Journal of Oral and Maxillofacial Pathology最新文献

The pathologies of the neck are varied and at times may cause a diagnostic dilemma for the pathologist. In this report, we present a case of a 32-year-old man with a slow-growing nodular swelling in the right neck region, which was diagnosed as a simple colloid cyst arising in a parasitic thyroid nodule. Simple colloid cysts are cysts that develop due to impaired accumulation of thyroglobulin in inactive follicles. Most thyroid-related pathologies occur as midline swellings. However, the present case was unique due to its location with no connection to the thyroid gland. This case report describes the diagnostic process and adds insight into the pathology of a colloid cyst.

Tuberculosis (TB) is a serious infectious disease with significant mortality and most commonly affects the pulmonary system and rarely the oral cavity. Because oral tuberculosis is a rare disease, it is often overlooked in the differential diagnosis of oral lesions. Despite the recent decline in the incidence of tuberculosis, it remains a highly contagious and serious public health problem, thus requiring early diagnosis and rapid intervention. Extrapulmonary tuberculosis (EPTB) is defined as any bacteriologically confirmed or clinically diagnosed case of tuberculosis (TB). A 17-year-old girl reported at the outpatient Department of Dentistry with the chief complaint of a swelling at the backside of mouth along with pus discharge. She noticed these symptoms approximately one month after the extraction of the left mandibular first molar. The patient was referred to the Department of Pulmonary Medicine for further investigation and treatment. Subsequently, diagnosis of EPOTB was reached on the basis of the histopathological findings and the previous personal as well as family history. Drastic improvement was observed in the general condition and a complete resolution of the oral lesion after four weeks of ATT and the patient was completely free of all the symptoms after six months of follow-up period. This case demonstrated the importance of oral manifestation of oral tuberculosis for dentist who may be the first healthcare provider to encounter a variety of oral lesions.

Background: Stress is faced by every individual in their day-to-day life activities. During pandemic, most people have experienced multiple episodes of depression, anxiety, and insomnia. Several medical and dental problems are reported with stress and the fastest and easiest way to study and investigate is through body fluids, mainly saliva. Hence, we aim to study salivary α amylase in disabled individuals and hypothesize that salivary α amylase could be a reliable stress biomarker in disabled individuals.

Materials and methods: Cross-sectional study was conducted including 200 individuals grouped into controls (100) and disabled individuals (100). Disabled individuals were further grouped into physically (50) and mentally (50) disabled. Stimulated and unstimulated saliva was collected from all the participants and were investigated for salivary α-amylase by direct substrate method. The enzyme activity was analyzed using a spectrophotometer and the obtained were analyzed statistically.

Result: Salivary α-amylase showed significant difference between controls and disabled group (p = 0.000). Salivary α-amylase was least in the mentally disabled group compared to physically disabled group. Age related comparison of salivary α-amylase was higher in physically disabled whereas gender related comparison showed females in physically disabled group to be more affected than controls.

Conclusion: Saliva, the easy and most researched fluid, is rich in salivary α-amylase. Salivary α-amylase is a potential biomarker to assess stress. Further diagnostic studies are required to know the salivary changes and their influence on individual general health status.

Food particles get frequently impacted in the oral cavity in varying sites. Oral pulse granuloma develops as a consequence of implantation of food particles of plant or vegetable origin in oral tissues. The lesion might be central or peripheral. It has a differing histological picture and may be confused with many other lesions including parasitic infection. Impacted vegetable matter is rarely associated with multiple myeloma, bacterial and fungal osteomyelitis, and squamous cell carcinoma and has never been reported in the literature before. Thus, in the present case series, we have discussed about the above three rare associations along with pulse granulomas associated with periapical granuloma and periapical cyst. The paper aims to discuss the clinical, histological, and polarising microscopic features of the cases and theories substantiating aetiology and in general about the differential diagnosis.

Context: Programmed cell death ligand 1 (PD L1) is a transmembrane protein that is highly expressed in neoplastic cells. Therapy with immune checkpoint inhibitors target PD-1/PD-L1 blockade-inducing tumour regression. Immunohistochemistry (IHC) for PD-L1 expression enables patient selection for immunotherapy and can be considered as a potential predictive biomarker for immunotherapy in head and neck squamous cell carcinoma (HNSCC).

Aims: To determine the PDL1 expression in HNSCC, to correlate with clinicopathological features and outcome.

Settings and design: We retrospectively analysed 59 cases of HNSCC at our Tertiary Hospital between January 2017 and November 2018 and followed up until death/Nov 2022 for Overall survival.

Methods and material: IHC analysis of PD-L1 using Combined Positive Score (CPS) with antibody clone 22C3 in 59 cases of HNSCC was performed. PD-L1 expression was correlated with clinicopathological features and outcomes.

Statistical analysis used: Pearson Chi-square test was used to analyse the correlation between PD-L1 expression and clinicopathological parameters using SPSS20.0. Survival curves were calculated by Kaplan-Meier method, and differences were analysed by log-rank test.

Results: A total of 25 cases (42.4%) had positive PDL expression (CPS ≥1). 16/25 cases (27.1%) belonged to CPS (≥1, <10). An almost-perfect interobserver agreement was noted by two pathologists for PD-L1 IHC expression. No statistically significant correlation was noted between PD-L1 score and clinicopathologic features.

Conclusions: Detection of PD-L1 status gives further insight into frequency of PD-L1 expression in Indian HNSCC patients to possibly improve clinical treatment strategies, ensuring that our patients get the maximum therapeutic benefit of immunotherapy.

Background: The Bellary district in Karnataka, rich in mineral resources, is a major mining industry, but prolonged exposure to mining can lead to health hazards. The study aims to assess the genotoxic impact of mining pollutants on mine workers using the micro-nucleus (MN) assay.

Setting and design: Cross-sectional study.

Materials and methods: A total of 250 individuals (198 males and 52 females) working in mining areas were examined, and their oral findings were recorded in a proforma. For the micro-nucleus assay, buccal smears from 30 individuals working in mining areas with habits, 30 individuals working in mining areas without habits, and 30 individuals residing in non-mining areas (control group) were selected. Smears were stained with Giemsa stain to identity and quantify the MNs.

Results: The frequency of oral mucosal problems among 250 persons working in mining regions was 170 (68.0%) with no oral mucosal conditions, 79 (32.6%) with oral mucosal conditions, 25 (10%) with leukoplakia, 1 (0.4%) with lichen planus, and 8 (3.2%) with ulcerations. Acute necrotising gingivitis was reported in one person (0.4%), candidiasis in two (0.8%), abscess in two (0.8%), OSMF in 39 (15.6%), and oral cancer in two (0.8%). The mean MN count was 2.40 + 1.57 in mine employees with habits, 2.18 + 1.25 in mine workers without habits, and 1.40 + 0.55 in normal healthy controls.

Conclusion: Reduced occupational health risks brought on by exposure to mining contaminants require protective measures. After being exposed to mining pollutants, exfoliated buccal mucosal cells can be examined for genotoxicity.

[This corrects the article on p. 237 in vol. 24, PMID: 33456231.].

The practice of hand-off orientation in oral pathology plays a pivotal role in ensuring efficient and high-quality patient care. Given the intricate nature of oral health, the seamless transition of patient care from one healthcare provider to another is critical. Hand-off orientation in oral pathology begins with a comprehensive referral of oral biopsy specimens from a general dentist or clinical specialist to the oral pathology laboratory. Obtaining detailed information about oral biopsy tissue and complete patient information from clinicians is indeed crucial for a variety of reasons, including accurate diagnosis and treatment planning. This collaborative approach ensures that patients receive timely and accurate care, reducing the potential for misdiagnosis or treatment delays. In the field of oral pathology, effective hand-off orientation is a cornerstone of patient safety and positive outcomes.