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An Official Publication of the Indian Association of Oral and Maxillofacial Pathologists
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2013| January-April | Volume 17 | Issue 1
Online since
April 18, 2013
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REVIEW ARTICLES
Art of reading a journal article: Methodically and effectively
RV Subramanyam
January-April 2013, 17(1):65-70
DOI
:10.4103/0973-029X.110733
PMID
:23798833
Background:
Reading scientific literature is mandatory for researchers and clinicians. With an overflow of medical and dental journals, it is essential to develop a method to choose and read the right articles.
Objective:
To outline a logical and orderly approach to reading a scientific manuscript. By breaking down the task into smaller, step-by-step components, one should be able to attain the skills to read a scientific article with ease.
Methods:
The reader should begin by reading the title, abstract and conclusions first. If a decision is made to read the entire article, the key elements of the article can be perused in a systematic manner effectively and efficiently. A cogent and organized method is presented to read articles published in scientific journals.
Conclusion:
One can read and appreciate a scientific manuscript if a systematic approach is followed in a simple and logical manner.
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CASE REPORTS
Epidermoid cyst localized in the palatine tonsil
Keles Erol, Kaplama Mehmet Erkan, Dolen Tolga, Cobanoglu Bengu
January-April 2013, 17(1):148-148
DOI
:10.4103/0973-029X.110729
PMID
:23798854
Epidermoid and dermoid cysts are benign, developmental lesions that can be encountered anywhere in the body. Our literature search did not result in a finding of any report of an epidermoid cyst located in the palatine tonsils. This is a report of a 42-year-old female patient who underwent a tonsillectomy for diagnostic purposes because of an epidermoid cyst arising from the tonsil which was confirmed by histology.
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2
CASE REPORTS- SOFT TISSUE LESIONS
Keloid: A case report and review of pathophysiology and differences between keloid and hypertrophic scars
Santosh Hunasgi, Anila Koneru, M Vanishree, Ravikumar Shamala
January-April 2013, 17(1):116-120
DOI
:10.4103/0973-029X.110701
PMID
:23798844
Keloids extend beyond the borders of the original wound invading normal skin. Usually appear as firm nodules, often pruritic and painful, and generally do not regress spontaneously. Most often occur on the chest, shoulders, upper back, back of the neck, and earlobes. The aim of the paper is to discuss a case of keloid, review the pathophysiology and also to highlight the differences between keloid and hypertrophic scars. A 26-year-old female complains of swelling on ear lobe since 3 years. Swelling was firm, non-tender, dumbell-shaped with central wooden stick still present, measuring 3 cm in diameter medial to the inferior part of the helix. A clinical diagnosis of keloid was given. Histopathological sections showed hyperorthokeratinized stratified squamous epithelium with deep dermal sclerosis showing large dense bundle of glassy collagen diagnostic of Keloid. Special stain like Van Gieson's was used to identify collagen bundles. The sections were also subjected to immunohistochemical markers such as α-SMA (alpha Smooth muscle actin), Desmin, and S-100. Despite decades of research, the pathophysiology of keloids remains incompletely understood. Recent studies indicate that TGF-β (Transforming growth factor beta) and PDGF (Platelet-derived growth factor) play an integral role in the formation of keloids. In future, development of selective inhibitors of TGF-β might produce new therapeutic tools with enhanced efficacy and specificity for the treatment of keloids. Patients with a previous history of keloid or other risk-factors should avoid body piercing and elective cosmetic procedures. Keloid scars should be sent for histopathology in order to avoid missing potentially malignant conditions particularly those showing unusual features.
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REVIEW ARTICLES
Metastatic tumors to the jaws and oral cavity
GS Kumar, BS Manjunatha
January-April 2013, 17(1):71-75
DOI
:10.4103/0973-029X.110737
PMID
:23798834
Cancer is a disease involving complex multiple sequential irreversible dysregulated processes showing metastasis that results in morbidity and mortality. Metastasis is a complex biological course that begins with detachment of tumor cells from the primary tumor, spreading into the distant tissues and/or organs, invading through the lymphovascular structures followed by their survival in the circulation. Metastatic tumors to the oro-facial region are uncommon and may occur in the oral soft tissues or jawbones. The clinical presentation of metastatic tumors can be variable, which may lead to erroneous diagnosis or may create diagnostic dilemma. Therefore, they should be considered in the differential diagnosis of inflammatory and reactive lesions that are common to the oral region. Most of the literature on oral metastases involves either single case reports or reviews of these reported cases from scattered geographical areas. Hence this present article is an attempt to provide a detailed review of pathogenesis, epidemiological details including clinical and radiographic presentations, microscopic features and treatment of metastatic tumors to the jaws and oral cavity.
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ORIGINAL ARTICLES
Fibro-osseous lesions of the oral and maxillo-facial region: Retrospective analysis for 20 years
Sudeendra Prabhu, S Sharanya, Pooja M Naik, Ashritha Reddy, Vatsala Patil, Sameer Pandey, Alok Mishra, K Rekha
January-April 2013, 17(1):36-40
DOI
:10.4103/0973-029X.110707
PMID
:23798827
Background:
Fibro-osseous lesions (FOLs) are one of the commonest entities reported in the head and neck region. However, studies on these groups of lesions on Indian population were not carried out before. So this motivated us to analyze the clinico-pathologic correlation of fibro-osseous lesions reported at our hospital.
Materials and Methods:
A retrospective review was made of all the lesions surgically treated in our hospital. A total of 6,175 biopsies were performed during the study period. All the cases which were histopathologically diagnosed as FOLs were included in the study. The demographic data, radiographic features, and histopathologic findings were analyzed and compared with similar studies on other races.
Results and Conclusion:
We could find 80 cases diagnosed as fibro-osseous lesions and information about them was documented. The most common FOL reported in the region was cemento-ossifying fibroma (COF) (75%) than fibrous dysplasia (FD) (25%). These were commonly occurring in 2
nd
decade without any sex or site predilection. However, COF was showing a slight female predominance and FD with a definite male predominance. COF was commonly seen in mandible (posterior region) whereas FD mainly confined to the maxilla (as a whole bone). Radiographically, most of COF showed well-defined mixed opaque and lucent areas whereas FD showed diffuse borders. Cortical plate expansion and resorption of associated teeth was a frequent finding in COF when compared with FD. Histopathologically, stroma was fibrocellular in many cases of COF, whereas most FDs showed fibrous stroma, interspersed with mainly woven bone.
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Clinico-epidemiological profile of oral potentially malignant and malignant conditions among areca nut, tobacco and alcohol users in Eastern India: A hospital based study
Jay Gopal Ray, Madhurima Ganguly, BH Sripathi Rao, Sanjit Mukherjee, Basudev Mahato, Keya Chaudhuri
January-April 2013, 17(1):45-50
DOI
:10.4103/0973-029X.110720
PMID
:23798829
Context:
With an increase in the abuse of various oral habitual products in India over the past few decades; the incidence of oral potentially malignant conditions as leukoplakia, oral submucous fibrosis and squamous cell carcinoma (SCC) rates have also increased. No recent study has been conducted reporting the scenario of oral cancer and potentially malignant conditions in Eastern India (specifically Kolkata).
Aims:
The present study was conducted at Dr. R. Ahmed Dental College, Kolkata during 2010-2011 to find a possible correlation between the effects of the different oral habits, age, sex and the different types of oral mucosal lesions among patients reported to the hospital. This study also enabled us to see the predilection of the various histopathological stages of the lesions for different sites of the oral cavity.
Subjects and Methods:
The study group consisted of 698 patients having either oral potentially malignant or malignant lesion. The control group consisted of 948 patients who had reported to the hospital for different oral/dental problems and had the habit of tobacco, areca nut and/or alcohol usage for at least 1 year.
Statistical Analysis
: The unadjusted odds ratio, the 95% confidence interval, and the
P
value were calculated to correlate patients with/without different kinds of habit and having/not having various kinds of oral lesions.
Results:
Our study shows that for males having the habit of taking smokeless tobacco or mixed habit poses the highest risk for developing SCC. For females, significant risk of developing SCC was found in patients habituated to processed areca nut chewing.
Conclusion:
This study presents probably for the first time in recent years the occurrence of oral potentially malignant and malignant conditions amongst patients having deleterious habits in a hospital based population of Kolkata.
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Comparing modified papanicolaou stain with ayoub-shklar and haematoxylin-eosin stain for demonstration of keratin in paraffin embedded tissue sections
Surekha Ramulu, Alka D Kale, Seema Hallikerimath, Vijayalaxmi Kotrashetti
January-April 2013, 17(1):23-30
DOI
:10.4103/0973-029X.110698
PMID
:23798825
Aim:
The aim of the present study was to stain the known keratin containing tissues by Haematoxylin and eosin stain (H-E), ayoub-shklar (A/S) and modified Papanicolaou (PAP) stain and to compare the efficacy of modified PAP staining procedure with that of A/S stain and H-E staining technique, so as to device a staining procedure which is easy and effective for keratin.
Materials and Methods:
A Total Number of 60 paraffin embedded tissue sections of known keratin containing tissues including normal keratinized oral mucosa (NKOM), Keratinized Odontogenic Keratocyst (OKC), Verrucous Carcinoma (VC) and Well differentiated Squamous Cell Carcinoma (WDSCC) were taken and 3 sections of 4 microns thickness of each block were cut and stained with above mentioned three stains.
Results:
Surface keratin was stained distinctly and uniformly in all the three staining techniques in NKOM, OKC, and VC and WDSCC. But results were statistically significant in WDSCC when Amount of keratin pearls and Pattern of staining were compared in all 3 staining procedures and p value was p=0.000 and p=0.001 respectively.
Conclusion:
Based on the above findings we conclude that the efficacy of modified PAP is comparable with that of H-E stain and A-S stain for surface keratin and thus be used effectively to stain Surface keratin. Whereas to know the exact pattern of cytokeratin expression in SCC a more sensitive tool like immunohistochemical method can be applied.
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CASE REPORTS
Florid cemento-osseous dysplasia
Bijay Kumar Das, Surya Narayan Das, Aprna Gupta, Suryakanti Nayak
January-April 2013, 17(1):150-150
DOI
:10.4103/0973-029X.110735
PMID
:23798858
Floridcemento-osseous dysplasia (FCOD) is a"fibro-osseouslesion" that characteristically affects the jaw bones of the middle-aged with multi-quadrant radiopaque cementum-like masses. In thepast, the condition was known with a variety of names causing confusion in diagnosis and treatment. The condition is usually asymptomatic and needs no treatment as such. The diagnosis of FCOD is made on the basis of typical clinico-radiological features and biopsy is usually not recommended due to the risk of postoperative infection. This paper reports a rare case of FCOD affecting mandible bilaterally in a forty-two years old woman.
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Spindle cell lipoma of the tongue: A case report of unusual occurrence
Orlando Cavezzi, Eduardo Castro Guerra de Aguiar, José Henrique França Sartori, Flavio de Oliveira Lima
January-April 2013, 17(1):148-148
DOI
:10.4103/0973-029X.110730
PMID
:23798855
Spindle cell lipoma (SCL) is a benign lipomatous tumor predominantly occurring at the posterior neck and shoulder area. Face, forehead, scalp, cheek, perioral area, and upper arm are less common sites. In oral cavity, it is a relatively uncommon neoplasm, particularly in tongue, which is relatively devoid of fat cells. We present a case report of SCL located on the left lateral border of the tongue in a 64-year-old Caucasian female patient with diabetes mellitus type 2 and arterial hypertension.
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REVIEW ARTICLES
Hidden keys in stroma: Unlocking the tumor progression
Madhusudan Astekar, Rashmi Metgud, Ashish Sharma, Aparna Soni
January-April 2013, 17(1):82-88
PMID
:23798836
Malignancy is considered as a pathological imbalance of tissue-cell societies, a state that emerges from tumor-host microenvironment in which host participates in induction, selection and expansion of the neoplastic cells. Invasion of these malignancies can be viewed as a derangement in the proper sorting of cell populations, causing a violation of normal tissue boundaries. This violation is carried out by certain stromal cells like carcinoma associated fibroblasts (CAFs), tumor associated macrophage (TAMs), endothelial cells (ECs) leucocytes, bone marrow derived cells, etc. Tumor cells may alter the surrounding stroma and in turn, stromal cells may promote cancer progression and invasion. Thus, this review compares the role of CAFs, TAMs and ECs in tumor microenvironment towards tumor progression. This compilation aims to collate existing literature on stromal cell with particular emphasis on their role in tumor invasiveness and summarize experimental studies, trials and literature of last 10 years collected from pubmed central indexed journals.
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CASE REPORTS- ODONTOGENIC LESIONS
Clear cell odontogenic carcinoma of maxilla: A case report and mini review
Niharika Swain, Richa Dhariwal, Jay Gopal Ray
January-April 2013, 17(1):89-94
DOI
:10.4103/0973-029X.110681
PMID
:23798837
Clear cell odontogenic carcinoma is a rare odontogenic tumor occurring predominantly in posterior mandible during 5
th
-7
th
decades with a female predilection. It is a potentially aggressive tumor, capable of frequent recurrences and loco-regional and distant metastases. Till date, only 73 cases have been reported in the literature. Current case is of a 55-year-old woman with tumor mass extending from canine to molar region on the left maxillary arch. Being locally aggressive tumor with the capacity to metastasize, it demands to be distinguished from other primary and metastatic clear cell tumors of the oral and maxillofacial region. A brief compilation of the reported cases is being attempted in the current article to better understand the behavior of the tumor.
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CASE REPORTS - DEVELOPMENTAL
Ellis-van Creveld syndrome
: A rare clinical entity
Reet Kamal, Parveen Dahiya, Simerpreet Kaur, Rohit Bhardwaj, Karun Chaudhary
January-April 2013, 17(1):132-135
DOI
:10.4103/0973-029X.110716
PMID
:23798848
Ellis-van Creveld (EVC) syndrome is a genetic disorder with autosomal recessive transmission, which may clinically present as small stature, short limbs, fine sparse hair, hypoplastic fingernails, multiple musculofibrous frenula, conical teeth, hypoplasia of the enamel, hypodontia, and malocclusion. Heart defects, especially abnormalities of atrial septation, have been found in about 60% of cases. The mutation in EVC and EVC2 gene is responsible for this syndrome. The presence of multiple orodental findings makes this syndrome important for dentists. The aim of this article is to present a rare case of EVC syndrome in a 10-year-old girl along with the review of literature.
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2
ORIGINAL ARTICLES
Histopathologic evaluation of follicular tissues associated with impacted lower third molars
Anand S Tegginamani, Rajendra Prasad
January-April 2013, 17(1):41-44
DOI
:10.4103/0973-029X.110713
PMID
:23798828
Context:
Previous studies have reported that the dental follicular tissues associated with impacted lower third molars (ILTMs) may undergo cystic degeneration and/or neoplastic transformation. This is especially likely when the pericoronal space is >2.5 mm on intraoral radiographs and >3 mm on panoramic radiographs and to examine dental follicular tissue for pathological changes in patients with ILTMs and pericoronal radiolucencies of <2.5 mm.
Aim:
Histopathological evaluation of follicular tissues associated with ILTMs.
Materials and Methods:
The morphology of the hematoxylin and eosin-stained follicular tissues of 146 such impactions were studied.
Results:
On microscopy, no cystic structures with fibrous walls were identified. 85 cases (58%) showed fibrous or myxomatous connective tissue and no epithelial elements. 61 cases (42%) showed epithelial elements in addition to fibrocollagenous tissue. Of these, 16 cases exhibited epithelium, of which 13 cases showed reduced enamel epithelium and three cases showed squamous metaplasia/non-keratinized stratified squamous epithelium.
Conclusions:
All asymptomatic unerupted third molars with pericoronal radiolucency of <2.5 mm should be retained since they do not exhibit cyst formation microscopically.
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CASE REPORTS- SOFT TISSUE LESIONS
Clear cell variant of squamous cell carcinoma of skin: A report of a case
Ahmed Oluwatoyin Lawal, Akinyele Olumuyiwa Adisa, Mofoluwaso A Olajide, Adeola Adenike Olusanya
January-April 2013, 17(1):110-112
DOI
:10.4103/0973-029X.110697
PMID
:23798842
Clear cell squamous cell carcinoma (SCC) is a rare variant of SCC of skin in which ultraviolet radiation has been suggested as possible etiology. This case is that of a 62-year-old male concrete block maker/bricklayer who presented with a 6 months history of a non-healing ulcer on the left side of his face. Histology showed features of malignant epithelial neoplasm composed of islands of large oval to polyhedral malignant squamous cells with eosinophilic to amphophilic cytoplasm and vesicular nuclei and there were areas showing clear cell differentiation and isolated areas of keratin pearl formation. The lesion was also negative for periodic acid schiff, mucicarmine, and alcian blue stains but was strongly positive for AE1/AE3 (immuno-stain). This case showed an aggressive and bizarre clinical presentation but more report of cases are needed to have a better characterization of the clinical presentation and prognosis of this variant of SCC.
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ORIGINAL ARTICLES
Analysis of the changes in the basal cell region of oral lichen planus: An ultrastructural study
Mayura Paul, Devi Charan Shetty
January-April 2013, 17(1):10-16
DOI
:10.4103/0973-029X.110690
PMID
:23798823
Context:
Oral lichen planus (OLP) affects 0.5-1% of the total world's population. The histological features of oral lichen planus were first described by Dubreuill in 1906. Despite the advent of various techniques, the etiology of lichen planus remains obscure, although many theories for the etiology have been proposed.
Aims:
By studying OLP electron microscopically, we shall be emphasizing on the cells and its interactions in specific/altered surroundings which would help us in hypothesizing the effects of its specific cell-to-cell interactions.
Materials and Methods:
A total of 20 cases of oral lichen planus were selected and categorized into erosive and nonerosive forms based upon clinical pattern and confirmed as lichen planus by histopathological analysis. Tissue specimens thus obtained were cut into two halves and fixed in appropriate fixatives, i.e., neutral buffered formalin for paraffin-embedded hematoxylin and eosin stained sections and 2.5% glutaraldehyde and 2% paraformaldehyde for electron microscopic purpose respectively.
Results:
Ultrastructural comparison among the two forms showed significant differences between them. The basal layer showed cytoplasmic processes, intercellular spaces, desmosomes, nuclei, and signs of degeneration. The erosive form showed elongated, narrow or irregular cytoplasmic projections whereas the nonerosive showed short and broad based projections.
Conclusions:
The present study confirms the ultrastructural findings of basal cells in OLP with previous authors findings. Besides this, the categorization of the ultrastructural differences between erosive and nonerosive has raised the question of difference in the probable cellular and molecular mechanism between erosive and nonerosive forms.
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ENIGMATIC MORPHO INSIGHT
Bizzare Plasma Cell - Mott Cell
Radhika M Bavle
January-April 2013, 17(1):2-3
DOI
:10.4103/0973-029X.110682
PMID
:23798821
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3
CASE REPORTS- SALIVARY GLAND LESIONS
Sialolipoma of the parotid gland: Case report with literature review comparing major and minor salivary gland sialolipomas
Sohail Qayyum, Ryan Meacham, Merry Sebelik, Nadeem Zafar
January-April 2013, 17(1):95-97
DOI
:10.4103/0973-029X.110687
PMID
:23798838
Sialolipoma is a rare tumor found within both major and minor salivary glands. Here we discuss sialolipoma of the parotid gland and briefly review the English literature. Including our case, a total of 35 sialolipomas have been reported, 18 within major salivary glands and 17 within minor salivary glands. Major gland sialolipomas most often are presented in the parotid gland (77%) and those from minor glands were most often seen in the palate (41%). All lesions were well circumscribed and contained mature adipose tissue intimately admixed with benign salivary gland components. Ductal dilatation was found in 100% of minor salivary gland sialolipomas but in only 28% of major salivary gland tumors. Nerve entrapment has also rarely been noted in major salivary glands (14%) whereas myxoid degeneration has been identified in rare minor salivary glands tumors (13%). Treatment is surgical excision and is curative with no reports of recurrence.
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5
ORIGINAL ARTICLES
Estimation of plasma lipids and its significance on histopathological grades in oral cancer: Prognostic significance an original research
Eugenia J Sherubin, Karthiga S Kannan, Dhineksh N Kumar, Isaac Joseph
January-April 2013, 17(1):4-9
DOI
:10.4103/0973-029X.110685
PMID
:23798822
Background Objectives:
Alterations in the lipid profile have long been associated with various cancers because lipids play a key role in maintenance of cell integrity. This study was to estimate the plasma lipid levels in patients with oral cancer and to correlate the values with the histopathological grades.
Materials and Methods:
The study group included 50 patients with oral cancer aged between 20 and 60 years who had visited the Department of Oral Medicine and Radiology during the period of September 2005 to July 2007. After the histotopathological confirmation, their plasma lipid levels were estimated using auto analyzer and the data was statistically analyzed.
Results:
The study revealed a significant decrease in the total plasma lipid levels in patients with oral cancer in comparison with the standard values. Comparing the plasma lipid levels with the histopathological grades, we observed a significant variation in the levels of total cholesterol, very low density lipoprotein, low-density lipoprotein, high-density lipoprotein and triglycerides
Conclusion:
The variation in the levels of plasma cholesterol and other lipid constituents in patients with cancer might be due to their increased utilization by neoplastic cells for new membrane biosynthesis. This study was an attempt to estimate the plasma lipids in oral cancer patients and its significance on histopathological grades. We observed a relationship between lower plasma lipids and oral cancer. The result of our study strongly warrants an in-depth research with larger samples and a longer follow-up to consider the low plasma lipid status in oral cancer patients as a useful indicator to assess the course and prognosis of the disease.
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CASE REPORTS - INFECTION
Disseminated histoplasmosis with oral and cutaneous manifestations
S Vidyanath, PM Shameena, S Sudha, Resmi G Nair
January-April 2013, 17(1):139-142
DOI
:10.4103/0973-029X.110722
PMID
:23798850
Histoplasmosis is a systemic mycotic infection caused by the dimorphic fungus,
Histoplasma capsulatum
. Systemic histoplasmosis has emerged as an important opportunistic infection in human immunodeficiency virus (HIV) patients and those in endemic areas. Reported cases of histoplasmosis have been low in India with less than 50 cases being reported. We are reporting a case of disseminated histoplasmosis with oral and cutaneous involvement in an HIV seronegative patient.
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11
CASE REPORTS- SALIVARY GLAND LESIONS
Primary clear cell carcinoma of parotid gland: Case report and review of literature
Marta Saldaña Rodriguez, Maria Fe Garcia Reija, Irene Gonzalez Rodilla
January-April 2013, 17(1):101-105
DOI
:10.4103/0973-029X.110692
PMID
:23798840
Clear cell carcinoma (CCC) is a rare low-grade carcinoma that represents only 1% to 2% of all salivary glands tumors. The finding of a clear cell tumor in a parotid gland involves the necessity of differential diagnosis between primary clear cell parotid tumors and metastases, mainly from kidney. The biological behavior is not very aggressive and development, which is very slow, is usually asymptomatic and indeed, the tumor often reaches considerable dimensions before being diagnosed. The treatment of choice is the surgical excision. There are rare cases of local recurrence and distant metastases. The aim of this article is to report a primary CCC in the parotid gland that microscopically closely resembled a metastatic CCC of renal origin, making microscopic differentiation difficult.
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4
CASE REPORTS
Granular cell tumor of the tongue: Report of a case
Alka Dive, Akshay Dhobley, Prajakta Zade Fande, Sudhanshu Dixit
January-April 2013, 17(1):148-148
DOI
:10.4103/0973-029X.110728
PMID
:23798853
Granular cell tumor (GCT) is a benign lesion characterized by the accumulation of plump cells with abundant granular cytoplasm. The formation of a granular cell tumor is a neoplastic process and the lesions formed are of neural derivation, as supported by immunophenotypic and ultra structural evidence. This type of tumor has been found to be both benign and malignant although malignancy is rare and comprises only 2% of all granular cell tumors. Here we report a case of GCT in a 40 year old male patient on the posterolateral border of tongue.
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3,667
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1
CASE REPORTS - BONE PATHOLOGY
Intraosseous myofibroma of mandible: A rarity of jaws: With clinical, radiological, histopathological and immunohistochemical features
Subbaraj Sundaravel, Krishnamurthy Anuthama, Harikrishnan Prasad, Herald J Sherlin, Vadivel Ilayaraja
January-April 2013, 17(1):121-125
DOI
:10.4103/0973-029X.110703
PMID
:23798845
Myofibroma is an uncommon benign mesenchymal neoplasm composed of myofibroblasts, but it can be confused with more aggressive spindle cell tumors. Solitary myofibroma is common in soft tissues of head and neck, but rare in the jaw bones with only 38 cases of central myofibroma of mandible reported in English medical literature. When encountered in the jaws, lesions exhibit clinical and radiographic features suggestive of odontogenic cysts/tumors or other neoplastic conditions. We hereby present the 39
th
case of intraosseous myofibroma of the mandible which had been reported to our institution. A 16-year-old male reported with a chief complaint of swelling in the right side of face. Intraorally there was a firm, nontender swelling in the right buccal aspect of the mandible. Radiologically the lesion was osteolytic, destroying the buccal cortical plate. Histologically, characteristic biphasic pattern of myofibroma was noticed. Immunoreactivity was positive for vimentin and αSMA but negative for desmin, thus confirming our diagnosis. The patient was treated by local-wide surgical excision of the lesion. A 3-year follow-up revealed no signs of recurrence. Occurrence of myofibroma involving the jaw bones is common in the younger age groups and represents a unique diagnostic and therapeutic challenge. Differentiating this lesion from other benign and malignant neoplasms is crucial in deciding between a radical and a conservative treatment approach.
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334
3
ORIGINAL ARTICLES
c-Myc oncogene expression in selected odontogenic cysts and tumors: An immunohistochemical study
Zama Moosvi, K Rekha
January-April 2013, 17(1):51-56
DOI
:10.4103/0973-029X.110725
PMID
:23798830
Aim:
To investigate the role of c-Myc oncogene in selected odontogenic cysts and tumors.
Materials and Methods:
Ten cases each of ameloblastoma, adenomatoid odontogenic tumor (AOT), odontogenic keratocyst (OKC), dentigerous cyst, and radicular cyst were selected and primary monoclonal mouse anti-human c-Myc antibody was used in a dilution of 1: 50. Statistical Analysis was performed using Mann Whitney U test.
Results:
80% positivity was observed in ameloblastoma, AOT and OKC; 50% positivity in radicular cyst and 20% positivity in dentigerous cyst. Comparison of c-Myc expression between ameloblastoma and AOT did not reveal significant results. Similarly, no statistical significance was observed when results of OKC were compared with ameloblastoma and AOT. In contrast, significant differences were seen on comparison of dentigerous cyst with ameloblastoma and AOT and radicular cyst with AOT.
Conclusion:
From the above data we conclude that (1) Ameloblastoma and AOT have similar proliferative potential and their biologic behavior cannot possibly be attributed to it. (2) OKC has an intrinsic growth potential which is absent in other cysts and reinforces its classification as keratocystic odontogenic tumor.
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3,622
366
3
KNOW YOUR FIELD
Molluscum contagiosum
Kavita Rao, NS Priya, HS Umadevi, T Smitha
January-April 2013, 17(1):146-147
DOI
:10.4103/0973-029X.110726
PMID
:23798852
[FULL TEXT]
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[PubMed]
3,466
387
2
CASE REPORTS- SOFT TISSUE LESIONS
Amelanotic melanoma of the tongue
M Venugopal, IV Renuka, G Saila Bala, N Seshaiah
January-April 2013, 17(1):113-115
DOI
:10.4103/0973-029X.110699
PMID
:23798843
Malignant melanoma of the oral cavity is a rare lesion, with an incidence of about 0.2% to 0.8% of all melanomas. Melanoma of tongue is still rarer and represents less than 2% of oro-nasal melanoma cases. We report a rare case of amelanotic melanoma of the tongue in a young man. The importance of consideration of melanoma in the differential diagnosis of oral cavity lesions is discussed since mucosal melanoma carries a bad prognosis and early diagnosis is vital.
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3,525
306
4
CASE REPORTS - BONE PATHOLOGY
Intraosseous lipoma of mandible presenting as a swelling
Shaini Basheer, Jerly Abraham, PM Shameena, Anita Balan
January-April 2013, 17(1):126-128
DOI
:10.4103/0973-029X.110705
PMID
:23798846
Lipomas are the most common form of benign mesenchymal tumors and are composed of mature adipocytes. They can occur anywhere in the body where fat is found and thus, called as the 'universal tumor' or the 'ubiquitous tumor'. Intraosseous lipomas (IOL) are among the rarest (0.1%) of primary bone tumors and are very rarely seen in head and neck bones. They have been subdivided based on the site of origin within bone, into intramedullary and intracortical. Of the two, few cases of intramedullary lipoma have been reported intraorally and none of the latter. Intraosseous lipomas are usually asymptomatic and are detected incidentally on radiographs taken for other complaints. Here, we report a case of intraosseous lipoma in the mandible presenting as a large swelling.
[ABSTRACT]
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3,452
368
6
ORIGINAL ARTICLES
Fluorescence
in-situ
hybridization technique as a diagnostic and prognostic tool in oral squamous cell carcinoma
PM Sunil, CR Ramachandran, S Gokul, N Jaisanghar
January-April 2013, 17(1):61-64
DOI
:10.4103/0973-029X.110731
PMID
:23798832
Background and Objectives:
Early diagnosis and appropriate management are of prime importance for oral squamous cell carcinoma (OSCC) in the present scenario. Molecular changes in OSCC are well documented with the occurrence of a wide range of genetic damage. Identification of the genetic damage in OSCC using various diagnostic aids is mandatory, and one of the important advances in this field is cytogenetics using fluorescence
in-situ
hybridization (FISH). The aim of the present study is to analyze the genetic alteration in OSCC using FISH as a diagnostic aid.
Materials and Methods:
Peripheral blood was analyzed in 20 clinically and histopathologically proven OSCC cases and 10 healthy controls for chromosomal alteration under standardized conditions.
Results:
Of the 20 OSCC cases, 7 (35%) cases showed chromosomal alterations. No cases from the control group showed any chromosomal changes. Of the positive cases in OSCC, 30% cases showed increased copy number of cyclin D1 gene and 1 (5%) case showed positivity indicating extra copy of chromosome 11p11.11-q11 region.
Interpretation and Conclusion:
Increased genetic damage in OSCC which is a prominent feature can be identified by the use of FISH as seen from the present study. The findings suggest that FISH can be used as a diagnostic aid in the detection of genetic changes occurring in OSCC. The present study also suggests the importance of peripheral blood as a medium for assessing cytogenetic damage in OSCC.
[ABSTRACT]
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3,339
427
2
CASE REPORTS- SOFT TISSUE LESIONS
Malignant peripheral nerve sheath tumor of facial nerve: Presenting as parotid mass
Bageshri P Gogate, Mani Anand, Sanjay D Deshmukh, Snehal N Purandare
January-April 2013, 17(1):129-131
DOI
:10.4103/0973-029X.110708
PMID
:23798847
Malignant peripheral nerve sheath tumor (MPNST) is very uncommon tumor of parotid gland and it is an uncommon spindle cell sarcoma accounting for approximately 5% of all soft-tissue sarcoma. There is strong association between MPNSTs and neurofibromatosis (NF-1) and previous irradiation. Structural abnormality of chromosome 17 is associated with NF-1 and so MPNST. We present a case of a 78-year-old male presenting with slowly growing parotid mass who underwent tumor resection.
[ABSTRACT]
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3,281
228
7
CASE REPORTS- SALIVARY GLAND LESIONS
Adenoid cystic carcinoma on the dorsum of the tongue
Subhalakshmi Sengupta, Anadi Roychowdhury, Palash Bhattacharya, Anjali Bandyopadhyay
January-April 2013, 17(1):98-100
DOI
:10.4103/0973-029X.110689
PMID
:23798839
Adenoid cystic carcinoma is a relatively rare epithelial tumor of the salivary glands accounting for about 5-10% of all salivary gland neoplasms. Approximately, 31% of salivary gland neoplasms affect minor salivary glands particularly the palate. It involves tongue in only 19.8% of cases and even rarely the dorsum of the tongue. We report such a rare case that affected dorsum of the tongue in a 45-year-old-female patient.
[ABSTRACT]
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3,140
299
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ORIGINAL ARTICLES
Impact of highly active antiretroviral therapy on salivary flow in patients with human-immuno deficiency virus disease in Southern India
S Pavithra, K Ranganathan, UmaDevi K Rao, Elizabeth Joshua, T Rooban, N Kumarasamy
January-April 2013, 17(1):17-22
DOI
:10.4103/0973-029X.110695
PMID
:23798824
Aims:
To ascertain and compare between highly active antiretroviral therapy (HAART) and non-HAART patients, the stimulated salivary flow rates and unstimulated salivary flow rates (USFR and SSFR) and to correlate the salivary flow rates with immune suppression.
Materials and Methods:
One hundred human-immuno deficiency virus seropositive patients attending RAGAS-YRG CARE were examined and divided into two groups, a HAART group (patients on combination antiretroviral therapy) comprising 50 patients and a non-HAART group comprising 50 patients. The HAART group was followed every 3 months after the baseline visit (0) for a period of 9 months, during which a clinical oral examination and collection of unstimulated and stimulated saliva was done. Their salivary gland function was assessed using a xerostomia inventory during each visit. The study on non-HAART group was cross-sectional.
Statistical Analysis:
Statistical analysis were performed with the aid of the Statistical Package for the Social Sciences (SPSS version 10.05) software.
Results:
There was no significant difference in mean SSFR and USFR between the two groups at baseline. In the HAART group, the mean stimulated salivary flow rate increased from baseline to 3 months (
P
= 0.02), with the increase being maintained at 6 months and 9 months. When salivary flow rates were correlated with Cluster of Differentiation, CD4 counts, patients in the HAART group with a CD4 ≤ 200 at 6 months visit had a higher mean stimulated salivary flow rate when compared with patients with CD4 ≥ 200 (
P
= 0.02). The xerostomia inventory did not reveal any significant difference between the two groups and HAART was not significantly associated with xerostomia.
Conclusion:
In our study HAART was neither associated with xerostomia nor a reduction in salivary flow rate and immune suppression was not a significant factor for decreasing the salivary flow rate.
[ABSTRACT]
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3,109
274
2
CASE REPORTS
Ameloblastic fibroma in one-year-old girl
Anita D Munde, Ravindra R Karle, Ujwala B Kale
January-April 2013, 17(1):149-149
DOI
:10.4103/0973-029X.110734
PMID
:23798857
Ameloblastic fibroma (AF) is a relatively rare, slow growing benign mixed odontogenic tumor, comprising of 1.5-4.5% of all odontogenic tumors. It is usually asymptomatic except for the eventual expansion of the jaw. AFs are most common in adolescents and young adults, mostly affecting the mandible as a well-defined uni or multilocular radiolucency. The effective surgical treatment includes enucleation and curettage of the surrounding bone and removal of the affected teeth. Although recurrence of AF is rare, a long term follow up is recommended. This report describes a 1-year-old girl with AF in the mandible and discusses its clinical, radiographic and histological findings.
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3,052
312
3
REVIEW ARTICLES
Human immunodeficiency virus vaccine an update
VT Beena, Kanaram Choudhary, R Rajeev, R Sivakumar, R Heera, SK Padmakumar
January-April 2013, 17(1):76-81
DOI
:10.4103/0973-029X.110741
PMID
:23798835
Since the discovery of acquired immuno deficiency syndrome (AIDS) in late1980s, the spread of human immunodeficiency virus (HIV) has reached pandemic proportions, representing a global developmental and public health threat. Finding of a safe, globally effective and affordable HIV vaccine offers the best hope for the future control of the disease pandemic. Significant progress has been made over the past years in the areas of basic virology, immunology, and pathogenesis of HIV/AIDS and the development of anti-retroviral drugs. However, the search for an HIV vaccine faces formidable scientific challenges related to the high genetic variability of the virus, the lack of immune correlates of protection, limitations with the existing animal models and logistical problems associated with the conduct of multiple clinical trials. Most of the vaccine approaches developed so far aim at inducing cell-mediated immune responses. Multiple vaccine concepts and vaccination strategies have been tested, including DNA vaccines, subunit vaccines, live vectored recombinant vaccines, various prime-boost vaccine combinations and vaccine based on broadly neutralizing human anti-HIV Antibody 2G12. This article reviews the state of the art in HIV vaccine research, summarizes the results obtained so far and discusses the challenges to be met in the development of a successful HIV vaccine.
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2,873
483
2
ORIGINAL ARTICLES
An immunohistochemical study of basement membrane heparan sulfate proteoglycan (perlecan) in oral epithelial dysplasia and squamous cell carcinoma
Mithilesh Mishra, Vidyadevi Chandavarkar, Veena V Naik, Alka D Kale
January-April 2013, 17(1):31-35
DOI
:10.4103/0973-029X.110704
PMID
:23798826
Background:
Basement membrane heparan sulfate proteoglycan (perlecan) has been demonstrated in precancer lesions and carcinomas of oral cavity. It helps in malignant transformation of epithelial cells. The aim of our study was to understand the immuno-localization of perlecan in oral dysplastic epithelium and oral carcinomas.
Materials and Methods:
A total of 50 cases comprising 10 normal mucosa, 20 dysplastic mucosa, and 20 oral squamous cell carcinomas (OSCC) were included in the retrospective study. They were examined for the presence of perlecan protein core by immunohistochemistry using monoclonal antibody. Interpretation of the pattern of staining was done, and majority of the observations were taken for statistical analysis.
Results:
In normal epithelium, perlecan was found to be present in basal layer at the cell border. In dysplastic epithelium, it was present in suprabasal layers also. With the increase in severity of dysplasia, its expression was more in suprabasal layers, and the immuno-localization was found to be at cell border and cytoplasm. In OSCC cases, perlecan was present in stroma and tumor islands.
Conclusion:
It was deduced from the above results that perlecan helps potentially in dysplastic changes of epithelial cells. It gets accumulated within the cell and intercellular spaces and serves as a reservoir for various growth factors. In OSCC, it breaks down and releases growth factors, which help in tumor progression, angiogenesis, and metastasis of the carcinoma.
[ABSTRACT]
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3,004
338
4
CASE REPORTS
Leimyosarcoma of the buccal mucosa and review of literature
Deepak Kumar J Nagpal, Prashant R Prabhu, Amisha Shah, Sangeeta Palaskar
January-April 2013, 17(1):149-149
DOI
:10.4103/0973-029X.110732
PMID
:23798856
Leiomyosarcoma (LMS) is an uncommon malignant spindle cell tumor of the head and neck region. The occurrence is particularly rare in the buccal mucosa of the oral cavity. It is a rapidly growing tumor with aggressive behavior and poor prognosis. Method: This article presents a rare case of primary leimyosarcoma of the buccal mucosa in a 35 year old female and retrospective analysis of primary oral LMS published in the English literature since past 20 years is done. Diagnosis was confirmed by immunohistochemistry profile showing positivity for vimentin, smooth muscle actin (SMA), high proliferative index displayed by Ki-67, focal positivity for pan-CK and negativity for S-100. Conclusion: Based on the presence of malignant spindle cells showing positivity for vimentin and SMA, a diagnosis of leiomyosarcoma was made.
[ABSTRACT]
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2,924
381
4
CASE REPORTS - DEVELOPMENTAL
Clear cell hidradenoma: An unusual tumor of the oral cavity
MV Paranjyothi, Archana Mukunda
January-April 2013, 17(1):136-138
DOI
:10.4103/0973-029X.110719
PMID
:23798849
Clear cell hidradenoma (CCH) is a benign tumor of skin appendage. This lesion is commonly seen on the head, face, extremities and rarely in the oral cavity. The clinical appearance of this lesion is not specific and differential diagnosis from other lesions, both benign and malignant, can only be made after complete removal of the lesion. Histopathology of these lesions is often confused with tumors of salivary glands because of their striking resemblance. In this case of oral CCH, histopathology was an important aid in the diagnosis and hence, CCH should be considered in the differential diagnosis of lesions of the oral cavity.
[ABSTRACT]
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2,895
244
2
ORIGINAL ARTICLES
Revealing anti-cariogenic efficacy of smokeless tobacco: A pilot study
Ankita Tandon, Narendra Nath Singh, Gadiputi Sreedhar
January-April 2013, 17(1):57-60
DOI
:10.4103/0973-029X.110727
PMID
:23798831
Background:
The tobacco plant,
Nicotiana tabacum
, has been responsible for more deaths than any other herb. However, the literature has also been endowed with its use as "holy herb" since the pre-Columbian era. Used for treating pain, poisonous bites, ulcers, nasal polyps, and basal cell carcinoma; it also acts as an important ingredient of commercially available toothpastes; and even used as tobacco vaccines against
Streptococcus
species as highlighted in the literature.
Aims and Objectives:
(1) To elicit the anti-microbial property of tobacco against
Streptococcus mutans
, if any, in raw smokeless tobacco. (2) To study the relationship of duration and growth inhibition efficacy of smokeless tobacco.
Materials and Methods:
Extracts were prepared by centrifugation of mixed raw smokeless tobacco with Ringer's lactate solution and with saliva. The extracts were placed in wells prepared on Mitis salivarius culture plate and incubated at 37C for 24 h after 0 h, 1 h, and 2 h of extract preparation. The inhibition zones were measured on the underside of plate using the vernier calipers.
Results:
Smokeless tobacco has a statistically significant zone of inhibition, which proves its anti-microbial activity against
S. mutans
. However, the mean zones of inhibition were greater for Ringer's lactate and tobacco group as compared to test samples (saliva and tobacco) with subsequent reduction of inhibition zones with an increase in duration.
Conclusion:
The anti-microbial property of extensive tobacco resources can be utilized from their extracts in order to balance the deterioration it had caused to mankind.
[ABSTRACT]
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2,753
357
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KNOW YOUR FIELD
Histomorphological array in odontogenic keratocyst
Mohsin Gadiwan, K Paremala, M Soumya, Sreelatha S Hosthor
January-April 2013, 17(1):143-145
DOI
:10.4103/0973-029X.110724
PMID
:23798851
[FULL TEXT]
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2,369
425
1
CASE REPORTS- SOFT TISSUE LESIONS
Multisystem Langerhans cell histiocytosis presenting as an oral lesion
Kallarakkal Thomas George, Ramanathan Anand, Sockalingam Ganasalingam, Rosnah B Zain
January-April 2013, 17(1):106-109
DOI
:10.4103/0973-029X.110694
PMID
:23798841
Langerhans cell histiocytosis (LCH) is a rare proliferative disorder in which the pathologic Langerhans cells infiltrate and destroy the tissues. Patients with LCH present varied clinical manifestations. Cutaneous lesions in LCH manifest as vesiculopapular eruptions that often mimic various infectious diseases particularly in infants. We present a case of a female infant with an ulcerative lesion intraorally. The baby was asymptomatic otherwise. A detailed history revealed the presence of cutaneous lesions that was overlooked by her parents.
Conclusion:
This report tries to briefly discuss the current concepts regarding the etiology of LCH. An attempt has been made to emphasis the need for a through systemic examination. The protocol of investigative procedures to be adopted in LCH is also discussed.
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2,515
268
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EDITORIAL
From the Editor's desk
Radhika M Bavle
January-April 2013, 17(1):1-1
DOI
:10.4103/0973-029X.110680
PMID
:23798820
[FULL TEXT]
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1,894
306
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