We studied histometrically the degeneration with aging of the submandibular glands removed from 103 autopsied cadavers (0 ∼ 102 years old). To evaluate arteriosclerosis of the mediumand small-sized arteries and the arterioles in the glands, we determined the stenotic index (SI). We assessed the correlations between SI and degeneration in the glands, age, general physical conditions and underlying diseases. SI of the medium- and small-sized arteries and the arterioles correlated with age (p < 0.001). Whereas, the medium- and small-sized arteries had intimal fibro-elastosis, the arterioles had hyaline arteriosclerosis in young cases and, in addition, intimal fibro-elastosis in elderly cases. As for degeneration, SI correlated with the grade of fatty infiltration and fibrosis but not with lymphoplasmacytic cell infiltration. The findings suggest that arteriosclerosis of the arteries in the glands is one of the causes of atrophy of the glands. SI correlated strongly with the atherosclerotic grade of the aorta and moderately with the atherosclerotic grade of the coronary artery. SI correlated weakly with heart weight ? body weight ratio but not with BMI.

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Cervical nodal metastasis has a major influence on survival in squamous cell carcinoma (SCC) of the tongue. However, predictive factors for metastasis remains inconclusive, especially in stage I-II SCC of tongue. This study analyzed the clinicopathologic factors associated with late nodal metastases in patients with stage I-II SCC of tongue. The clinicopathologic factors of 62 consecutive patients between January 1998 and December 2001 with surgically treated stage I-II SCC of the tongue were reviewed prospectively, and the factors predicting late cervical nodal metastasis were analyzed. All patients were treated with partial glossectomy without elective neck dissection. Fourteen of 62 (22.6%) developed late cervical nodal metastases within median follow-up of 36 months. Thirteen patients (92%) developed late nodal metastases within 13 months. In Cox regression analysis, pattern of invasion at the invasive tumor front and invasive front grading score had predictive values for late nodal metastasis. Patients who are surgically treated for stage I-II SCC of tongue with diffused invasive pattern at invasive tumor front and high invasive grading score should be carefully followed up, and delayed elective neck dissection after partial glossectomy should be carried out in selective patients.

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Benign mixed and mesenchymal odontogenic tumors (ameloblastic fibroma, ameloblastic fibrodentinoma, ameloblastic fibro-odontomas, odontogenic fibroma and odontogenic myxoma) were immunohistochemically examined using antibodies against amelogenin, cytokeratin 19, bcl-2, hepatocyte growth factor (HGF), c-Met, transforming growth factor-β (TGF-β), TGF-β receptors and Ki-67 to know cytodifferentiation, epithelial-mesenchymal interaction and proliferative activity. Expression of amelogenin was detected in odontogenic epithelial cells and enamel matrices in ameloblastic fibro-odontomas, and cytokeratin 19 was expressed in odontogenic epithelial cells, indicating odontogenic epithelial properties. Expressions of bcl- 2, HGF, TGF-β, TβR I and TβR II were detected in odontogenic epithelial and mesenchymal cells in mixed and mesenchymal odontogenic tumors, while expression of c-Met was detected in odontogenic epithelial cells. Odontogenic epithelial and mesenchymal cells sporadically showed positive reactions for Ki-67 in mixed and mesenchymal odontogenic tumors, and no apparent differences were obtained among these tumors or between the components. Conclusion: Immunohistochemical localization of HGF, TGF-β and their receptors suggests that these growth factor signaling are effective in the epithelial component in paracrine and autocrine manner in mixed and mesenchymal odontogenic tumors. These results of growth factor signaling suggest that certain epithelial-mesenchymal interactions are related to neoplastic cell growth in these tumors.

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We describe an unusual case of metastatic choriocarcinoma of the mandible. Sixteen months after odontogenic keratocyst excision, the tumor was found growing in the left molar region of the mandible, the same site of the previously enucleated odontogenic keratocyst. Histopathological examination revealed sheets of atypical cells similar to syncytiotrophoblast or cytotrophoblast, and the tumor was diagnosed as metastatic choriocarcinoma of unknown origin. A whole-body examination was performed; however, the tumor origin was not determined. Surgical excision of the tumor was performed due to rapid growth. One month after tumor excision, multiple tumor masses were detected in both lung lobes by the chest Xray examination. In addition, a high level of serum hCG was detected. The clinical course and histopathological findings, this unusual choriocarcinoma are discussed with referring to the literature.

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Lipomatous pleomorphic adenoma is an unusual subtype of adenoma with a lipomatous stromal component. Although there are a few reports about lipomatous pleomorphic adenoma in the parotid gland, we report an extremely rare case of lipomatous pleomorphic adenoma in the palatine gland of a 33-year-old female. Histologically, approximately 80% of the tumor tissue was fatty tissue containing univacuolar adipocytes. The pleomorphic epithelial elements consisted of duct-like cells forming small lumina and also consisted of spindle-shaped myoepithelial cells.

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