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An Official Publication of the Indian Association of Oral and Maxillofacial Pathologists
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   2014| May-August  | Volume 18 | Issue 2  
    Online since September 17, 2014

 
 
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REVIEW ARTICLES
MicroRNAs - Biology and clinical applications
Kannan Ranganathan, Vaishnavi Sivasankar
May-August 2014, 18(2):229-234
DOI:10.4103/0973-029X.140762  PMID:25328304
MicroRNAs are a highly conserved group of small, non-coding RNA molecules, which are 19-25 nucleotides in size. Previously thought to be evolutionary debris with no evident function, these small RNAs have been found to control gene expression primarily by silencing the gene. MicroRNAs are critical to cell physiology and development. They are also implicated in pathological processes such as autoimmune diseases, viral infections and carcinogenesis.
  38 4,139 804
Uncommon opportunistic fungal infections of oral cavity: A review
AG Deepa, Bindu J Nair, TT Sivakumar, Anna P Joseph
May-August 2014, 18(2):235-243
DOI:10.4103/0973-029X.140765  PMID:25328305
The majority of opportunistic oral mucosal fungal infections are due to Candida albicans and Aspergillus fumigatus species. Mucor and Cryptococcus also have a major role in causing oral infections, whereas Geotrichum, Fusarium, Rhodotorula, Saccharomyces and Penicillium marneffei are uncommon pathogens in the oral cavity. The broad spectrum of clinical presentation includes pseudo-membranes, abscesses, ulcers, pustules and extensive tissue necrosis involving bone. This review discusses various uncommon opportunistic fungal infections affecting the oral cavity including their morphology, clinical features and diagnostic methods.
  27 7,263 1,189
ORIGINAL ARTICLES
Expression of Ki-67 in normal oral epithelium, leukoplakic oral epithelium and oral squamous cell carcinoma
Smita Shrishail Birajdar, MB Radhika, K Paremala, M Sudhakara, M Soumya, Mohsin Gadivan
May-August 2014, 18(2):169-176
DOI:10.4103/0973-029X.140729  PMID:25328294
Aims and Objective: To demonstrate the presence, location and pattern of cell proliferation in different histological grades of oral epithelial dysplasia (OED), oral squamous cell carcinoma (OSCC) and normal oral epithelium (NOE) using an antibody directed against the Ki-67 antigen and its intensity of staining evaluated respectively. Materials and Methods: A total number of 100 archival paraffin embedded blocks obtained from Department of Oral and Maxillofacial Pathology were studied. The case details were retrieved which consisted of histopathologically diagnosed cases of OSCC (n = 20), low risk OED (n = 30), high risk OED (n = 30) and normal appearing mucosa (n = 20) were taken as standard for comparison. Ki-67 immunostaining was detected. Ki-67 positive cells were counted in the five random high power fields in each case. Results: Ki-67 labeling Index (LI) was restricted to the basal and parabasal layers of the normal oral epithelium irrespective of age, sex and site whereas it was seen in the basal, suprabasal and spinous layers in OED. Ki-67 LI is increased in high risk cases than the low risk cases of OED. Ki-67 positive cells in OSCC were located in the periphery of the tumor nests than the center, where frequent mitoses were observed. Conclusion: The architectural alteration evaluated by Ki-67 antibody in proliferating cell distribution in the layers of epithelial dysplasias may provide useful information to evaluate the grading of OED. Ki-67 LI increased in high risk cases than low risk cases of OED. This study showed that over expression of Ki-67 antigen between well-differentiated and poorly differentiated OSCC was in accordance with histologic grade of malignancy but not in accordance with moderately differentiated OSCC.
  22 4,737 520
Evaluation of c-kit protein (CD117) expression in common salivary gland neoplasms
Jahanshah Salehinejad, Nooshin Mohtasham, Ali Bagherpour, Hamid Abbaszadeh-bidokhty, Ala Ghazi
May-August 2014, 18(2):177-182
DOI:10.4103/0973-029X.140732  PMID:25328295
Background: Adenoid cystic carcinoma (AdCC) is a malignant salivary gland neoplasm with poor long-term prognosis. Differentiating between AdCC and other salivary gland neoplasms can be a diagnostic challenge, particularly in examining tissues obtained from small incisional biopsies. Aim: The aim of this study was to evaluate c-kit expression in four common benign and malignant salivary gland neoplasms. Materials and Methods: Immunohistochemical techniques were used to analyze the level of c-kit expression in normal salivary gland (n = 10) and four different types of salivary gland tumors: Pleomorphic adenoma (PA) (n = 17), AdCC (n = 9), polymorphous low-grade adenocarcinoma (PLGA) (n = 4) and mucoepidermoid carcinoma (MEC) (n = 6). Samples were immunostained using monoclonal antibody against c-kit. Results: The immunoreactivity for c-kit was found in all cases of AdCC, PLGA and MEC and majority of PAs. Positive reactivity was observed in more than 50% of the tumor cells of AdCC and less than 50% in PLGA. PA did not show strong immunostaining and c-kit was predominantly localized to the cell membrane. Furthermore, the difference in the expression of c-kit between the benign and malignant neoplasms was not statistically significant. Conclusions: CD117 expression itself cannot be used as a marker in differential diagnosis of salivary gland neoplasms. However, the percentage of the CD117 immunoreactive cells and the staining intensities appeared to be important factors in distinguishing AdCC from PLGA and PA.
  10 2,705 292
Evaluation and comparison of expression of p63 in odontogenic keratocyst, solid ameloblastoma and unicystic ameloblastoma
BK Varsha, A Leena Gharat, BR Nagamalini, M Jyothsna, Sahana T Mothkur, Uma Swaminathan
May-August 2014, 18(2):223-228
DOI:10.4103/0973-029X.140755  PMID:25328303
Background and Objectives: The behavior of odontogenic lesions varies with some tumors behaving like a cyst and some cysts behaving like tumors. p63, a member of the p53 family of tumor suppressor genes has recently come into light in view of its role as an oncogene. The aim of the present study was to investigate the expression of p63 protein in OKC, Solid ameloblastoma, Unicystic Ameloblastoma and Follicular tissue. Materials and Methods: p63 expression was compared in 12 cases of OKC, 12 Solid Ameloblastoma, 14 cases of Unicystic ameloblastoma and 10 cases of Follicular tissue using immunohistochemical technique. All 48 cases were subjected to heat-induced antigen retrieval method using citrate buffer in a pressure cooker. Then the sections were stained with anti-p63 polyclonal antibody and visualized using super sensitive polymer HRP detection system. In each case, number of cells showing p63 positivity were assessed in two compartments - basal and suprabasal and compared. Results: Statistical analysis showed that p63 expression in the suprabasal compartment in Odontogenic keratocysts was equivalent to that of central neoplastic cells of Solid Ameloblastoma and Unicystic Ameloblastoma type 3. Statistically significant difference in the expression of p63 was observed between OKC and Unicystic Ameloblastoma Type 1 and Solid Ameloblastoma and Unicystic Ameloblastoma Type 1. Conclusion: We conclude that the higher expression of p63 in these odontogenic lesions correlates well with their aggressive behavior and thereby suggesting alterations in treatment modalities.
  9 2,761 350
CASE REPORTS
Craniofacial brown tumor as a result of secondary hyperparathyroidism in chronic renal disease patient: A rare entity
Pradhuman Verma, Kanika Gupta Verma, Dinesh Verma, Nitin Patwardhan
May-August 2014, 18(2):267-270
DOI:10.4103/0973-029X.140779  PMID:25328310
Brown tumors are erosive bony lesions caused by rapid osteoclastic activity and peritrabecular fibrosis due to primary or secondary hyperparathyroidism resulting in a local destructive phenomenon. The differential diagnosis based on histological examination is only presumptive. Clinical, radiological and laboratory data are necessary for definitive diagnosis. Here, we report a very rare case of brown tumor involving maxilla and mandible, which is the result of secondary hyperparathyroidism in 30-year-old female patient with chronic renal disease.
  7 2,962 232
ORIGINAL ARTICLES
Clinico-pathological correlation of E-cadherin expression at the invasive tumor front of Indian oral squamous cell carcinomas: An immunohistochemical study
Monica Mehendiratta, Monica Charlotte Solomon, Karen Boaz, Vasudeva Guddattu, Aashima Mohindra
May-August 2014, 18(2):217-222
DOI:10.4103/0973-029X.140753  PMID:25328302
Background: Recent studies have indicated that although malignant cells at the invasive tumor front, bare morphological resemblance to the cells at central portion of the tumor, their molecular character differs significantly. E-cadherin is a cell-cell adhesion molecule that connects epithelial cells. This study attempts to correlate the E-cadherin expression at the invasive tumor front with tumor differentiation along with its clinico-pathological parameters. Materials and Methods: Immunohistochemical staining with E-cadherin was carried out on archival cases of primary oral squamous cell carcinomas (n = 30). The E-cadherin expression at the invasive tumor front was analyzed and was linked to clinico-pathological parameters including patient prognosis. Results: The downregulation of E-cadherin expression at the invasive tumor edge when compared with patient's prognosis yielded a significant correlation (P = 0.041) but its correlation with the degree of differentiation determined was not significant (P = 0.27). Also, its association with tumor size and lymph node status was negative. Conclusions: Loss of E-cadherin expression at the invasive tumor front is an important event in the progression of oral squamous cell carcinomas. Tumors with a loss of expression of E-cadherin are those which had a poor prognosis
  7 4,139 301
CASE REPORTS
Squamous cell carcinoma of submandibular salivary gland: A rare case report
Vardendra Manvikar, Surekha Ramulu, Shilpa T Ravishanker, Chitra Chakravarthy
May-August 2014, 18(2):299-302
DOI:10.4103/0973-029X.140909  PMID:25328317
Malignant tumors of submandibular salivary gland are rare in occurrence. Squamous cell carcinoma of salivary glands accounts for about 0.9-4.7% of all salivary gland tumors with a predilection to occur in parotid gland due to perinodal involvement. Primary squamous cell carcinoma of submandibular salivary gland accounts to about 2% of the tumors and hence it is being represented for its rarity.
  5 3,387 300
ORIGINAL ARTICLES
Relationship among tobacco habits, human papilloma virus (HPV) infection, p53 polymorphism/mutation and the risk of oral squamous cell carcinoma
Bidyut Chakrobarty, Jay Gopal Roy, Sumit Majumdar, Divya Uppala
May-August 2014, 18(2):211-216
DOI:10.4103/0973-029X.140752  PMID:25328301
The prevalence of oral squamous cell carcinoma (OSCC) has significantly increased over decades in several countries and human papilloma virus (HPV) has been indicated as one of the underlying causes. This suggests that HPV plays a role in the early stages of carcinogenesis but is not a requisite for the maintenance and progression of malignant state. p53 is a tumor suppressor gene that checks the cell and promotes apoptosis and cell repair that can be deactivated by mutations and a viral interaction leading to cancer and individuals with particular polymorphic variant of p53 is more susceptible to HPV-induced carcinogenesis. The present study has been carried out to detect and correlate p53 polymorphism/mutation, HPV DNA in the biopsy samples of oral cancer patients who had tobacco habits.
  5 2,612 366
Immunohistochemical analysis of Ki-67 in dental follicle of asymptomatic impacted third molars
Hasan Kucukkolbasi, Alparslan Esen, Ozgur Hilal Erinanc
May-August 2014, 18(2):189-193
DOI:10.4103/0973-029X.140737  PMID:25328297
Introduction: Dental follicle (DF) is an ectomesenchymal tissue that surrounds the developing tooth germ and contains precursor cells for cementoblasts, periodontal ligaments and osteoblasts. Radiographically, the DFs are seen as semicircular radiolucencies around unerupted teeth. However, if the DFs are larger than 2.5 mm, they are considered to be a pathological change. Aims and Objectives: The purpose of this study is to assess the cell proliferation activity of DF surrounding an asymptomatic impacted third molar teeth using the Ki 67 proliferation marker and to evaluate the variation of cell proliferation depending on the age factor. Materials and Methods: Forty-four specimens of DFs associated with impacted mandibular third molars fully covered by mucosa or bone were surgically removed from 44 patients. The patients were divided into 2 age groups. Twenty of forty-four DFs were between 18 and 29 years (Group 1) and 24 were 30 years and above (Group 2). Ki-67 immunostaining was evaluated in epithelial component of the DFs. Results: Ki 67 expression was found to be 60% in Group 1 and 75% in Group 2. Statistically significant differences were found among the two groups in both the basal layer and the supra-basal layer. Conclusion: This study shows that DFs have more proliferative potential in older people as compared to the young and squamous metaplasia may be an early sign of developing lesions of odontogenic origin. Therefore, clinicians should be aware that histopathological changes could be found in DFs without clinical and radiographic alterations.
  5 1,756 204
Immunohistochemical study of CD44s expression in oral squamous cell carcinoma-its correlation with prognostic parameters
KN Hema, Kavita Rao, HS Uma Devi, NS Priya, T Smitha, HS Sheethal
May-August 2014, 18(2):162-168
DOI:10.4103/0973-029X.140722  PMID:25328293
Background and Objectives: The study aims at the observation of the immunohistochemical expression of CD44s in Oral Squamous Cell Carcinoma (OSCC) and to correlate its expression with prognostic parameters. Materials and Methods: A total of 30 cases of OSCC, - 10 cases of each well differentiated (WD SCC), moderately differentiated (MD SCC) and poorly differentiated squamous cell carcinomas (PD SCC) were included in the study. The sections were subjected to immunohistochemical study using CD44s antigen marker. The degree of intensity and distribution of CD44s immunostaining was assessed and correlated with prognostic markers such as tumor stage (tumor size), tumor grade (Broder's histological grading), tumor site, tumor thickness (histological depth of invasion) and nodal status. Results: CD44s expression by tumor cells in OSCCs is statistically correlated with tumor grade i.e. Higher mean of CD44s immunoexpression was observed in WD SCC group (10.80 ± 3.97), followed by MD SCC group (5.90 ± 3.38) and PD SCC group showed least CD44s immunoexpression (3.70 ± 4.64). There was no statistical significance observed with respect to the other prognostic markers. Conclusion: Based on these observations it can be suggested that the decrease in expression of CD44s in OSCC cells may be due to the reduced cell-to-cell and cell-to-matrix adhesion, resulting in easy detachment from the rigid constitution. Low expression of CD44s in OSCC tissues may be an indicator of tumor invasion and high metastatic potential.
  5 2,642 310
REVIEW ARTICLES
Contemporary practice in forensic odontology
Shalini Gupta, Archana Agnihotri, Akhilesh Chandra, Om Prakash Gupta
May-August 2014, 18(2):244-250
DOI:10.4103/0973-029X.140767  PMID:25328306
Forensic odontology plays a major role in the identification of those individuals who cannot be identified visually or by other means. The unique nature of dental anatomy and placement of custom restorations ensure accuracy when the techniques are correctly employed. It is evident that identification of victims in accidents and natural calamities is of utmost importance and is a challenging task. The teeth may also be used as weapons and under certain circumstances; they may provide information regarding the identity of the biter. Dental professionals play a major role in keeping accurate dental records and providing all necessary information so that legal authorities may recognize malpractices, negligence, fraud child abuse and also, identify an individual. In this article, we will discuss such evolvement of the subject.
  5 5,098 702
CASE REPORTS
Undetected hypothyroidism: A rare dental diagnosis
Sonal B Dudhia, Bhavin B Dudhia
May-August 2014, 18(2):315-319
DOI:10.4103/0973-029X.140922  PMID:25328321
Thyroid dysfunction is the second most common glandular disorder of the endocrine system, which may rear its head in any system in the body including the mouth. The oral cavity is adversely affected by either an excess or deficiency of thyroid hormone. Childhood hypothyroidism known as cretinism is characterized by thick lips, large protruding tongue (macroglossia), malocclusion and delayed eruption of teeth. Neonatal screening for congenital hypothyroidism is not performed in all countries and not every affected patient might be determined by neonatal screening alone. The dentist by detecting the early signs and symptoms of hypothyroidism can refer the patient for medical diagnosis and treatment and avoid potential complications of treating patients with uncontrolled disease. Herein, we present a case of undetected hypothyroidism in a 13-year-old female patient based on dental features by oral medicine specialists.
  4 5,702 527
Basaloid squamous cell carcimoma: A rare case report with review of literature
BN Shivakumar, Bishwajeet Dash, Anshuta Sahu, Barakha Nayak
May-August 2014, 18(2):291-294
DOI:10.4103/0973-029X.140797  PMID:25328315
Basaloid squamous cell carcinoma (BSCC) is a distinct variant of conventional squamous cell carcinoma (SCC), predominantly localized in the upper aerodigestive tract. In the head and neck region, the tumor has a strong predilection for extra-laryngeal sites, such as the base of the tongue, tonsil, hypopharynx and supraglottic larynx. BSCC has well-defined histological features, characterized by nesting, lobular and trabecular arrangement of basaloid cells. Central comedonecrosis within the cell nests, cells with nuclear palisading and high-grade dysplasia in overlying mucosa are the main characteristics. The tumor is considered to be highly aggressive and often presents itself as an advanced stage lesion, thus demanding early diagnosis and prompt treatment. We here report a case of 72-year-old male diagnosed with BSCC involving the right tonsillar region.
  4 3,123 263
ORIGINAL ARTICLES
Immunohistochemical expression of CD34 and basic fibroblast growth factor (bFGF) in oral submucous fibrosis
Deepak Pandiar, PM Shameena
May-August 2014, 18(2):155-161
DOI:10.4103/0973-029X.140718  PMID:25328292
Background: Oral submucous fibrosis (OSMF) is an insidious chronic fibrotic condition that involves the oral mucosa and occasionally the pharynx and esophagus. Vascularity in OSMF has always been a matter of debate. The prevailing concept is that epithelial atrophy occurs due to lack of perfusion but the recent data challenges this concept. Therefore, the present study was conducted to evaluate the immunoreactivity of CD34 and basic fibroblast growth factor (bFGF) in different histological grades of OSMF. This might further shed light to the role of microvasculature in OSMF, so that the epithelial atrophy and resultant malignant transformation seen in the advanced stages might be elucidated. Materials and Methods: A total of 30 cases of OSMF were included in the study and mean vascular density (MVD) was calculated using CD34 and bFGF. Five cases of OSMF with dysplasia and 2 cases of OSMF turning malignant were added during the course of the study. Results: Mean vascular density was found to decrease significantly as the diseases advanced. Furthermore, vascularity increased significantly in cases of OSMF turning towards malignancy. Conclusion: Our study supports the concept of epithelial atrophy aftermath of lack of perfusion. There is reduced vascularity as the disease advances and this denies the systemic absorption of carcinogens, which affects the already compromised epithelium. Consequently, liberation of angiogenic factors occurs because of malignant transformation, which explains the neoangiogenesis and increased vascularity in OSMF turning towards malignancy. Further studies are required to identify the mechanism leading to carcinogenesis in the atrophied epithelium aftermath of fibrosis and decreased vascularity.
  4 3,123 437
CASE REPORTS
Spindle cell carcinoma of maxilla: Histomorphological and immunohistochemical analysis of a case
Rachna Rath, Bijay K Das, SN Das, Manas Baisakh
May-August 2014, 18(2):256-261
DOI:10.4103/0973-029X.140772  PMID:25328308
The intriguing array of spindle cell lesions occurring, especially in the head and neck region, poses a critical diagnostic challenge not only to the histopathologist but also ultimately to the clinicians for planning an appropriate treatment protocol. Overlapping spectrum of clinico-radiographic and microscopic features further compounds this problem. In such situations, the aid of ancillary techniques like immunohistochemistry (IHC) is sought to clinch the diagnosis. But is the diagnosis based on IHC most decisive? Probably the answer lies in the Pandora's Box. This paper analyzed the potential doubts, apprehensions and the reliability that is singularly based on the morphological spindle appearance of an abnormal cell that has deviated from the usual clinical and microscopic presentation and thus posed a diagnostic dilemma warranting more questions than the answers. We review the etiopathogenesis of this entity and its differential diagnosis from few other spindle cell lesions of head and neck with special reference to use of immunohistochemical markers, with a case study.
  3 3,393 320
Bilateral orthokeratinized odontogenic cyst: A rare case report and review
Rahul Devidas Pimpalkar, Suresh R Barpande, Jyoti D Bhavthankar, Mandakini S Mandale
May-August 2014, 18(2):262-266
DOI:10.4103/0973-029X.140776  PMID:25328309
Orthokeratinized odontogenic cyst (OOC) is a developmental cyst of jaw and was initially considered by the World Health Organization (1992) as the uncommon orthokeratinized variant of odontogenic keratocyst (OKC). However, studies have shown that OOC has peculiar clinicopathologic aspects when compared with other developmental odontogenic cysts, especially OKC. So orthokeratinized odontogenic cyst now stands out to be a distinct entity. Clinically, it occurs as a single cyst, shows a predilection for males and is most often found in the second to the fifth decade. Its bilateral occurrence is extremely rare. The purpose of the article is to present a rare case of bilateral OOC arising in the mandible and review the literature on bilateral occurrence of this lesion.
  3 2,518 373
ORIGINAL ARTICLES
Antimicrobial and anti-adherence activity of various combinations of coffee-chicory solutions on Streptococcus mutans: An in-vitro study
Rama Sharma, Vamsi Krishna L Reddy, GM Prashant, Vivek Ojha, Naveen PG Kumar
May-August 2014, 18(2):201-206
DOI:10.4103/0973-029X.140749  PMID:25328299
Context: Several studies have demonstrated the activity of natural plants on the dental biofilm and caries development. But few studies on the antimicrobial activity of coffee-based solutions were found in the literature. Further there was no study available to check the antimicrobial effect of coffee solutions with different percentages of chicory in it. Aims: To evaluate the antimicrobial activity of different combinations of coffee-chicory solutions and their anti-adherence effect on Streptococcus mutans to glass surface. Materials and Methods: Test solutions were prepared. For antimicrobial activity testing, tubes containing test solution and culture medium were inoculated with a suspension of S. mutans followed by plating on Brain Heart Infusion (BHI) agar. S. mutans adherence to glass in presence of the different test solutions was also tested. The number of adhered bacteria (CFU/mL) was determined by plating method. Statistical Analysis: Statistical significance was measured using one way ANOVA followed by Tukey's post hoc test. P value < 0.05 was considered statistically significant. Results: Pure chicory had shown significantly less bacterial count compared to all other groups. Groups IV and V had shown significant reduction in bacterial counts over the period of 4 hrs. Regarding anti-adherence effect, group I-IV had shown significantly less adherence of bacteria to glass surface. Conclusions: Chicory exerted antibacterial effect against S. mutans while coffee reduced significantly the adherence of S. mutans to the glass surface.
  3 2,752 259
CASE REPORTS
Myositis ossificans traumatica of temporalis and medial pterygoid muscle
Shyam Prasad D Reddy, Ajay P Prakash, M Keerthi, Brahmaji J Rao
May-August 2014, 18(2):271-275
DOI:10.4103/0973-029X.140781  PMID:25328311
Myositis ossificans is a rare disease that is characterized by bone deposition in the muscle or soft tissues. Myositis ossificans of the masticatory muscles is an uncommon finding. The condition is benign and results in heterotopic bone formation in the muscles of mastication, usually producing limitation of opening of the jaws. It is important to know the exact cause of the limitation of opening of the jaws for successful treatment. Computed tomographic scan and panoramic radiographs along with histological findings are essential diagnostic aids for evaluating conditions such as myositis ossificans. A rare case of myositis ossificans traumatica of temporalis and medial pterygoid muscle is presented here along with the discussion of clinical, radiological and histological features. The present case emphasizes not only on the importance of considering myositis ossificans in the differential diagnosis of limitation of opening of the jaws but also on the improvement of the overall mouth opening and treatment results.
  2 5,643 301
Chondroblastic osteosarcoma of the left zygomatic bone: Rare case report and review of the literature
Shubhangi Khandekar, Alka Dive, Prashant Munde, Prajakta Zade Fande
May-August 2014, 18(2):281-285
DOI:10.4103/0973-029X.140791  PMID:25328313
Chondroblastic osteosarcoma (COS), a subgroup of intramedullary osteosarcoma (OS), is the most common osteosarcoma that occurs in adolescents and early adulthood. The COS has similar clinical and radiological features to those of conventional OS. We present a case of 20-year-old male patient with the chief complaint of pain and swelling in the left zygomatic region. The computed tomography (CT) and three-dimensional (3D) CT face showed erosion, calcific foci, sunray type of spicules suggestive of OS. On fine-needle aspiration cytology (FNAC) examination, initial diagnosis was malignant chondroid lesion, with differential diagnosis of mesenchymal chrondrosarcoma, COS on incisional biopsy and finally COS on excisional biopsy. The patient underwent radical resection of left zygomatic arch, followed by chemotherapy. Although clinically unsuspected in this unusual site, histopathology along with immunohistochemistry (IHC) results confirmed the COS. Because zygomatic location of COS is very rare, this report aimed to discuss clinical, radiographic, histopathologic, IHC findings and diagnostic pitfalls of COS in light of the literature.
  2 3,268 263
KNOW YOUR FIELD
Seborrheic keratosis
Rashmi GS Phulari, Khushbu Buddhdev, Rajendrasinh Rathore, Sweety Patel
May-August 2014, 18(2):327-330
DOI:10.4103/0973-029X.140926  PMID:25328324
  2 7,112 0
ORIGINAL ARTICLES
Molecular screening of lysyl oxidase G473A polymorphism in oral submucous fibrosis
Amit Thorawat, Kirty Nandimath, SV Hiremath, Venkatesh G Naikmasur
May-August 2014, 18(2):207-210
DOI:10.4103/0973-029X.140751  PMID:25328300
Aim: To investigate the presence of lysyl oxidase (LOX) G473A polymorphism in group 1 {Oral submucous fibrosis (OSMF) patients}, group 2 (betel quid chewers without OSMF) and group 3 (healthy individuals). Materials and Methods: A total of 60 patients were taken for the study, which included 20 OSMF patients (group 1), 20 betel quid chewers without OSMF (group 2) and 20 healthy individuals without OSMF and betel quid chewing habit (group 3). DNA was isolated using Qiagen kit. The isolated DNA was quantified using spectroscopic methods. Polymerase chain reaction (PCR) was carried out at annealing temperature of 67 o C. PCR amplification was checked on 2% agarose gel. Further, the amplified PCR products were subjected to automated DNA sequencer, to assess LOX G473A polymorphism. Results: The gene sequence data generated from the automated DNA sequencer was received as colored electropherograms. These gene-sequencing results did not show LOX G473A polymorphism in any of the 3 groups. Conclusion: In our study, gene-sequencing results did not show LOX G473A polymorphism in OSMF patients. Since only one study in the literature has shown the association of LOX gene polymorphism and OSMF patients, we conclude that further studies are required to unveil the role of LOX gene polymorphism in OSMF.
  2 1,908 228
Nuclear features in different grades of epithelial dysplasia in leukoplakia: A computer assisted microscopic study
Mohsin Gadiwan, GS Madhushankari, DD Mandana, SB Praveen, MS Selvamani, DS Pradeep
May-August 2014, 18(2):194-200
DOI:10.4103/0973-029X.140747  PMID:25328298
Context: Abnormalities in nuclear morphology are very frequently seen in dysplasia, such as nuclear area, diameter, shape, number of nucleoli and membrane outline. The purpose of this study was to observe and compare the nuclear features in different grades of epithelial dysplasia in leukoplakia and to evaluate the use of Feulgen stain for observing the nuclear features in oral epithelial dysplasia in leukoplakia. Seventy paraffin embedded tissue section (20 mild, 20 moderate, 20 severe dysplasia cases and 10 control specimens) were analyzed for nuclear morphology using Feulgen stain under trinocular research microscope. Statistically significant results were obtained with P > 0.001, when intergroup comparison was done except in case of nuclear area and diameter between mild and moderate dysplasia. Nuclear features reflect cell's biological potential and its morphometry was found to be a useful tool for differentiating different grades of dysplasia.
  2 3,686 456
Histopathological correlation of oral squamous cell carcinoma among younger and older patients
Syed Mukith Ur Rahaman, BR Ahmed Mujib
May-August 2014, 18(2):183-188
DOI:10.4103/0973-029X.140734  PMID:25328296
Background: Oral Squamous Cell Carcinoma (OSCC) is commonly noted in elder men, when occurring in younger individuals, its aggression and prognosis is questioned due to biased data in literature. Traditionally, various histopathological grading systems have been used for assessing aggression and prognosis of OSCC. However, multifactorial grading of Anneroth et al., is considered effective. Materials and Methods: In this retro-prospective study, files of 75 OSCC patients were retrieved from Oral Pathology Department; among this 50 patients were >40 years and 25 patients were ≤40 years of age. Archival formalin fixed paraffin embedded tissue blocks of these patients were used to prepare hematoxylin and eosin (H and E) stained sections for grading OSCC based on Broder's and Anneroth et al., criteria. Further, recurrence of OSCC among study subjects within 5 years of treatment was evaluated. Chi-square test was used to compare the disease in patients who were >40 years with ≤40 years. Results: Comparison according to Broder's classification didn't show any relevant variation. Three of the six parameters and overall grading according to Anneroth et al., criteria showed statistically higher grades of OSCC in the younger age-group; however, there was no significant difference in 5-year recurrence rate. Interpretation and Conclusion: Results of the study are suggestive of aggressive OSCC among young patients when compared to older. Conversely, this aggression didn't affect the recurrence in younger patients. Further studies on genetics, diet and demographics of patients below 40 years of age affected by OSCC will be of greater value.
  2 3,862 503
CASE REPORTS
Ewing's sarcoma of maxilla: A rare case report
Deepak Kumar Jairamdas Nagpal, Prashant Ramesh Prabhu, Sangeeta Jayant Palaskar, Swati Patil
May-August 2014, 18(2):251-255
DOI:10.4103/0973-029X.140769  PMID:25328307
Ewing's sarcoma is uncommon malignancy of childhood, frequently involving the mandible. The occurrence in maxilla is rare. It is histopathologically characterized by sheets of round cells positive for CD99. Although the prognosis is poor but early diagnosis and long term follow up can improve the survival. This article presents a rare case of Ewing's sarcoma of maxilla in a 15 year old male patient showing excessive fibro-osseous response which is not a frequent presentation. A retrospective analysis of cases of Ewings sarcoma of maxilla published in the English litreture is reviewed. In our case, diagnosis was confirmed by immunohistochemistry where sheets of round tumor cells were positive for CD 99. Ewings sarcoma of maxilla is a rare and aggressive tumor. Hence early diagnosis, combined therapy and long term follow up is suggested in such cases.
  1 2,184 323
Glandular odontogenic cyst in maxilla: A case report and literature review
Sharad Purohit, Vandana Shah, Vikas Bhakhar, Ashutosh Harsh
May-August 2014, 18(2):320-323
DOI:10.4103/0973-029X.140923  PMID:25328322
Glandular odontogenic cyst (GOC) is an uncommon jaw bone cyst of odontogenic origin described in 1987 by Gardner et al. It is a cyst having an unpredictable and potentially aggressive behavior. The increased recurrence rate can be due to its multilocularity and incomplete removal of the lining following conservative treatment. Clinically, the most common site of occurrence is the anterior region of mandible. GOC has a slight male predilection and occurs primarily in middle-aged patients. This article presents a case of glandular odontogenic cyst in a 30-year-old female patient in the posterior region of the maxilla, which is quite rare.
  1 3,059 365
Osteochondroma of the palate: An interesting and an unusual case presentation
Kranti Kiran Reddy Ealla, Surekha V Reddy, Srinivas Gadipelly, CR Charan
May-August 2014, 18(2):303-307
DOI:10.4103/0973-029X.140912  PMID:25328318
A 40-year-old Indian male patient was referred to the Department of Oral and Maxillofacial Surgery with a slowly enlarging intra-oral, right-sided palatal swelling of one-year duration, with a previous diagnosis of osteochondroma. Extraorally, patient presented with a mild right-sided facial swelling. On intraoral examination, the palatal swelling was extending from the distal aspect of canine to the distal aspect of second molar with involvement of the maxillary tuberosity. The swelling was non-tender, bony-hard in consistency and covered by normal mucosa. The medical history was non-contributory with no relevant family history of any skeletal disease. Despite the attempt for complete removal of the tumor previously, it recurred within six months. The present article reports an extremely rare clinical case of endosteal (central) osteochondroma, manifesting itself as a radiopaque mass in the right posterior aspect of the palate.
  1 2,930 190
Primary leiomyosarcoma of the mandible
Saede Atarbashi Moghadam, Abbas Khodayari, Sepideh Mokhtari
May-August 2014, 18(2):308-311
DOI:10.4103/0973-029X.140915  PMID:25328319
Leiomyosarcoma (LMS) is a malignant soft tissue tumor that exhibits smoothmuscle differentiation. Its occurrence in the oral cavity is exceedingly rare. This article presents a 67-year-old woman with 9-month history of a painful tumoral lesion on the right side of mandible. Tumor was composed of fascicles of spindle-shaped cells with cigar-shaped nuclei and eosinophilic cytoplasm. Immunohistochemistry showed that tumor cells were positive for smooth muscle actin (SMA) and desmin. The findings were consistent with the diagnosis of LMS.
  1 1,840 194
Malignant rhabdoid tumor of the tongue: A rare occurrence
Munlima Hazarika, Tashnin Rahman, Anupam Sarma, Manigreeva Krishnatreya
May-August 2014, 18(2):312-314
DOI:10.4103/0973-029X.140921  PMID:25328320
Malignant rhabdoid tumors (MRTs) are highly aggressive neoplasms that most commonly occur in the kidneys of young children. Malignant rhabdoid tumor of the tongue is an extremely rare entity and very few have been reported in the literature. The course of extra-renal MRT is short and its prognosis is very poor. A 19-year-old female presented with a progressive swelling and restricted mobility of the tongue for over 3 months duration. We present here a locally advanced case of MRT of the tongue, its diagnosis, management and review of the literature related to it.
  1 1,944 155
Adenoid cystic carcinoma: An unusual presentation
M Pushpanjali, D Naga Sujata, S Bala Subramanyam, M Jyothsna
May-August 2014, 18(2):286-290
DOI:10.4103/0973-029X.140796  PMID:25328314
The adenoid cystic carcinoma is a relatively rare epithelial tumor of the major and minor salivary glands, accounting for about 1% of all malignant tumor of the oral and maxillofacial regions. Peak incidence occurs between the 5 th and 6 th decades of life. The clinical and pathological findings typical of this tumor include slow growth, peri-neural invasion, multiple local recurrences and distant metastasis. Herein, we report a case of adenoid cystic carcinoma of oropharynx with unusual clinical presentation. The diagnosis of this case and importance of cytology in diagnosing such cases is discussed.
  1 3,286 290
Chondrolipoma: Report of a rare intra oral variant with review of histiogenetic concepts
Vineet Raj, Nidhi Dwivedi, Kunal Sah, Shaleen Chandra
May-August 2014, 18(2):276-280
DOI:10.4103/0973-029X.140785  PMID:25328312
Chondrolipomas are benign mesenchymal tumors characterized by the proliferation of mature adipocytes associated with variable amounts of mature cartilaginous tissue. Herein, we describe a case of chondrolipoma of the tongue in a 35-year-old Indian male. The lesion presented as a nodular, sessile, pink mass on posterio-dorsal surface of left side of the tongue since approximately 20 years. Histopathologically, the mass revealed a well circumscribed, encapsulated proliferation of mature adipocytes with islands of well formed mature cartilaginous tissue. Chondrolipomas are uncommon in the oral cavity, with only 14 cases being reported in the English literature.
  1 2,795 217
ENIGMATIC MORPHO INSIGHT
Eosinophilic Nucleoli
Radhika M Bavle
May-August 2014, 18(2):152-154
DOI:10.4103/0973-029X.140716  PMID:25328291
  1 4,206 542
ONLINE ONLY - CASE REPORTS
Granular cell type of a unicystic ameloblastoma: An unusual case and review of the literature
Pouria Motahhary, Arghavan Etebarian, Fatemeh Asareh
May-August 2014, 18(2):331-331
DOI:10.4103/0973-029X.140927  PMID:25328325
Ameloblastomas are locally invasive tumors of odontogenic epithelial origin. They have been categorized broadly into three biologic variants: solid, cystic (unicystic) and peripheral, of which only 13% of all cases are unicystic. Although rare in unicystic or cystic ameloblastoma, granular cell change in ameloblastoma is a recognized phenomenon. Here we present a distinctive case of cystic ameloblastoma with an unusual histopathological pattern along with an added emphasis on its review.
  1 2,218 272
A tender swelling of the left posterior mandible: An unusual case
Harshaminder K Grewal, Poonam Goel, Ranmeet Batra, Sumit Chopra
May-August 2014, 18(2):332-332
DOI:10.4103/0973-029X.140929  PMID:25328327
Tender swellings of the mandible are majorly due to inflammatory lesions like infected dental cyst, peri-apical abscess or neoplasms like osteoblastomas, cementoblastomas, osteosarcoma and intraosseous squamous cell carcinoma. Florid cemento-osseous dysplasia is a subgroup of cemento-osseous dysplasia typically found in middle-aged black women as multiple, non-tender, diffuse, lobulated radio-opacities distributed throughout the maxilla and mandible, which are usually bilaterally symmetrical. Histologically, they are composed of proliferating fibrous connective tissue stroma containing foci of cementum, osteoid and bone. Florid cemento-osseous dysplasia is rare in Indian population and among all cases of florid cemento-osseous dysplasia, almost 97% of the cases reported till date are in females. The present case describes florid cemento-osseous dysplasia in a 26-year-old male who reported with pain in the left mandibular premolar region.
  1 2,843 281
CASE REPORTS
Parotid angiofibroma
Neelakamal H Hallur, Heena Zainab, Ashwin Shah, Aaisha Siddiqua
May-August 2014, 18(2):295-298
DOI:10.4103/0973-029X.140798  PMID:25328316
Angiofibromas are rare, benign, locally invasive vascular tumors, which represent 0.05-0.5% of all head and neck tumors. Most frequent site of occurrence is the posterior nasopharynx, called as nasopharyngeal angiofibromas (NA), when these arise outside the nasopharyngeal region they are termed as extranasopharyngeal angiofibromas (ENA). Only 65 cases of ENA have been reported, and the most common site has been reported to be maxilla followed by ethmoids. Other unusual sites of occurrence reported so far in literature are nasal cavity, nasal septum, larynx, sphenoid sinus, pterygomaxillary fissure, infratemporal fossa, cheek, oropharynx, retromolar area, middle turbinate, inferior turbinate, and tonsil. ENA arising from the superficial lobe of parotid gland has not been reported in the literature so far and this case is the first to be reported.
  - 1,764 165
EDITORIAL
From the Editor's desk: Redefining a Step Towards Professionalization
Radhika M Bavle
May-August 2014, 18(2):151-151
DOI:10.4103/0973-029X.140713  PMID:25328290
  - 1,255 153
KNOW YOUR FIELD
Myoepithelioma of minor salivary gland
Sangeeta J Palaskar, Pargatsingh T Kathuriya, Sanjay D Deshmukh, Deepakkumar J Nagpal
May-August 2014, 18(2):324-326
DOI:10.4103/0973-029X.140925  PMID:25328323
  - 1,922 217
ONLINE ONLY - CASE REPORTS
A rare syndrome with unusual dental findings: Oculo-facio-cardio-dental syndrome
Geeta Verma, Gulshan Kumar Singh, Pradeep Tandon, Sneh Lata Verma
May-August 2014, 18(2):331-331
DOI:10.4103/0973-029X.140928  PMID:25328326
Radiculomegaly of a tooth is a rare condition. When it is associated with other dental abnormalities, facial dysmorphism and congenital cataracts, the condition is named as oculofaciocardiodental (OFCD) syndrome. This is an X-linked dominant trait, reported only in women, suggesting that it is lethal in males. The most consistent and pathognomic dental finding of OFCD is radiculomegaly (extremely long roots), particularly of the canines and occasionally of other teeth including premolars and incisors, which can easily be diagnosed on dental panoramic radiographs by a dentist or an orthodontist. Till date, 21 cases have been reported worldwide. The aim of this report is to present a new case of a 24 year old female affected by this syndrome and to evaluate it from a dental perspective to call the attention of dentists to this rare anomaly.
  - 3,237 208
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Journal of Oral and Maxillofacial Pathology | Published by Wolters Kluwer - Medknow
Online since 15th Aug, 2007