Low-Grade Myofibroblastic Sarcoma of the Oral and Maxillofacial Region: An International Clinicopathologic Study of 13 Cases and Literature Review.

Low-grade myofibroblastic sarcoma (LGMS) represents an atypical tumor composed of myofibroblasts with a variety of histological patterns and with a high tendency to local recurrence and a low probability of distant metastases. LGMS has predilection for the head and neck regions, especially the oral cavity. This study aimed to report 13 new cases of LGMS arising in the oral and maxillofacial region. This study included LGMS cases from five oral and maxillofacial pathology laboratories in four different countries (Brazil, Peru, Guatemala, and South Africa). Their clinical, radiographic, histopathological, and immunohistochemical findings were evaluated. In this current international case series, most patients were females with a mean age of 38.7 years, and commonly presenting a nodular lesion in maxilla. Microscopically, all cases showed a neoplasm formed by oval to spindle cells in a fibrous stroma with myxoid and dense areas, some atypical mitoses, and prominent nucleoli. The immunohistochemical panel showed positivity for smooth muscle actin (12 of 13 cases), HHF35 (2 of 4 cases), ß-catenin (3 of 5 cases), desmin (3 of 11 cases), and Ki-67 (range from 5 to 50%). H-caldesmon was negative for all cases. The diagnosis of LGMS was confirmed in all cases. LGMS shows predominance in young adults, with a slight predilection for the female sex, and maxillary region. LGMS should be a differential diagnosis of myofibroblastic lesions that show a proliferation of spindle cells in a fibrous stroma with myxoid and dense areas and some atypical mitoses, supporting the diagnosis with a complementary immunohistochemical study. Complete surgical excision with clear margins is the treatment of choice. However, long-term follow-up information is required before definitive conclusions can be drawn regarding the incidence of recurrence and the possibility of metastasis.

Detection of AA-type amyloid protein in labial salivary glands

Objectives: Among the diverse forms of amyloidosis, secondary type is the most frequent one. Diagnosis of amyloiddeposition is based on the identification of the fibrillary protein amyloid by means of Congo Red (CR) or crystalviolet (CV) stains, but these techniques do not differentiate between the different types of amyloid fibrils. Theaim of this study was to identify by immunofluorescence (IF) AA amyloid a pathological fibrillar low-molecularweightprotein formed by cleavage of serum amyloid A (SAA) protein in labial salivary gland (LSG) biopsies frompatients with secondary amyloidosis.Study design: 98 LSG were studied, 65 were from patients with secondary amyloidosis and 33 from subjects withchronic inflammatory diseases without evidence of this anomaly. All sections were stained with hematoxylin andeosin (H&E), CV, CR and IF using anti-AA antibodies. Positive and negative controls were used for all techniques.Results: CV and CR demonstrated that the amyloid substance was found mainly distributed periductally (93.8%),followed by periacinar and perivascular locations (p<0.001); however, the IF demonstrated that amyloid AA substancepredominates in the periacinar area (73.8%), followed by periductal and perivascular locations (p<0.001).IF has a sensitivity of 83%, 100% of specificity, 100% of predictive positive value and 75% of predictive negativevalue.Conclusions: The results of this study confirm the efficacy of the LSG biopsy as a highly reliable method fordiagnosis of secondary amyloidosis (AU)

Functional biomarkers for the acute effects of alcohol on the central nervous system in healthy volunteers.

The central nervous system (CNS) effects of acute alcohol administration have been frequently assessed. Such studies often use a wide range of methods to study each of these effects. Unfortunately, the sensitivity of these tests has not completely been ascertained. A literature search was performed to recognize the most useful tests (or biomarkers) for identifying the acute CNS effects of alcohol in healthy volunteers. All tests were grouped in clusters and functional domains. Afterwards, the effect of alcohol administration on these tests was scored as improvement, impairment or as no effect. Furthermore, dose-response relationships were established. A total number of 218 studies, describing 342 different tests (or test variants) were evaluated. Alcohol affected a wide range of CNS domains. Divided attention, focused attention, visuo-motor control and scales of feeling high and of subjective drug effects were identified as the most sensitive functional biomarkers for the acute CNS effects of alcohol. The large number of CNS tests that are used to determine the effects of alcohol interferes with the identification of the most sensitive ones and of drug-response relationships. Our results may be helpful in selecting rational biomarkers for studies investigating the acute CNS effects of alcohol or for future alcohol- interaction studies.

Detection of AA-type amyloid protein in labial salivary glands.

OBJECTIVES: Among the diverse forms of amyloidosis, secondary type is the most frequent one. Diagnosis of amyloid deposition is based on the identification of the fibrillary protein amyloid by means of Congo Red (CR) or crystal violet (CV) stains, but these techniques do not differentiate between the different types of amyloid fibrils. The aim of this study was to identify by immunofluorescence (IF) AA amyloid a pathological fibrillar low-molecular-weight protein formed by cleavage of serum amyloid A (SAA) protein in labial salivary gland (LSG) biopsies from patients with secondary amyloidosis. STUDY DESIGN: 98 LSG were studied, 65 were from patients with secondary amyloidosis and 33 from subjects with chronic inflammatory diseases without evidence of this anomaly. All sections were stained with hematoxylin and eosin (H &E), CV, CR and IF using anti-AA antibodies. Positive and negative controls were used for all techniques. RESULTS: CV and CR demonstrated that the amyloid substance was found mainly distributed periductally (93.8%), followed by periacinar and perivascular locations (p <0.001); however, the IF demonstrated that amyloid AA substance predominates in the periacinar area (73.8%), followed by periductal and perivascular locations (p <0.001). IF has a sensitivity of 83%, 100% of specificity, 100% of predictive positive value and 75% of predictive negative value. CONCLUSIONS: The results of this study confirm the efficacy of the LSG biopsy as a highly reliable method for diagnosis of secondary amyloidosis.

14th International Congress IAOP/AAOMP Clinical Pathology Conference Case 6.

The clinicopathologic features of oral cryptococcosis manifested as multifocal tumor-like lesions located in the upper and lower gingival tissues of a 36-year-old male patient with AIDS are described. The gingival lesions were the initial manifestation of disseminated cryptococcosis from which central nervous system involvement was established. Clinical differential diagnosis and histopathologic features are discussed. Effect of treatment on the gingival lesions after 18 months follow-up is presented.

An updated clinical and epidemiological profile of the adenomatoid odontogenic tumour: a collaborative retrospective study.

BACKGROUND: Adenomatoid odontogenic tumour (AOT) is a benign odontogenic jaw lesion. The aim of this study was to update the biological profile of AOT. MATERIAL AND METHODS: Cases published in the literature and cases in files of co-authors were included. RESULTS: 550 new cases were retrieved, and of a total of 1082 cases analysed, 87.2% were found in the second and third decades. The M:F ratio was 1:1.9. 70.8% were of the follicular variant (extrafollicular: 26.9%, peripheral: 2.3%). 64.3% occurred in the maxilla. 60% of follicular AOTs were associated with unerupted canines. Nineteen cases of AOT (2.8%, M:F ratio was 1:1.4) were associated with embedded third molars. Twenty-two peripheral AOTs (2.3%, M:F ratio was 1:5.3) were recorded. The relative frequency (RF) of AOT ranged between 0.6% and 38.5%, revealing a considerably wider AOT/RF range than hitherto reported (2.2-7.1%). CONCLUSIONS: This updated review based on the largest number of AOT cases ever presented, confirms the distinctive, although not pathognomonic clinicopathological profile of the AOT, its worldwide occurrence, and its consistently benign behaviour.

Enfermedad de Kikuchi-Fujimoto, tuberculosis ganglionar y tuberculide, comunicación de casos y revisión de literatura / Disease of Kikuchi-Fujimoto, tuberculosis, lymph node and tuberculide, communication of cases and review of literature

Se comunican dos casos de tuberculosis ganglionar que simulan histológicamente la enfermedad de Kikuchi, es decir, un patrón de linfadenitis histiocítica necrotizante. Uno de ellos presentó, además, cambios clínicos e histológicos de la tuberculide rosaceiforme de Lewandowsky, lo que demuestra que esta última entidad puede excepcionalmente ser una verdadera tuberculide.

Amiloidosis secundaria: características clínicas / Clinical characteristic: secundary amyloidosis

Objetivo: determinar las características clínicas de la amiloidosis secundaria. Material y métodos: Se realizó un estudio retrospectivo de 115 pacientes con diagnóstico histopatológico de amiloidosis secundaria entre 1964 y 1997, determinados por biopsia renal (97.5 por ciento) o de glándula salival menor (2.5 por ciento). Resultados: como enfermedades determinantes se encontraron TBC pulmonar (90.43 por ciento), bronquiectasias (6.08 por ciento), osteomielitis (1.74 por ciento). Las manifestaciones clínicas fueron: edema en 98.2 por ciento, proteinuria 100 por ciento, e hipotensión en 30.43 por ciento. La proteinuria en 24 horas fluctuó entre 1.26 y 3.23 gr. El rango en que fluctuó la albúmina sérica fue de 0.6 a 3 gr/dl. Se encontró función renal normal en 5 por ciento e insuficiencia renal en 95 por ciento de los pacientes

Amyloid deposits in labial salivary glands identified by electron microscopy: short communication / Depósitos de amilóide nas glândulas salivares labiais identificados por microscopia eletrônica

Abnormal proteinaceous deposits identified by light microscopy as amyloid in labial salivary gland biopsies were studied by transmission electron microscopy in order to establish their ultrastructural characteristics. Results showed fine fibrils approximately 10nm in diameter located in close relation to the basal lamina of the secretory end-pieces and ducts as well as in the interstitial connective tissue stroma of labial salivary glands; these are the typical features of amyloid. Thus, the present study confirms the light microscopy diagnosis of amyloid deposits in labial salivary gland biopsies, supporting the use of lip biopsy as a readily accessible method for the diagnosis of secondary amyloidosis

Valor de la biopsia de glándulas salivales labiales en el diagnóstico de amiloidosis sistémica / Value of the lips salivary glands biopsy in the diagnosis of sistemic amyloidosis

En 78 pacientes con sospecha clínica de amiloidosis secundaria se tomaron igual número de biopsias de glándulas salivales labiales y 26 de encía. Así mismo se analizaron los resultados de 11 biopsias renales, 4 de mucosa rectal y 1 de piel. La substancia amiloide fue detectada en todas las biopsias de glándulas salivales (100 por ciento), en tanto que en las biopsias de encía se le observó sólo en 4 casos (15 por ciento). Los resultados de las biopsias labiales en 42 pacientes control fueron negativos. En 11 pacientes con biopsia renal y labial ambas biopsias fueron positivas (100 por ciento de correlación). La biopsia rectal fue positiva en 3 casos y la biopsia de piel fue negativa. En todas las glándulas salivales el depósito de amiloide tenía un definido patrón periductal comprometiendo la membrana nasal. Adicionalmente en 72 casos (92 por ciento) se ubicaba en la membrana basal periacinar, en 51 casos (65 por ciento) se observó depósito perivascular y en 25 casos (32 por ciento) habían depósitos intersticiales. En la encía era escasa y estaban localizada en la membrana basal epitelial, en la punta de algunas papilas dérmicas y en pequeños vasos sanguíneos. Las observaciones histológicas indican que en infecciones o enfermedades inflamatorias crónicas la sustancia amiloide se deposita primero en las membranas basales epiteliales, con especial predilección por la membrana basal periductal y periacinar. El compromiso perivascular es posterior. Los resultados de este estudio permiten proponer a la biopsia de glándulas salivales labiales (biopsia labial) como un nuevo método, eficaz y seguro para diagnosticar amiloides secundaria, además es un procedimiento técnicamente simple, libre de complicaciones y bien aceptado por los pacien

Guia de practicas de laboratorio de microbilogia / Guide of practices of laboratory of microbiology

Demuestra el procedimiento de aislamiento, indentificaci¢n y titpificaci¢n de los agentes bacterianos...

Guia de practicas de laboratorio de microbiologia / Guide of practices of laboratory of microbiology

Estudia las reacciones serol¢gicas aplicadas al diaggn¢stico bacteriol¢gico y pruebas espec¡ficas de diagn¢stico serol¢gico...

Guia de practicas de laboratorio de microbiology / Guide of practices of laboratory of microbiology

Hace una introducci¢n al estudio práctico de la microbiolog¡a, presenta la estructura bacteriana y las técnicas de laboratorio. También presenta procedmientos especiales empleados en bacteriolog¡a médica...