RESUMEN
BACKGROUND: The aim of this study was to describe the relative frequency and the main demographic and clinic-radiographic features related to patients diagnosed with Simple bone cyst (SBC) in an Oral Diagnosis Service in Southeast Brazil and present a review and discussion of international literature on this topic. MATERIAL AND METHODS: SBC cases from our service encompassing the period between 1978 and 2017 were selected. In addition, a literature search was performed in the Pubmed/MEDLINE online electronic database published between 1951 and 2019. RESULTS: A total of 2,459 cystic lesions were documented in our service, thus 60 patients were diagnosed with the SBC representing 2.4% of all jaw cystic. Most of cases were asymptomatic. Multiple SBC lesions were seen in two patients (3.4%) and association with cemento-osseous dysplasia was seen in one female patient (1.7%). A total of 793 cases were enrolled in this literature review. CONCLUSIONS: The SBC is an asymptomatic lesion often discovered in routine image exams in young patients. The unilocular, well defined margin with scalloped appearance is characteristic and helps the definition of diagnosis. This review suggests a different epidemiologic trend concerning to the sex and it confirms the posterior region of mandible as the more frequent location. The conservative treatment with limited exploration and curettage remains as the gold-standard treatment.
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Quistes Óseos , Tumores Odontogénicos , Brasil , Femenino , Humanos , Mandíbula , Instituciones AcadémicasRESUMEN
BACKGROUND: Oral lichen planus (OLP) is a chronic inflammatory disease mediated by T cells, which manifests as reticular (white) or erosive (red) lesions, that are eventually painful. Oral lichenoid lesion (OLL) are distinguished from OLP by the presence of precipitating factors. The aim of this study was to evaluate whether the presence of metallothionein, which is involved in anti-apoptotic pathways and the anti-oxidative response, could serve as a differential diagnostic for OLP and OLL. MATERIAL AND METHODS: We evaluated the expression of metallothionein in 40 cases of OLP and 20 cases of OLL using immunohistochemistry. RESULTS AND CONCLUSIONS: White OLP has higher concentrations of metallothionein than red OLP in basal and parabasal layers. Moreover, metallothionein was more frequently observed in the cytoplasm and nuclei of basal cells in OLP patients compared to the same regions of OLL cases. Metallothionein levels are related to OLP severity and may contribute to a differential diagnosis between OLP and OLL.
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Amalgama Dental , Liquen Plano Oral/diagnóstico , Liquen Plano Oral/metabolismo , Metalotioneína/biosíntesis , Adulto , Amalgama Dental/efectos adversos , Diagnóstico Diferencial , Femenino , Humanos , Masculino , Persona de Mediana Edad , Enfermedades de la Boca/diagnóstico , Enfermedades de la Boca/etiología , Enfermedades de la Boca/patologíaRESUMEN
Adenoid cystic carcinoma (ACC) is the most common malignant salivary gland tumour of the maxillary sinus. The present study describes 24 cases seen over a period of 10 years at the Brazilian National Cancer Institute. Socio-demographic, clinical, pathological, and follow-up data were retrieved from the medical files for the period 1997-2006. The mean age of the patients was 51.1 years. Twenty-one (87.5%) presented advanced tumours. The main signs and symptoms found were a tumour mass (87.5%), pain (50%), nasal obstruction (25%), and epistaxis (20.8%). Most cases (62.5%) were treated with surgery and radiation therapy. Follow-up data showed two patients (8.3%) with residual disease, local recurrences in four (16.7%) patients, and distant metastasis in five (20.8%). The overall 5- and 10-year survival rates were 72.61% and 62.11%, respectively. Maxillary sinus ACC has an aggressive but indolent behaviour, typically presenting at an advanced T stage that reflects a poor prognosis for patients.
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Carcinoma Adenoide Quístico/patología , Seno Maxilar/patología , Neoplasias de los Senos Paranasales/patología , Neoplasias de las Glándulas Salivales/patología , Adulto , Anciano , Brasil , Carcinoma Adenoide Quístico/terapia , Terapia Combinada , Diagnóstico por Imagen , Femenino , Humanos , Masculino , Persona de Mediana Edad , Recurrencia Local de Neoplasia/patología , Recurrencia Local de Neoplasia/terapia , Estadificación de Neoplasias , Neoplasias de los Senos Paranasales/terapia , Factores de Riesgo , Neoplasias de las Glándulas Salivales/terapia , Tasa de SupervivenciaAsunto(s)
Antirretrovirales/uso terapéutico , Sarcoma de Kaposi/tratamiento farmacológico , Sarcoma de Kaposi/patología , Infecciones Oportunistas Relacionadas con el SIDA/tratamiento farmacológico , Infecciones Oportunistas Relacionadas con el SIDA/patología , Adenina/análogos & derivados , Adenina/uso terapéutico , Adulto , Alquinos , Benzoxazinas/uso terapéutico , Ciclopropanos , Quimioterapia Combinada , Humanos , Lamivudine/uso terapéutico , Masculino , Organofosfonatos/uso terapéutico , TenofovirRESUMEN
Data regarding the development of head and neck metastases are limited, with the majority of the studies focusing on single cases affecting mainly the oral cavity and surrounding tissues. This study describes the incidence of head and neck metastases from primary tumours originating elsewhere. The medical records of selected patients were reviewed, and socio-demographic data as well as information about the localization of the primary tumours and their metastases to this region, treatment modalities employed, follow-up, and outcomes were collected. A total of 24 cases were found. The mean age at diagnosis was 52.1±17.6 years and the male to female ratio was 1:1.4. Most primary tumours were located in the lung and breast. The overall 1-, 2-, and 5-year survival rates were 63.0%, 39.1%, and 19.6%, respectively. Radiotherapy for the metastatic focus significantly prolonged the survival time of the patients (P=0.048). Cervical lymph node metastases are a common event in patients with primary tumours growing elsewhere.
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Neoplasias de Cabeza y Cuello/secundario , Adulto , Anciano , Brasil/epidemiología , Neoplasias de la Mama/patología , Estudios de Cohortes , Femenino , Neoplasias de Cabeza y Cuello/epidemiología , Neoplasias de Cabeza y Cuello/patología , Humanos , Incidencia , Estimación de Kaplan-Meier , Neoplasias Pulmonares/patología , Masculino , Persona de Mediana Edad , Estudios Retrospectivos , Tasa de Supervivencia , Centros de Atención Terciaria , Resultado del TratamientoRESUMEN
This study describes the epidemiology and clinical presentation of odontogenic tumours (OT) seen at a regional Brazilian oral and maxillofacial pathology service; to assess the quantitative impact of the most recent World Health Organization (WHO) classification of these lesions; and to compare this series with others available in international databases. The study was carried out by retrospectively analysing 240 cases diagnosed from 1978 to 2009, followed by a comprehensive review of the literature. The patients' mean age was 29 years, with a male to female ratio of 1:1.1. Benign lesions comprised 97.9% of the cases (mostly keratocystic odontogenic tumours (KCOT), odontomas and ameloblastomas) with the remaining tumours depicting a prevalence of less than 5%. Adenomatoid OT were less frequent than in most previous studies, while malignant OT were strikingly numerous. Most OT in children and in the anterior maxilla were odontomas, while maxillary ameloblastomas were rare. Lack of swelling was more frequent in KCOT than in ameloblastomas. The present study confirms the relative impact of KCOT in the epidemiology of OT and identifies more similarities between the present series with reports from the United States and Europe than with African and Asian populations.
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Tumores Odontogénicos/epidemiología , Tumores Odontogénicos/patología , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Población Negra , Brasil/epidemiología , Distribución de Chi-Cuadrado , Niño , Preescolar , Estudios Transversales , Femenino , Humanos , Indígenas Sudamericanos , Clasificación Internacional de Enfermedades , Masculino , Persona de Mediana Edad , Tumores Odontogénicos/clasificación , Prevalencia , Estudios Retrospectivos , Estadísticas no Paramétricas , Población Blanca , Adulto JovenRESUMEN
Salivary gland small cell carcinoma is a rare neoplasm, accounting for less than 1% of salivary gland tumours. Little is known about the epidemiologic factors and treatment of this lesion. The authors report two cases and perform a systematic literature search from 1960 to 2011 for articles on salivary gland small cell carcinoma. Once the papers were reviewed, a database was generated to analyse clinical and pathological features, treatments and outcomes, and an attempt was made to identify prognostic factors. Available data were retrieved for 44 cases which fully satisfied the inclusion criteria; the median age was 64.25 years and the male:female ratio was 2.4:1. The parotid gland was the most common site (79.6%). The overall 1-, 2- and 5-year survival rates were 75.3%, 56.4% and 36.6%, respectively. According to the present review, patient age, tumour size, distant metastasis and cytokeratin-20 positive immunostaining were all significant prognostic factors in a univariate analysis. No particular treatment approach appeared to improve survival. This work reinforces knowledge about salivary gland small cell carcinoma's epidemiologic features, and identifies new prognostic markers. The optimal management of this lesion remains controversial.
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Carcinoma de Células Pequeñas/patología , Neoplasias de la Parótida/patología , Neoplasias de la Glándula Submandibular/patología , Anciano , Biopsia con Aguja Fina , Carcinoma de Células Pequeñas/secundario , Quimioterapia Adyuvante , Resultado Fatal , Humanos , Metástasis Linfática/patología , Imagen por Resonancia Magnética , Masculino , Disección del Cuello , Estadificación de Neoplasias , Neoplasias Pancreáticas/secundario , Radiografía Torácica , Radioterapia Adyuvante , Tomografía Computarizada por Rayos XRESUMEN
This study describes the oral and maxillofacial pathological characteristics of a series of odontogenic tumours in children and adolescents from three Brazilian reference centres. The records were reviewed for all odontogenic tumours in patients up to 18 years old based on criteria proposed by the World Health Organization (WHO) in 2005. Data concerning sex, age, skin colour and tumour location were collected and plotted. Four hundred and thirty one odontogenic tumours in children and adolescents were found, accounting for 37.5% of the total number of odontogenic tumours diagnosed. Benign tumours were predominant (99.8% of the cases), and odontoma was the most frequent type (41.4%), followed by keratocystic odontogenic tumours (25.5%) and ameloblastoma (14.6%). Odontogenic tumours were rarely detected in early childhood, and their prevalence increased with age. An almost equal distribution was observed with respect to sex and the site of the lesions. This study is the largest reported retrospective analysis describing odontogenic tumours in children and adolescents to date. The authors detected some variation in the relative frequency of odontogenic tumours compared with similar reports. Additional studies should be conducted based on the new WHO classification and predetermined age parameters to enable comparative analysis among different worldwide populations.
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Tumores Odontogénicos/epidemiología , Adolescente , Factores de Edad , Ameloblastoma/epidemiología , Brasil/epidemiología , Niño , Preescolar , Estudios de Cohortes , Femenino , Humanos , Lactante , Masculino , Neoplasias Mandibulares/epidemiología , Neoplasias Maxilares/epidemiología , Odontoma/epidemiología , Prevalencia , Estudios Retrospectivos , Factores SexualesAsunto(s)
Citodiagnóstico/métodos , Histoplasma/aislamiento & purificación , Histoplasmosis/diagnóstico , Amoxicilina/uso terapéutico , Histoplasma/patogenicidad , Histoplasmosis/tratamiento farmacológico , Histoplasmosis/patología , Humanos , Macrófagos/patología , Masculino , Persona de Mediana Edad , Neoplasias de la Boca/diagnóstico , Neoplasias de la Boca/microbiología , Neoplasias de la Boca/patología , Coloración y Etiquetado/métodosRESUMEN
This is the first description of solitary phaeohyphomycosis affecting the mucosal surface. The lesion developed in the inferior lip of a 57-year-old woman. After surgical resection, histopathological examination evidenced characteristic brownish fungal structures within granulomatous-purulent inflammation. Amplification and sequencing of rDNA obtained from paraffin-embedded tissue identified Alternaria species, as the causative agent.
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Enfermedades de los Labios/diagnóstico , Micosis/diagnóstico , Alternaria/aislamiento & purificación , Femenino , Humanos , Enfermedades de los Labios/patología , Persona de Mediana Edad , Mucosa Bucal/microbiología , Mucosa Bucal/patología , Micosis/patologíaRESUMEN
BACKGROUND: Graft-vs.-host disease (GVHD) is the major cause of morbidity and mortality in patients undergoing allogeneic Bone Marrow Transplantation (BMT). The aim of our study was to identify the most relevant histological features for diagnosis of chronic Graft-vs.-Host Disease (cGVHD) in oral mucosa and minor salivary glands of 25 patients, as well as to evaluate the immunophenotype of the inflammatory cells. METHODS: Sixteen patients that were submitted to allogeneic BMT but did not present cGVHD were selected as a control group. The sections were studied on H & E and CD68, CD45, CD4, CD8, CD20 staining. RESULTS: The most frequent histologic findings in oral mucosa at the day of diagnosis of cGVHD were: hydropic degeneration of the basal layer of the epithelium, apoptotic bodies, lymphocytic infiltration, and focal or total cleavage between the epithelial and connective tissue. In the labial salivary glands (LSG), lymphocytic infiltration, acinar loss and fibrosis were the main alterations. Cytotoxic CD8-T cells and macrophages were predominant both in the epithelium and connective tissue, as well as in minor salivary glands. CONCLUSIONS: Histological features were useful in the diagnosis of oral cGVHD. It is suggested that CD8-T cells and macrophages play important role in the pathogenesis of the disease.
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Enfermedad Injerto contra Huésped/patología , Enfermedades de la Boca/patología , Mucosa Bucal/patología , Enfermedades de las Glándulas Salivales/patología , Glándulas Salivales Menores/patología , Adolescente , Adulto , Antígenos CD/análisis , Antígenos CD20/análisis , Antígenos de Diferenciación Mielomonocítica/análisis , Apoptosis , Antígenos CD4/análisis , Antígenos CD8/análisis , Linfocitos T CD8-positivos/patología , Enfermedad Crónica , Tejido Conectivo/patología , Epitelio/patología , Femenino , Enfermedad Injerto contra Huésped/inmunología , Humanos , Antígenos Comunes de Leucocito/análisis , Linfocitos/patología , Macrófagos/patología , Masculino , Persona de Mediana Edad , Enfermedades de la Boca/inmunología , Mucosa Bucal/inmunología , Estudios Retrospectivos , Enfermedades de las Glándulas Salivales/inmunología , Glándulas Salivales Menores/inmunologíaRESUMEN
OBJECTIVE: This study describes the involvement and the histological alterations found in the tongues of 92 autopsied patients who died with AIDS. MATERIALS AND METHODS: Sex, age, CD4 cell count and clinical history were obtained from the files of 92 patients who died with AIDS. All the tongues were examined for macroscopical alterations and stained using H&E, Gomori-Grocott, Ziehl-Neelsen, PAS, Brow-Hopps and Mucicarmine. Histological autopsy findings were grouped based on a protocol that was designed following the World Health Organization recommendations. RESULTS: The mean age of the patients who died of AIDS and CD4 cell count were 36 years and 82 cells microL(-1), respectively. Histological alterations of the tongues were found in 75% of the cadavers. The most common lesions were hairy leukoplakia (HL) (42 cases), candidosis (31 cases) and non-specific chronic glossitis (29 cases), followed by concomitant lesions (28 cases), non-specific chronic ulceration (17 cases), melanotic pigmentation (13 cases), herpes simplex (10 cases), lymphoepithelial cysts (two cases), cryptococcosis (two cases), mycobacteriosis (one case), histoplasmosis (one case), cytomegalovirus infection (one case) and non-Hodgkin Lymphoma (one case). HL with oral candidosis (n = 13) were the most common concomitant lesions. CONCLUSION: These findings indicate that the tongue is a favorite site to occurrence of reactive, infectious and concurrent lesions in the end-stage of AIDS patients.