Ectodermal Dysplasia in Primary Dentition – A Rare Case Report

Development of the primary and permanent dentition is a complex process wherein there is series of interactions between the ectoderm and ectomesenchyme. A cascade of signaling pathways occur in a spatio-temporal manner resulting in the development and eruption of the human dentition. Any developmental aberrations in shape, size, number, and position can lead to deviations from normal development of teeth. In this book, dental anomalies including gemination, fusion, concrescence, dilaceration, dens invaginatus, DE, taurodontism, enamel pearls, fluorosis, peg?shaped laterals, dentinal dysplasia, regional odontodysplasia and hypodontia etc. are discussed. Diagnosing dental abnormality needs a thorough evaluation of the patient and careful clinical and radiographical examination is required. Furthermore, more complex cases need multidisciplinary planning and treatment.

Extrarenal angiomyolipoma in uterine cervix: rare presentation in unusual site

Angiomyolipoma is a benign neoplasm composed of variable admixture of blood vessels, smooth muscle cells and adipose tissue. Cervical angiomyolipoma are extremely rare and to the best of our knowledge only five cases of angiomyolipoma in cervix have been reported in the literature till date. Authors are presenting a case of angiomyolipoma arising from the uterine cervix. 43 years old female presented with mass descending per vagina for 6 months. This case had no association with tuberous sclerosis. Microscopic examination showed an ill-defined polypoidal, non-encapsulated lesion covered by keratinized stratified epithelium. The lesion is made up of three components, predominantly by fascicles of spindle shaped cells, varying sized blood vessels and multiple foci of mature adipocytes with no evidence of atypia or increased mitotic activity. Smooth muscle component showed strong immunoreactivity to SMA and absence of elastic fibres in the blood vessels were confirmed by histochemistry. Non-vascular smooth muscle cells were negative for HMB-45 in contrast to renal and other extra-renal angiomyolipoma in which HMB-45 immunoreactivity in seen in these cells. To conclude, the differential diagnosis of lower abdominal mass and dysfunctional uterine bleeding should include the angiomyolipoma, even though the uterine cervix is an extremely rare location where they occur.

Scrape cytology – can it replace punch biopsy in diagnosing oral lesions.

Background: Oropharyngeal carcinoma is one of the leading causes of morbidity and mortality in Indian population due to increased use of tobacco chewing products. Mucosal biopsy is widely regarded as the gold standard for detecting oral carcinomas, but exfoliative cytology are increasingly used for early detection of malignancy and strict follow up in suspicious looking lesions. Aims & Objective: The aim of this study was to see the reliability of oral scrape cytology to detect pre-malignant and malignant oral lesions in terms of sensitivity and specificity and to see whether it can replace biopsy for diagnosing the same. Material and Methods: A total of 100 cases with oral lesions were included in the study. All patients underwent oral scrape cytology and 55 cases were followed up with punch biopsy. Sensitivity, specificity, positive and negative predictive values were calculated. Cytopathology and histopathology of premalignant and malignant lesions were compared using T test. Results: Oral cancer is most common in male (M: F 7:1). Premalignant lesions were more common in the tongue, whereas the floor of mouth was more involved by malignant lesions. Four cases were marked insufficient on cytopathology. 25% of cases were false negatives. The sensitivity, specificity, positive predictive value and negative predictive value were 91.5%, 100%, 100% and 66.7%, respectively. Statistical analysis showed P of 0.7491 suggesting that there is no significant difference between histopathology and brush cytology in assessing clinically premalignant lesions but for clinically malignant lesions P values of 0.0001 suggesting that there is significant difference between histopathology and scrape smear cytopathology in assessing malignant lesions. Conclusion: The high specificity and the high positive predictive value of oral scrape cytology makes it an ideal screening test for early detection of oral cancer. However, its low sensitivity means that it can miss cases of carcinoma, and should be followed up with biopsy with string clinical suspicion. Also, there is statistically significant difference between histopathological and cytopathological diagnosis in diagnosing dysplasia or carcinoma.