We compared nuclear DNA contents of oral squamous cell carcinomas (oral SCC) as measured by flow cytometry (FCM) and cytophotometry (CPM). Biopsy specimens from36 patients with oral SCC were analyzed. Nuclear DNA contents of cancer cells were measured by FCM and CPM. Analyses of flow cytometric DNA histograms (FCMDHs) were based on evidence of G0/1 peaks. FCMDHs were classified as follows: group-Al, histograms with only a single G0/1 peak obtained for 80% or more of total cells; group-A2, histograms with only a single G0/1 peak obtained for less than 80% of total cells; and group-B, histograms with more than two peaks. Analyses of cytophotometric DNA histograms were based on the rate of cells with contents exceeding 4c (exceeding rate of 4c, 4cER). Cells having DNA contents exceeding 4c were regarded as polyploid, aneuploid, or both. The relationship between FCMDH and 4cER was as follows: range/mean of 4cER for groups-Al, A2, and B were 0-12.3%/5.5%. 0-41.0%/16.4%, and 3.0-32.5%/16.9%, respectively. Histograms of group-A2 and B showed significantly higher 4cER than that of group-A1 (P<0.05). In nine cases, flow cytometric DNA histograms showed only a single G0/1 peak despite evidence of aneuploid cells on cytophotometric DNA histograms. The results suggested that cytometric analysis was useful in detecting DNA aneuploid cells, especially when small numbers of cancer cells intermingled with stromal cells.
Polymorphous low-grade adenocarcinoma (PLGA) appears at a markedly higher frequency in the palate than at other locations. It is often misdiagnosed because of its infrequency and deceptively bland histological appearance. It is sometimes especially difficult to distinguish between PLGA and adenoid cystic carcinoma when there are overlapping histologic features. Here, we describe the immunohistochemical characterization of PLGA arising in the palate. The wide range of PLGA immunohistochemical findings was analogous to histological polymorphism. The components of PLGA definitely showed myoepithelial characteristics, as shown by the immunohistochemical expression of epithelial markers (cytokeratin and epithelial membrane antigen), vimentin, and S-100 protein.
Angiomyoma is a benign tumor of smooth muscle origin that arises commonly in the skin and rarely in the oral mucosa. we describ the clinical features and immunohistochemical findings of angiomyoma occurring in the palate. A 61-year-old man had noted swelling of the central part of the palate for 8 months, but it was asymptomatic and not treated previously. The lesion was sutgically removed and diagnosed as angiomyoma pathologicallybecause of proliferation of muscle fibers and capillary vessels. Immunohistochemical studies of this angiomyoma showed that the tumor cells were positive to actin and myosin. Reaction products of factor VIII and vimentin were found in the capillary vessel angioendothelial cells and the surrounding tumor cells. Tenascin was negative in tumor cells, and positive in peripheral tumor tissue and normal smooth muscle. We conclude that angiomyoma arises from neoplastic changes of vascular smooth muscule cells in associationwith endothelial cell proliferation.
Spindle cell carcinoma is considered a subtype of squamous cell carcinoma that has a sarcomatoid appearance. In the head and neck region, cases of spindle cell carcinoma of the larynx have occasionally been reported. However, spindle cell cacrcinoma of the maxillary sinus is extremely rare. We describe a case of spindle cell carcinoma of the maxillary sinus in a 53-year-old woman. Surgical treatment was performed under the clinical diagnosis of a maxillary neoplasm. During the operation, a biopsy specimen was taken, and the histopathological diagnosis was a spindle cell carcinoma. The lesion was removed under general anesthesia. Radiotherapy and chemotherapy were additionally given to prevent recurrence and metastasis of the tumor. There has been no evidence of recurrence as of 5 years 6 months after surgrey.
Open reduction and intermaxillary fixation were carried out in a patient with multiple facial bone fractures who had diabetes mellitus after gastrectomy, duodenectomy, pancreatectomy, and splenectomy. We devised a method to control the blood sugar level by use of a liquid diet and administration of digestive enzymes and insulin injections.
Lennox syndrome is infantile epilepsy characterized by mental retardation and diffuse slow spike and waves on the electroencephalogram. It is classified as a type of agedependent epileptic encephalopathy and is the most severe of all epileptic syndromes. A case of Lennox syndrome associated with gum hypertrophy in a 20-year-old man is described. Gum hypertrophy was apparently a side effect of phenytoin, given to treat epilepsy. Intraoral examination revealed lower and upper gum hypertrophy. The hypertrophied gums were resected under general anesthesia. The gum disease was evaluated with respect to its cause and clinical course. Suggestions based on our experience are described.
Oral manifestations associated with HIV infection are highly predictive markers of severe immunosupressive status and disease progression. In this report, the oral manifestations of 21 HIV-infected individuals, including 15 AIDS patients are described. Most of the patients (95.2%) had hemophilia. Only one (4.8%) was infected by heterosexual contact. The oral lesions were oral candidiasi (66.7%), herpes simplex virus lesions (28.6%), hairy leukoplakia (19.1%), and HIV-related periodontal disease (4.8%). The oral lesions were clinically similar to those reported in HIV infection in other countries. This study showed that all oral lesions associated with HIV infection increased in frequency when the CD 4+ lymphocyte count fell below 500 cells/mm3.
Desmoplastic ameloblastoma is a rare histologic variant of ameloblastoma. This tumor is unique in forming abundant collagenous stroma with small nests or strands of odontogenic epithelium. In this paper, we report a case of desmoplastic ameloblastoma arising in the anterior maxilla of a 64-year-old woman. Radiological examination revealed unicystic maxillary bone resorption with an ill-defined border. The tumor and regional maxillary bone were excised. The tumor measured 24×22×19mm, and the cut surface showed a solid mass containing a cystic space. Microscopically, proliferation of basal-cell-like odontogenic epithelial cells scattered in a mature fibrous stroma was noted. The related literature is discussed.