Clinical correlation of oral-dental findings with radiographs and with total body bone scans.

Bone scans are frequently used to detect osteoblastic areas in bone, including bony metastases in patients with existing tumors. Various dental conditions have been found to cause areas in the jaws to have increased uptake of radiopharmaceuticals. We studied 30 patients with an existing cancer or previous history of cancer with the use of total body bone scans, panoramic radiographs, and dental examinations, and we found no correlation between the intensity of radionuclide uptake in the jaws on the bone scans and the number of teeth in each jaw, the age of the patient, the degree of periodontal disease, or the number of dental pathoses per jaw. The frequency and intensity of positive scan results were related to the presence or absence of intrabony lesions in the jaws. Dental disease therefore does not appear to mask metastatic disease in the jaws; however, when metastasis is suspected, a dental examination with radiographs is recommended.

Evaluation of a rapid enzyme-linked immunoassay for the diagnosis of herpes simplex virus in cancer patients with oral lesions.

Oral herpes simplex virus infection in immunocompromised cancer patients can have a variety of different clinical appearances, which makes diagnosis difficult, and it can be associated with significant morbidity. Prompt diagnosis is important so that therapy can be started as soon as possible. The standard by which the diagnosis of herpes simplex virus is made is a culture that can take up to 10 days to produce results. In an effort to test a possibly better method, we evaluated a 12-minute, enzyme-linked immunoassay and found the sensitivity, specificity, positive predictive value, and negative predictive value to be 75.9%, 90.0%, 84.6%, and 83.7%, respectively. This test is easy, inexpensive, and can be done in a clinical setting, thus providing a prompt, accurate result so that treatment can be started without delay. This promptness is especially important in the immunocompromised cancer patient.