Journal of Oral and Maxillofacial Pathology最新文献

In a scenario where there is an increased incidence of oral squamous cell carcinoma (OSCC) in younger age groups, the diagnosis of pseudo-malignant lesions that mimic the histopathology of a moderate or even high-grade carcinoma becomes imperative for oral pathologists. Though paediatric malignancies such as melanomas and thyroid carcinomas and even OSCCs have been reported in young children, they are rare in the pre-pubertal age group. Melanocytic naevi such as Spitz naevi (SNs) or atypical SNs is, however, more common in this age group and could create some difficulty in diagnosis due to its histological variations that could mimic a malignancy. Hence, the need for a cautious correlation between clinical and histopathological features becomes manifold. Adjunct tools that use diagnostic and molecular techniques such as immunohistochemistry (IHC) and comparative genomic hybridisation (CGH) help in diagnosis and in differentiating certain types of SNs from Spitzoid melanomas or melanomas. A case that histopathologically resembled a moderately differentiated squamous cell carcinoma without any evidence of melanocytic content proved to be a melanocytic naevus after clinical correlation of both age and immunohistochemical analysis. This case report with review brings to light the importance of being aware of such pseudo-malignant lesions in our daily practice.

Background: Oral squamous cell carcinoma (OSCC) is a prevalent malignancy with significant morbidity and mortality. Identifying potential premalignant lesions is crucial for early detection and effective management. Lichen planus (LP), a chronic inflammatory disorder has been associated with an increased risk of developing OSCC. This study aimed to assess the diagnostic importance of p16 and p53 expression in identifying LP as a potential premalignant lesion for OSCC.

Materials and methods: A retrospective analysis was conducted on archived tissue samples from patients diagnosed with LP (n = 80) and OSCC (n = 60) between 2017 and 2022. Immunohistochemistry was performed to evaluate p16 and p53 protein expression levels in both LP and OSCC tissues. Clinical data, including patient demographics and lesion characteristics, were collected and correlated with the immunohistochemical findings.

Results and discussion: The results revealed a significantly higher prevalence of p16 and p53 expression in LP tissues compared to normal oral mucosa (P < 0.001). Notably, p16 expression was observed in 70% of LP cases, while p53 was detected in 55% of LP cases. Furthermore, a significant association was established between p53 expression and the presence of dysplasia within LP lesions (P = 0.003). This indicates the potential of p53 as a predictive biomarker for malignant transformation in LP. The correlation between p16 and p53 expression levels in LP and OSCC tissues suggests a potential mechanistic link between LP and OSCC development.

Conclusion: This study underscores the diagnostic importance of p16 and p53 expression as potential markers for identifying LP as a premalignant lesion in the context of OSCC. The elevated prevalence of these markers in LP tissues suggests a potential role in predicting malignant transformation. The findings contribute to a deeper understanding of the molecular pathways underlying OSCC development from LP and emphasize the need for regular monitoring and early intervention in patients diagnosed with LP. Further prospective studies are warranted to validate these findings and to explore the clinical utility of p16 and p53 as biomarkers for predicting OSCC risk in LP patients.

Introduction: Pleomorphic adenoma (PA) is a benign epithelial tumour originating from the salivary gland, specifically the parotid gland. This study aims to comprehensively analyse the clinical and pathological features of PA by examining the characteristics of the tumour, including its histological structure and immunohistochemical profile.

Materials and methods: Over 8 years, beginning in October 2015 and ending in October 2023, an exhaustive retrospective study was conducted in the Department of Pathology, Kasturba Medical College, Mangalore, Manipal University, Karnataka, India. The research focused on 100 cases of pleomorphic adenoma and involved a meticulous examination of the clinical and pathological characteristics obtained by retrieving the pertinent files.

Results: Out of all the primary tumours, the majority (n = 70) was found in the parotid gland, followed by PA that developed from the minor salivary glands of the palate (n = 07), the submandibular gland (n = 17), and the lacrimal gland (n = 04). Only two cases had a primary tumour located in the lips. Females were more susceptible to these tumours than males. The parotid gland tumours showed a distinct trend in laterality, with 73 cases observed on the right side. In 85%, the initial symptom of the condition was painless swelling.

Conclusion: Salivary gland PA is typically a benign tumour. However, a subset of these tumours can exhibit a malignant phenotype. The preferred treatment is surgical excision with adequate margins.

Sclerosing odontogenic carcinoma (SOC) was first described by Koutlas et al. in 2008. Despite its inclusion in the World Health Organization (WHO) as a distinct entity, it is a tumour that remains poorly defined in the literature, with only 10 reported cases to date. The mandibular premolar and molar region is more commonly affected compared to the maxilla. In the maxilla, the anterior and the molar regions are most commonly affected. This article describes a case report of a Sclerosing Odontogenic Carcinoma in a 50 year old male patient in the mandibular region. The radiograph showed a well-defined radiolucency extending from the left ramus of the mandible to the right lower molar region. SOC is low grade with mild atypia and frequent mitosis and diffused infiltrative and perineural spread.

Oncocytic mucoepidermoid carcinoma (OMEC) is an uncommon variant of mucoepidermoid carcinoma. Histopathologically, it is characterised by the predominance of cells with large polygonal morphology and with an abundance of eosinophilic granules. We present a rare case of OMEC manifested as painless palatal swelling in a 25-year-old young male. The overlying mucosa was normal in appearance, with no evidence of ulceration or discharge. Histopathology examination showed the presence of sheets of mucous and intermediate cells along with cystic areas of variable sizes and shapes. On high power magnification, oncocytes were evident, showing abundant granular eosinophilic cytoplasm with central dark round nuclei. Around 75-80% tumour cell population was composed of oncocytic cells. The predominant presence of oncocytes can present diagnostic difficulties to pathologists due to overlapping features with adenoid cystic carcinoma, oncocytoma, acinic cell carcinoma, Warthin's tumour, and other oncocyte tumours. Although the presence of oncocytes is a pathognomonic feature, the role of immunohistochemistry and genetic analysis in diagnosis is discussed in the present paper. Moreover, considering its behaviour as a low-grade MEC, it is prudent to avoid an aggressive treatment strategy and prevent unwarranted morbidity. We recommend prospective studies to better understand the factors that influence the prognosis of OMEC.

Background: Gutka chewing is the most common deleterious oral habit prevalent in the geographical distribution of the Indian subcontinent. Gutka leads to the production of numerous free radicals, which causes oxidative stress in regional oral tissues. Oxidative stress brings about the oxidation of guanine bases of DNA that generates 8-OHdG as its main byproduct. The presence of 8-OHdG can be evaluated not only in tissue but also in saliva, blood and urine. The availability of 8-OHdG in these samples is quite documented. In addition, a comparative assay of 8-ohdg DNA damage marker in multiple samples is yet to be done.

Material and methodology: A sample size of 60 was divided into two groups, i.e., gutka consumers without any lesion and gutka consumers with OSMF. Ten samples each of saliva, serum and urine were collected from these two groups and healthy controls. Samples were centrifuged at 1000 RPM at 2-8°C for 15-20 minutes. A volume of 1.5 ml resultant supernatant was pipetted out in labelled Eppendorf tubes and stored at -80°C. The ELISA test was performed to measure the concentration of 8-OHdG protein in different samples at 450 nm after adding stop solution in 96-well microplate.

Results: 8-OHdG concentration was found to be highest in saliva followed by urine and serum. 8-OHdG concentration in serum was significantly less than that in saliva and urine (P-value <0.05). Intergroup difference in concentration of 8-OHdG of urine, saliva and serum was significant (P-value <0.05). Post hoc analysis revealed that concentration of 8-OHdG in saliva and urine was non-significantly different (P-value >0.05).

Conclusion: Saliva appears to be the most appropriate sample type as compared to serum and urine for the evaluation of 8-OHdG in OSMF subjects.

Odontogenic myxomas (OMs) represent asymptomatic, slowly expanding gnathic lesions with aggressive biological behaviour. Though the spectrum of OMs remains classical with multilocular radiolucency and presentation of stellate-shaped cells embedded in a mucoid stroma, they may mimic many other lesions radiographically or histopathologically. We hereby discuss a case of OM in a 28-year-old woman with special emphasis on pathogenesis and differential diagnosis.