Immunohistochemical assessment of proliferating cell nuclear antigen protein expression in plaque, reticular and erosive types of oral lichen planus.

BACKGROUND: Proliferating cell nuclear antigen (PCNA) is a nuclear protein synthesized in the late G1 and S-phase of the cell cycle. Immunodetection of this protein represents a useful marker of the proliferation status of lesions. AIMS: The aim of this study is to evaluate the immunohistochemical expression of PCNA in oral lichen planus (OLP) and to assess the PCNA expression in a different layer of epithelium in different types of OLP. SUBJECTS AND METHODS: A total of 96 cases of histologically proven OLP, 32 cases each of erosive, reticular and plaque type were selected. Two sections were taken from each one for H and E. Other sections were stained according to super sensitive polymer horseradish peroxidase method for identifying PCNA expression. RESULTS: Of the three types of OLP, erosive type showed higher expression of PCNA (average 66.8%, minimum of 55% and maximum of 80.3%) followed by reticular (average 37.7%, minimum of 26% and maximum of 47%) and plaque type (average 17%, minimum of 5% and maximum of 25%) indicating increased proliferative activity. The erosive type also showed higher expression of PCNA in all the layers of epithelium followed by reticular and plaque type. CONCLUSION: PCNA is a good marker to indicate proliferation status of disease. Out of three types, erosive type possess more proliferative ratio, chances of malignant changes is more in this type.

Mesenchymal chondrosarcoma of posterior maxilla: report of a case with brief literature review.

Mesenchymal chondrosarcomas (MCs) are infrequent, slow-growing malignant tumors of head and neck region affecting both bone and soft tissues. It represents approximately 1% of all chondrosarcomas. They usually occur in the middle aged individuals, but rarely seen in young patients. It is commonly found in the ribs and jaws. Involvement of the jaws is evident in 22-27% of cases of MC. Most commonly, MCs are painless and occurs in the anterior portion of maxilla. Maxillofacial MCs are aggressive, has a tendency for recurrence and late metastasis to lung, bone, and lymph nodes, and is associated with an overall poor prognosis. Histopathologically, it is characterized by a biphasic pattern consisting of areas of hyaline cartilage mixed with small cell malignancy. Very few case reports involving the posterior maxillary region has been reported. This article reports a rare case of MC along with a review of the pertinent literature.

Giant cemento-ossifying fibroma of the mandible.

Cemento-ossifying fibroma (COF) is classified as a fibro-osseous neoplasm and included among the non-odontogenic tumors derived from the mesenchymal blast cells of the periodontal ligament, with a potential for forming fibrous tissue, cementum and bone, or a combination of such elements. These are slow-growing lesions, and are more frequent in women between the third and fourth decades of life. Case reports of massive expansile COF, measuring more than 10 cm are rarely reported in the literature. We report a case of giant cemento-ossifying fibroma of the mandible in a 34 year old female patient.

Bilateral recurrent speckled leukoplakia: a case report

Largely oral cancers are preceded by potentially malignant lesions, which may appear as white or red patches on the oral mucosa. Leukoplakia is one of the most common epithelial precursors of oral squamous cell carcinoma. Speckled leukoplakia is a rare type of leukoplakia with a very high risk of premalignant growth and mortality rate. Though it is the common precancerous lesion, it poses a major diagnostic and therapeutic challenge. We present a rare case of bilateral recurrent speckled leukoplakia with malignant transformation and discuss this relatively rare entity in light of current information from the literature. We also attempt to present the clinical relevance, and the therapeutic modalities available for the management of the disease.

Cockayne‟s Syndrome: a case report

Cockayne's syndrome (CS) is a rare, autosomal recessive disease resembling progeria. The features of CS do not appear until 4 to 5 years of age. Most patient presents with cachectic dwarfism, cutaneous photosensitivity, loss of adipose tissue, mental retardation, skeletal and neurological abnormalities, similar to the current case. The additional feature observed in the present case was actinic chelitis. We report a case of Cockayne‟s syndrome with pronounced oral manifestations and an unusual feature of actinic chelitis.

Bilateral Cholesterol Granuloma of Maxillary Sinus: A Case Report

Cholesterol Granuloma [CG] is a rare pathology found in the paranasal sinuses and is usually associated with middle ear infections. The etiology of sinonasal CG is not yet known. The clinical manifestations are nonspecific. Most patient presents with nasal discharge, facial pain and nasal obstruction similar to current case. The additional feature observed in the present case was bilateral CG of the maxillary sinus which was extending into ostiomeatal complex and into the oral cavity, whose clinical, imaging and histological characteristics were unique.