Quantitative and qualitative assessment of argyrophilic nucleolar organizer regions in normal, premalignant and malignant oral lesions.

AIM: The aim of the study was to assess the cell proliferation and biologic aggressiveness of the lesions by evaluating the significance of number and dispersal pattern of Argyrophillic Nucleolar organizing Regions (AgNORs) using silver colloid technique in normal mucosa, premalignant and malignant lesions. SETTINGS AND DESIGN: In-vitro study, lab setting. METHODS AND MATERIAL: The study sample consisted of five groups each with a sample size of 10 and a control group. Group I (Control), Group II (Oral Submucous Fibrosis - Mild dysplasia), Group III (Oral Submucous Fibrosis - Moderate dysplasia), Group IV (Leukoplakia - Mild dysplasia), Group V (Leukoplakia - Moderate dysplasia) and Group VI (Squamous cell carcinoma). Two sections were cut, of which one was stained with H/E stain for histopathological analysis and the second one with Silver nitrate for AgNOR counting and grading. The data obtained were analyzed both qualitatively and qualititavely. STATISTICAL ANALYSIS USED: Student's Unpaired T test and One- way ANOVA. RESULTS: The Mean AgNOR count increased in the following ascending order: i.e OSMF with mild dysplasia, leukoplakia with mild dysplasia, OSMF with moderate dysplasia, leukoplakia with moderate dysplasia and squamous cell carcinoma. Qualititatively, Type II AgNOR pattern was found to be the predominant one in all the samples. Type III AgNOR pattern was found to be increasing with the increase in the grade of dysplasia. CONCLUSIONS: AgNOR quantity is proportional to the proliferative activity of the cell and does not necessarily always indicate malignancy. It is the qualitative characteristics of AgNOR that help to differentiate the premalignant and malignant lesions.

Ectomesenchymal chondromyxoid tumor: A rare case report.

Ectomesenchymal chondromyxoid tumor (ECMT) is a rare benign neoplasm of uncertain histogenesis, which exclusively involves the oral cavity, particularly the tongue. Clinically, it presents as slow growing, painless, firm, submucosal swelling exclusively occurring on the anterior dorsum of the tongue. Histopathologically, it comprised well circumscribed, unencapsulated lobular proliferation of fusiform and polygonal cells, with varying degree of cellularity, with neoplastic cells often seen in a myxoid, chondroid or hyalinized background. Until date, only 40 cases have been reported in the literature. Most documented lesions involve anterior tongue, however 2 cases in posterior tongue and one palatal tumor has been described. Here, we present a rare case diagnosed clinically and histopathologically as (ECMT) in a 7-year-old girl with the size of the lesion 5.0 cm making this case even rarer and throwing some light on this distinct entity.

Glandular odontogenic cyst: A rare entity.

Glandular odontogenic cyst (GOC) is an uncommon developmental odontogenic cyst of jaws with a relative frequency between 0.012 and 1.3%. GOC is very rare and only 111 cases have been documented in the English literature so far. Generally, this cyst is encountered in the anterior areas of the mandible and is more common with a wide age range, the mean age being 49.5 years and has a tendency to recur. GOC is often misdiagnosed because of its overlapping histopathological features with that of other odontogenic cysts such as lateral periodontal cyst (LPC) or botryoid cyst and central low-grade Mucoepidermoid carcinoma. Histopathological diagnosis and differential diagnosis of GOC is challenging for pathologist. Here, we present a case of GOC in a 40 year old male patient in left mandibular region that crossed the midline.

Oral discoid lupus erythematosus: A study of twenty-one cases.

AIMS: This study was undertaken to analyze the histopathological findings of oral discoid lupus erythematosus with conventional light microscopy for early diagnosis of the oral lesions that would aid in prompt treatment. OBJECTIVES: To find out the predominant age, sex, site and clinical features of oral discoid lupus erythematosus. To study the histopathological features of oral discoid lupus erythematosus. To study the alterations of basement membrane changes of oral discoid lupus erythematosus. MATERIALS AND METHODS: Our study consisted 21 cases of diagnosed DLE with oral lesions. A detailed clinical proforma was used for thorough clinical examination and light microscopy was used for histopathological study of the incisional biopsy specimens. STATISTICAL ANALYSIS USED: The lesions were diagnosed on the histopathological criteria given by Gisslen et al. and was statistically analyzed using the Chi square test. RESULTS: In the present study 9.52% patients had only oral lesions, while 90.47% patients had oral lesions along with skin lesions with the most common site of oral involvement being labial mucosa (76.19%), vermillion border (71.42%) and buccal mucosa (42.85%). On clinical examination, white spots were present in 28.6%, ulcers in 19% and central erythema in 52.4% lesions. Histopathologically, atrophy was observed in 66.66% cases, acanthosis in 66.66% and acanthosis alternating with atrophy in 33.33% cases along with the basement membrane appearing thin and homogenous in 66.7% and partially destroyed in 81% cases with Periodic Acid Schiff stain. CONCLUSIONS: Thus, from this study it was found that a diagnosis of oral discoid lupus erythematosus was based on the combination of clinical and histopathological findings. Thus the dentist may be in an important position to establish the diagnosis with the aid of clinical and histopathological findings before the cutaneous lesions become apparent.