ABSTRACT
Mucoepidermoid carcinoma is the most common salivary gland tumor with varying behavior among different histopathological grades. The objective of this study was to determine the expression of Bcl-2 protein in mucoepidermoid carcinoma [MEC] and to correlate with histological grades. The records of 40 cases of MEC were collected from the histopathology department. Fresh slides were prepared and fresh diagnoses were made using the grading criteria for MEC. Immunohistochemical markers for Bcl-2 were applied and the results analyzed using the chi-square test. Of 40 cases, 20 were males and 20 were females. The range in age of the patients was 6 to 67 years mean [SD] was 42.6 [1.85] years. Twenty-two were low grade [55%], 11 high grade [27.5%] and 7 [17.5%] were intermediate grade MEC. Among these 40 cases, Bcl-2 expression was positive in 24 cases and negative in 16 cases. In 22 cases of low-grade MEC, 19 were positive while only 3 were negative. In high-grade tumors, all 11 cases were found to have a negative expression of Bcl-2 protein. In intermediate-grade MEC, 5 cases showed positive expression while only 2 cases showed negative expression. Bcl-2 protein expression showed positive expression in low-grade and negative expression in high-grade MEC. Intermediate grade showed more than 50% positive results for Bcl-2. Correlation between grades of MEC and expression of Bcl-2 is statistically significant and can be used for the depicting the prognosis of MEC along with other prognostic and clinico-pathological parameters
ABSTRACT
To study the clinicopathological aspects of malignant salivary gland tumors, diagnosed at AFIP, Rawalpindi [Pakistan]. Descriptive study. Armed Forces Institute of Pathology, Rawalpindi from Jan 2005-Dec 2009. The study included all the cases diagnosed as malignant salivary gland tumors in the last five years. Records of all the tumors of head and neck region that presented during this period were analyzed and out of these clinicopathological features of malignant salivary gland tumors were studied. The data analysis included the age, gender, site of tumor and histopathological pattern. A total of 18685 malignant tumors presented in the last five years. Out of these, malignant tumors of head and neck were 2165. Total malignant salivary gland tumors were found out to be 150 with an overall frequency of 0.8% and frequency in head and neck malignancies was found out to be 6.9%. The age ranged from 6-80 years [mean 48.02 + 1.23]. Of these 150 cases, 58.7% were males and 41.3 were females with a male to female ratio of 1.4:1. The most common tumor seen was mucoepidermoid carcinoma [49.3%] followed by adenoid cystic carcinoma [31.3%]. A total of 48.7% of the tumors originated in minor salivary glands. Parotid gland was the second most commonly involved site [40.7%]. Malignant salivary gland neoplasms are a common malignancy of head and neck region and their frequency is slightly more in our population. Almost half of the tumors originated in minor salivary glands and mucoepidermoid carcinoma was the most common type of malignancy
Subject(s)
Humans , Male , Female , Carcinoma, Mucoepidermoid , Carcinoma, Adenoid Cystic , Salivary Glands, Minor , Parotid GlandABSTRACT
The main objective of the study was to evaluate the efficacy of Nasolabial Flap in the reconstruction of oral sub mucous fibrosis. Case series. Oral and Maxillofacial Surgery Department, Armed Forces Institute of Dentistry, Rawalpindi from Jan 2008 to Dec 2009. A total of 5 patients with moderate to severe degree of oral submucous fibrosis were treated surgically and the reconstruction was done using bilateral nasolabial flaps. Four patients were male and one patient was female. The mean age of the patients was 24.6 years. Pre-operative mouth opening was measured before the procedure. Similarly per-operative and post operative mouth openings were also recorded and compared with the pre operative mouth opening. Pre-operative openings ranged from 8mm to 18mm [mean= 12.3mm]. After 6 months of post operative follow up and vigorous physiotherapy exercises, patients were able to maintain mouth openings ranging from 32mm to 39mm [mean =34.5mm]. Paired t-test was used to analyze the results and the value was found to be statistically significant. [p<0.05]. Bilateral Nasolabial flap is a satisfactory treatment modality for oral submucous fibrosis both functionally and esthetically
Subject(s)
Humans , Male , Female , Nasolabial FoldABSTRACT
The aim of this cross sectional prospective study was to determine reasons and patterns of permanent 1[st] molar extraction in patients reporting to oral and maxillofacial surgery department at Armed Forces Institute of Dentistry, Rawalpindi. All patients referred to oral and maxillofacial surgery department for extraction of permanent first molar teeth from 1st of January 2009 till 31[st] of December 2009 were included in the study irrespective of their age and gender. The primary reason of extraction was recorded along with other relevant information. The pattern of extractions of the permanent first molars was also noted. A total of 470 patients were included in the study. Out of these 291 [61.9%] were males [M: F 1.6:1]. Caries was the most common cause with 281 extractions [59.8%] in all age groups in both genders followed by periodontitis, which was responsible for 109 [23.2%] of permanent first molar extractions. Mandibular molars were more frequently extracted [62.7%] as compared to the maxillary molars [37.3%], with the mandibular left molar being the most frequently extracted tooth in the sample population
Subject(s)
Humans , Male , Female , Tooth Extraction , Cross-Sectional Studies , Prospective Studies , Dentition, Permanent , Dental Caries , Periodontitis , Mandible , Maxilla , Tooth, ImpactedABSTRACT
To document p53 protein expression in Adenoid cystic carcinoma [AdCC] of salivary glands and correlate this expression with clinicopathological parameters in prognostic assessment of AdCC at microscopic level. This Correlation study was carried out at Armed Forces Institute of Pathology [AFIP], Rawalpindi for 6 months. A total of 40 cases of AdCC diagnosed in salivary glands of five years duration [2006-2010] were retrieved from tumor registry. Clinical information was extracted from histopathology request forms submitted with the specimens. Fresh slides were prepared for histopathological [H and E stalling] and subsequent p53 immunohistochemical evaluation. Out of 20 patients [50%] belonging to 31-50 years age category, 12 were positive and 8 cases were negative for p53 expression. Majority of patients were male [n=27, 67.5%], among which 17 yielded positive while 10 had negative p53 expression. Among tumors evolving from major salivary glands [n=13], 10 showed positive whereas only 3 displayed negative results for p53 expression. Maximum number of tumors [n=17, 42.5%] were greater than 4 cm in size with 12 of them as p53-positive and 5 as p53-negative. Results for histopathological subtype and tumor grade were similar, with 34 [85%] revealing cribriform growth pattern, thus having grade Il neoplasms, with equivocal p53 staining, yielding 18 as p53-positive and 16 as p53-negative neoplasms in each parameter. Though small in count, all tumors with solid histological subtype [n=5, 13%], hence with grade Ill neoplasms exhibit positive p53 expression. Perineural invasion '.vas present in 77% [n=31] of tumors, among which 17 were having positive while 14 were having negative p53 expression. Lymphovascular invasion was present in 37 [92.5%] cases, among which 22 yielded positive while 15 had negative expression of p53. Tumors with larger size [_4cm], solid growth pattern, grade Ill neoplasm and major salivary gland as primary tumor site bear positive correlation with p53 protein. Though none of the correlation turned out as statistically significant to be used as key element in prognostic assessment of AdCC at microscopic level, however the above mentioned parameters can be considered important while planning the management which may need an aggressive approach in these cases. There is a need of more research for additional comprehensive prognostic assessment of salivary gland AdCC
ABSTRACT
The purpose of this study was to determine the clinicopathological and demographical characteristics of histologically diagnosed cases of oral SCC. Evaluation is based on age, gender, site of tumor and histological differentiation. Histologically diagnosed cases of oral SCC during a period of 3 years [Jan 2007 - Dec 2009] were retrieved from the tumor records of Department of Histopathology, Armed Forces Institute of Pathology, Rawalpindi, Pakistan. Biopsy specimens at the institute are obtained from Armed Forces as well as public and private sector hospitals including the review cases for second opinion. All the cases were subjected to the analysis of age, gender distribution, site of tumor occurrence and grade of histological differentiation. Out of a total of 12611 tumors recorded at AFIP Tumor registry, 467 cases of oral neoplasms were diagnosed as SCC [3.7%]. Among head and neck tumors recorded in the study period, oral SCC comprises 32.9% of the total. The mean age [ +/- standard deviation] of patients was 55.9 +/- 13.3 years [range, 5-90 years] with a male predominance [52.5%], yielding male to female ratio of 1.1:1. Peak incidence is found in 60 years of age. Most common site was buccal mucosa [29.8%] followed by tongue [23.1%] and mandible [13.5%]. Most common histological grade was well differentiated [67.5%] followed by moderately differentiated [26.8%] and poorly differentiated [5.8%] histological subtypes. Oral SCC is the most common malignancy of head and neck region in our community with peak incidence in comparatively older age group. There is an overall male predominance except in younger age group, where it is more common in females. Most common site of tumor is buccal mucosa. The well differentiated grade is the most common histological type of differentiation