Journal of Oral and Maxillofacial Pathology最新文献

Systemic lupus erythematosus (SLE) is a chronic autoimmune disease with heterogeneous manifestations, often overlapping with other conditions and complicating diagnosis. Oral lesions, though less common than cutaneous involvement, may offer important diagnostic clues. We report a 51-year-old female with rosacea, who developed persistent oral ulcers initially linked to a dental prosthesis. Lesions worsened despite adjustments and corticosteroid therapy, and the first biopsy was inconclusive. A second biopsy showed features of lupus erythematosus, including basal layer degeneration, subepithelial lymphocytic infiltrate, and PAS-positive basement membrane thickening. Serology revealed low-titter ANA (1:160) without additional autoantibodies. The coexistence of rosacea and lupus-like lesions delayed diagnosis, highlighting the need for clinicopathological correlation. Over 2 years of multidisciplinary follow-up, the patient achieved remission of oral and cutaneous lesions despite persistently low ANA titters. This case underscores the diagnostic complexity of overlapping dermatologic conditions and reinforces the importance of interdisciplinary management and long-term follow-up in suspected SLE.

Oral carcinoma cuniculatum (OCC) is a rare, well-differentiated variant of oral squamous cell carcinoma, characterized by keratin-filled crypts and a burrowing growth pattern. Its occurrence in individuals with Down syndrome (DS) is exceptionally uncommon due to their reportedly lower risk of solid tumours. We present a rare case of OCC in a 38-year-old woman with DS, who reported a painful lesion on the lateral tongue. Histopathological analysis confirmed OCC, aided by E-cadherin immunohistochemistry to differentiate it from verrucous carcinoma. Surgical excision with neck dissection was performed. The case highlights diagnostic challenges in DS individuals, including misattribution of symptoms and oral hygiene difficulties. This report underscores the importance of awareness camps and early detection of oral malignancies in patients with DS and advocates for targeted education and preventive programmes for caregivers and dental professionals.

Brown Tumor is a rare, reactive, giant cell associated, late-stage bone lesion occuring as a result of long term untreated primary or secondary hyperparathyroidism (HPT). It clinically manifests as a high turnover bone disease, which typically shows increased parathyroid hormone (PTH) secretion in response to low serum calcium concentration thereby enhancing calcium reabsorption and osteoclastic bone resorption, hence called osteoclastoma or giant cell reparative granuloma or osteitis fibrosa cystica. Brown tumor associated with HPT can be seen in any part of the human skeleton, However clinically significant lesion involving the craniofacial skeleton is quite rare. Here we report a rare case of Brown tumor associated with HPT in a 28 year old female involving the right side of mandible.

An immunocompromised body state following the human immunodeficiency virus (HIV) infection increases the risk of certain cancers like Kaposi sarcoma and lymphoma. B-cell lymphomas are the common neoplasms that occur, and Oral Plasmablastic lymphoma is one of its types. It is categorized as a large B-cell lymphoma and an aggressive type of non-Hodgkin lymphoma. These are rare tumours that histologically resemble other lymphomas, like Burkitt lymphoma, causing a diagnostic dilemma for pathologists. Here we report a rare case of Oral Plasmablastic lymphoma in a 32-year-old HIV-positive male with tuberculosis infection. Immunohistochemistry (IHC) was performed to confirm the diagnosis, and the markers used for differentiating various lymphomas have been discussed.

Chondroid syringoma (CS) is a rare benign skin adnexal tumour that may be confused with various skin lesions. This tumour is thought to originate from both secretory and ductal segments of the sweat glands, and both eccrine and apocrine variants have been described. Its occurrence in other parts of body is very rare except in head and neck. This article presents the case of a 40-year-old female patient with a swelling on the dorsum of nose, diagnosed as CS.

Sjogren's syndrome (SS) is a chronic autoimmune disorder characterised by lymphocytic infiltration of exocrine glands, leading to xerostomia and keratoconjunctivitis sicca. To analyse the demographic details, clinical presentations, and serological and histopathological findings in a series of patients diagnosed with SS. This retrospective case series of SS was conducted at a tertiary institution in Kerala. The study comprised 10 patients with a mean age of 49 years, exhibiting a female-to-male ratio of 9:1. The most common clinical signs included xerostomia (90%), xerophthalmia (100%). Histopathological examination revealed focal lymphocytic sialadenitis in all cases (100%), with a mean focus score of 1.35. SS predominantly affects middle-aged women and presents with sicca symptoms. Histopathological examination of labial salivary glands remains the valuable diagnostic tool. Future research should concentrate on exploring targeted therapies that can improve the quality of life for those affected by SS.

Acuminated condyloma (AC), or venereal wart, is a viral infection caused by the human papillomavirus (HPV), primarily transmitted through sexual contact. Adolescents and young adults are the most vulnerable groups. Its presentation in the oral cavity is atypical, as is the involvement of HPV genotypes other than HPV-6/11/16/18. This report describes an unusual case of oropharyngeal condyloma in a young adult woman with dyslipidaemia and vitamin D deficiency, which exhibited co-infection with low-risk (HPV-6, 11) and high-risk oncogenic genotypes (HPV-59, 82). The latter two genotypes have not been reported in oral or oropharyngeal AC cases so far. Diagnosis was based on clinical and pathological findings, with a favourable prognosis despite the lesion's location. While AC diagnosis is primarily clinical, histopathological analysis is crucial for distinguishing it from other HPV-related oral conditions. Genotyping, though not essential for diagnosis, has epidemiological relevance in guiding vaccination strategies.

Spindle cell squamous cell carcinoma (SpSCC) is an uncommon, aggressive biphasic variant of oral SCC, known for high recurrence and poor prognosis. Spontaneous regression (SR) of malignant tumours is an exceptionally rare phenomenon, particularly in intraoral carcinomas. We report a unique case of SpSCC in a 66-year-old male, where 1 month post incisional biopsy, the primary intraoral lesion showed complete spontaneous regression, though regional submandibular lymph node metastasis subsequently developed. Diagnosis was established through histopathology and immunohistochemistry, with positivity for cytokeratin, p63, and vimentin. A literature review revealed very few documented instances of SR in oral malignancies, often following diagnostic procedures, potentially due to biopsy-induced immune activation and alterations in the tumour microenvironment. This case underscores the enigmatic nature of SR in oral cancers and highlights the need for long-term surveillance, while raising important considerations about immune mechanisms and their potential therapeutic implications in head and neck oncology.

Myoepitheliomas are exceedingly rare neoplasms of the salivary glands. Minor salivary gland neoplasms most frequently occur in the palate (hard palate), followed by the lips, oral mucosa, and tongue/floor of the mouth. Additionally, less prevalent locations encompass the retromolar area, pharynx, nasal cavity, paranasal sinuses, and larynx. The lack of distinctive cytologic features and bland morphology in both benign and malignant myoepitheliomas necessitates the use of histopathology and immunohistochemistry for accurate diagnosis. Hence, here, we report a series of three cases, including two benign and one malignant myoepithelioma, stressing the significance of the above-mentioned techniques for efficient diagnosis and management. This rare case series comprises many salivary gland myoepithelial neoplasms. Examples include the cystic plasmacytoid and clear cell myoepithelioma and low-grade myoepithelial carcinoma with parenchymal invasion. Immunohistochemical myoepithelial markers include vimentin, smooth muscle antigen, S 100, and p63. All of our patients had a positive p63. Myoepithelioma is diagnosed by biopsy because many tumours have similar clinical and radiological characteristics. They rarely reoccur, improving prognosis. Malignant myoepitheliomas may require wide local excision with clean margins. Regular follow-up is recommended. Myoepitheliomas are rare salivary gland tumours. Myoepithelioma should be suspected in slow-growing, well-defined salivary gland masses with variable post-contrast enhancement on CT images. Histopathology and immunohistochemistry are the best myoepithelioma diagnostic methods. Malignant myoepithelioma must be ruled out by thorough invasion testing.

T-cell non-Hodgkin's lymphoma (NHL) is a rare and aggressive malignancy with unusual oral manifestations. Its clinical diagnosis can be particularly challenging in HIV-positive individuals due to overlapping features with other HIV-associated lesions, such as Kaposi sarcoma or necrotizing periodontal conditions. We report a case of a 38-year-old HIV-positive man presenting with a rapidly enlarging mass in the left posterior maxilla. Clinical and radiographic findings were nonspecific, necessitating histopathological and immunohistochemical evaluation. Immunohistochemical analyses confirmed the diagnosis of T-cell NHL. This case highlights the importance of immunohistochemistry in accurately diagnosing atypical oral lesions, especially in immunocompromised individuals.