Cutaneous metastases of malignant melanoma--how difficult can it be?

Malignant melanoma is one of the most aggressive skin neoplasms with histopathological-based therapeutic approach. Unfortunately, in some cases, even the elementary issue of dealing with a primary or metastatic lesion may be sometimes incredible difficult to settle. We studied 11 cases of malignant melanomas that required careful histopathological and immunohistochemical analysis to differentiate between primary and secondary tumor. We evaluated epidermotropism of primary MM including synchronous tumors, local recurrences and metastases.

Local immune alterations in oral mucosa of the edentulous patients; possible cause of teeth loss?

UNLABELLED: Edentulous patients represent a difficult group of patients, especially in those cases when restorative prostheses are tempted on few remaining elements that eventually will be lost. MATERIAL AND METHOD: We performed a comparative histopathological and immunohistochemical (IHC) analysis of 20 oral mucosa biopsies in total edentulous patients (15 cases - group A) and ofnontumoral mucosa in oncologic patients (5 cases - group B, control). RESULTS: In group A the inflammatory infiltrate was dominated by the presence of numerous plasma cells (80%) and in 60% of the cases more numerous T cells than B cells were identified. We noticed various aspects of inflammatory infiltrate distribution in cases with epithelial ulceration (either CD8+ T cells intraepithelial and CD4+ T cells beneath the epithelium and perivascular or both CD4+ and CD8+ T cells in both lamina propria and intraepithelial location). 5 of seven cases which included salivary gland tissue revealed moderately to severe inflammatory infiltrate consisting of lymphocytes and plasma cells with lymphoepithelial lesion stage 1 aspects (71.42%). The control group (group B) presented plasma cell inflammatory infiltrate in one case (20%). None of the control cases had lymphoepithelial-like lesions within the salivary tissue. CONCLUSIONS: Presence of intraepithelial T citotoxic cells (CD8+) is correlated with presence of ulceration of the alveolar crest covering mucosa in the edentulous patients. Lymphoepithelial-like lesions of the minor salivary tissue in edentulous patients suggest an autoimmune response in local mucosa.