupam Sarma, Rajjyoti Das, J. D. Sharma, A. C. Kataki
Journal of Cancer Therapy (JCT) , 2012, DOI: 10.4236/jct.2012.36137
Abstract: Spindle cell carcinoma of head and neck, a subtype of squamous cell carcinoma is a unique and rare neoplasm. It has a more aggressive behavior as compared to classical squomous cell carcinoma warranting surgical interventions with wider surgical margins. Immunohistochemistry along with routine histopathology is essential in establishing the diagnosis of spindle cell carcinoma. We at Dr. B. Borooah Cancer Institute, Guwahati, a regional institute for treatment and research, hereby report 40 cases of such lesion with clinicopathological and immunohistochemical study. Out of total 40 cases included in the study group most of the cases were in the age group of 40 to 60 years. Commonest site of presentation was nasopharynx and buccal mucosa. 14 cases of the oral cavity (buccal mucosa, alveolus, oral tongue and hard palate) were treated with surgery. All the cases with disease of the larynx and hypopharynx were treated with radiotherapy and cases involving the nasopharynx received radiotherapy and chemotherapy. In the surgery group recurrence rate was found to be 71.4% and metastasis rate was 21.4%. Biopsy specimens were subjected to histopathological examination followed by immunohistochemistry. Immunohistochemical analysis show concurrent presence of malignant epithelial and sarcomatoid spindle cell components by co-expression of cytokeratin (CK) and vimentin to various degrees.
Pemphigus vulgaris macroscopically and cytologically resembling oral squamous cell carcinoma  [PDF]
Kayo Kuyama, Yan Sun, Hiroyasu Endo, Etsuko Kaneda, Miyuki Morikawa, Masanobu Wakami, Takanori Ito, Hirotsugu Yamamoto
Open Journal of Stomatology (OJST) , 2012, DOI: 10.4236/ojst.2012.21006
Abstract: We describe the clinical, macroscopic, cytological, histopathological, immunohistochemical, serodiagnostic and aspects of pemphigus vulgaris (PV) in the oral gingiva that clinically mimicked oral squamous cell carcinoma (OSCC) in a 57-year-old Japanese man. He developed slight haphalgesia of the buccal gingiva around teeth numbers 18 and 19 2 years ago. A dentist diagnosed intractable ulcer, but the patient ignored the condition for about 2 years until a sharp pain in the gingiva worsened. He consulted an otolaryngologist, who referred the patient to our hospital under a cytological diagnosis of OSCC. An oral examination revealed several extensive painful erosions/ ulcers from the buccal and lingual gingiva around teeth numbers 18 to 21 to the distal alveolar mucosa of no. 18 and the buccal and lingual gingiva around tooth number 31. A presumptive diagnosis of PV with dysplastic changes was determined from cytological smears. The cytological Nikolsky test was positive. The diagnosis of PV was confirmed from clinical and histopathological findings of a biopsy specimen obtained from the perilesional site. Although the definitive diagnosis of PV required only 2 weeks after this patient presented at our hospital, 2 years had elapsed since the onset of oral lesions.
A mucosa oral na hanseníase: um estudo clínico e histopatológico
Abreu, Marilda Aparecida Milanez Morgado de;Michalany, Nilceo Schwery;Weckx, Luc Louis Maurice;Neto Pimentel, Dalva Regina;Hirata, Cleonice Hitomi Watashi;Alchorne, Maurício Mota de Avelar;
Revista Brasileira de Otorrinolaringologia , 2006, DOI: 10.1590/S0034-72992006000300004
Abstract: introduction: multibacillary leprosy may involve the oral mucosa, with or without apparent lesions. there are few studies that deal with this issue in the era of multidrug therapy. aim: to assess the frequence of oral mucosa involvement in multibacillary leprosy patients. patients and methods: a transversal study with twenty non-treated multibacillary leprosy patients. the patients were treated in dracena, s?o paulo, between 2000 and 2002. clinical examination of the oral mucosa was carried out. all patients were submitted to jugal mucosa, soft palate and tongue biopsies, in altered or in pre-established sites. the cross-sections were stained by techniques of hematoxilin-eosin and ziehl-neelsen. granuloma and alcohol-acid-resistant bacilli findings determined the specific histopathological involvement. results: the study involved 19 patients with an average of 2.5 years of disease progression. specific histopathological involvement occurred in the tongue and soft palate of one lepromatous patient with an apparently normal oral mucosa. conclusions: (1) clinical alterations in the oral mucosa does not imply disease involvement, it is necessary to have histopathological confirmation. (2) apparent specific clinical alterations are rare. (3) the clinically normal oral mucosa can show specific histopathological involvement.
Pseudopathologies and Examination of the Oral Mucosa
Can Ceylan
Turkderm , 2012,
Abstract: Oral mucosa for shedding light on diagnosis of many cutaneous and systemic diseases, is an area not to be overlooked during the physical examination. Unlike cutaneous lesions, oral mucosa includes the non-keratinized sections and since it has anatomically and histologically special structures such as salivary glands and papillaries, the physician must recognize some detail, and features during the examination. To distinguish of usual and unusual changes in this area is important for both diagnostic and therapeutic aspects. In this presentation, a detailed explanation of how each area of the mouth should be examined is provided and normal variations of oral mucosa are emphasized.
Key Points in Oral Mucosa Biyopsies  [cached]
Leyla Kavak Evliyao?lu
Turkderm , 2012,
Abstract: Oral mucosa biopsy is not a challenging procedure as long one follows some principles. Here, some oral mucosa biopsy technics and types have been mentioned briefly.
Drug Reactions in Oral Mucosa  [cached]
Emine Dervi?
Turkderm , 2012,
Abstract: Both immunologic and nonimmunologic drug reactions can be seen in oral mucosa. Since considerable number of these reactions heals spontaneously without being noticed by the patients, exact frequency of the lesions is unknown. Most common lesions are xerostomia, taste disorders, mucosal ulcerations and edema. In this article, oral lesions resulting from drug intake similar to those from oral lesions of local and systemic diseases, and diagnostic problems caused by these similarities, have been reviewed.
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