Study of Prevalence of Koilocytes in Oral Squamous Cell Carcinoma

Ever since Dr. Harald zur Hausen won the noble prize in medicine in 2008 for discovering human papilloma virus (HPV) as the etiological factor for cervical cancer, the research has been robust in this field. More recent data from case–control studies and systematic review indicate that HPV is an independent risk factor for oral and oropharyngeal carcinomas. Oral squamous cell carcinoma (OSCC) represents 90% of all malignant tumours that affect the oral cavity. The most known viral cytopathic effect is koilocytosis, considered to be a major characteristic of HPV infection. Koilocytes are epithelial cells characterised by perinuclear haloes surrounding condensed nuclei and is accepted as pathognomonic (characteristic of a particular disease) of HPV infection. Aim The aim of this study was to verify the prevalence of koilocytes in OSCCs. Methodology A retrospective analysis was conducted on 60 paraffin-embedded tissue specimens that were obtained from patients with a histopathological diagnosis of OSCC. Haematoxylin and eosin-stained slides were submitted to examine under light microscopy, specifically for the determination of the presence of koilocytes and were analysed. Conclusion The results suggest that the presence of koilocytes is reliable for the detection of HPV presence in routine histopathology in OSCCs.

Walking the Age Trail on Cemental Lines-A Bright Light and Polarising Microscopic Study

Estimation of age using teeth is a proven and useful tool given an important consideration in the anthropology as well as forensic science. Among the various hard tissues, cementum is the most useful substance to evaluate the age of adult teeth. Thus this study was aimed to evaluate the efficacy of tooth cementum annulations method using cross sections of the teeth under bright light and polarised light microscopy and compare the age estimated using the tooth centum annulations method to the actual age of the individual. Material and method Twenty freshly extracted permanent maxillary and mandibular teeth were collected from department of oral and maxillofacial surgery including the age of the patient, date of extraction of the tooth, sex, type and place of the tooth in the dentition. Then the ground sections were prepared and microscopic analysis was done. Results The average difference in the estimated age and the actual age in cross sections of the teeth is 2–2.5 years and in transverse sections of the teeth is 3.5–4 years. A deviation of 5 or more than 5 years was observed in a cross-sectional case and three transverse-sectional cases. Conclusion In our study, we substantiate that age analysis can be performed by both bright field and polarising microscopy which provides similar accuracy. The choice of the method should be driven by the feasibility and ease to conduct them rather than the accuracy needed by these methods.

Role of bcl-2 oncoprotein in oral potentially malignant disorders and squamous cell carcinoma: An immunohistochemical study.

Background and Objectives: The product of bcl-2 gene, bcl-2 protein, an anti-apoptotic protein, is known to be over-expressed in potentially malignant disorders and squamous cell carcinoma (SCC) of the oral cavity. The aim of this study is to compare the topographical aspect and degree of bcl-2 over-expression in potentially malignant disorders including leukoplakia, oral submucous fibrosis (OSMF), and oral lichen planus (OLP), with that of the oral squamous cell carcinoma (OSCC), and to determine whether bcl-2 protein can be considered as a tumor marker. Materials and Methods : A group of 60 histo-pathologically diagnosed, formalin-fixed, paraffin embedded tissue samples was included in the study. The study group was further subdivided into four groups: Group I, consisting of oral leukoplakia; Group II, OSMF; Group III, OLP and Group IV, OSCC. These samples were collected from Government Dental College, Bangalore, and then subjected to immunohistochemical (IHC) staining using indirect immunoenzyme labeled streptavidin biotin (LSAB) method. Results : Out of 30 cases of OSCC: 11 (36.7%) cases showed greater supra-basal keratinocyte staining; 15 (50%) cases showed greater number of positive cells in the basal cell layer, with relatively less number of supra-basal cells showing positive staining; and, rest of the 4 (13.3%) cases did not show convincing staining. Among the total 30 cases of potentially malignant disorders: 10 each of leukoplakia, OSMF and OLP, 2 (20%), 2 (20%), 4 (40%) of the cases showed greater supra-basal cell layer positive staining and 8 (80%), 6 (60%), 6 (60%) of them showed greater basal cell staining, respectively. Two cases of OSMF did not show convincing staining. In the cases that were bcl-2 positive: 2 (6.67%) of the OSCC, 3 (30%) of leukoplakia, 2 (20%) of OSMF and 1 (10%) of OLP, showed more than 50% of the cells positive. 25-50% cells were positive in 21 (70%) of OSCC, 6 (60%) of leukoplakia, 4 (40%) of OSMF and 6 (60%) of OLP cases. 10-25% of cells were positive in 4 (13.3%) of OSCC, 1(10%) of leukoplakia, 2 (20%) of OSMF and 3 (30%) of OLP cases. Less than 10% of cells were positive in 3 (10%) of OSCC and 2 (20%) of OSMF cases. Clinical Significance and Conclusion : As definite number of cases showed bcl-2 over expression in our study, the role of bcl-2 in the development and progression of oral neoplasia needs further investigation along with other oncogenes.

A massive ameloblastic fibro-odontoma of the maxilla.

Ameloblastic fibro-odontoma is a rare, benign mixed odontogenic tumor. It occurs exclusively as an intraosseous lesion. It usually has a slow growth and is seen in children and young adults. A painless swelling is the most common clinical sign. Radiographically, ameloblastic fibro-odontoma appears as a circumscribed radiolucency which may contain radiopaque foci. Most cases of ameloblastic fibro-odontoma exhibit benign behavior, but cases of malignant transformation have been reported. The treatment modality in most cases involves conservative surgery, but cases with malignant transformation will require more radical treatment. A massive ameloblastic fibro-odontoma involving the maxilla has been described here with its clinical, radiological, and histopathological features.