Cell Block and Its Impact in the Diagnosis of Jaw Lesions over Fine Needle Aspiration Cytology.

OBJECTIVES: To determine the role and efficacy of fine needle aspiration cytology (FNAC) and cell block in diagnosis of jaw lesions and compare the agreement between FNAC and cell block to predict the diagnosis. METHOD: The sample comprised 51 cases, including 12 odontogenic keratocysts (OKCs), 8 ameloblastomas, 22 radicular cysts, 7 dentigerous cysts, and 1 each of intraosseous mucoepidermoid carcinoma (MEC) and adenomatoid odontogenic tumor (AOT). FNAC samples remaining after hematoxylin and eosin (H&E)-stained cytosmear diagnosis were centrifuged at 3,000 rpm for 10 min. The supernatant was discarded and sediment mixed with 2-3 mL alcohol and filtered. To this, 10% formalin was added, filtered, taken for routine processing, and stained with H&E. The result of FNAC smear and cell block was compared with histopathological diagnosis. RESULTS: On cytological examination of the smears, 7 OKCs and 22 radicular cysts were diagnosed, whereas ameloblastomas, AOT, intraosseous MEC, and dentigerous cysts were not. This gave an agreement of 56.8% with the biopsy reports. Cell block sections stained with H&E of 12 OKCs, 22 radicular cysts, 1 MEC, and 3 cases of ameloblastoma offered a diagnosis in accordance with the biopsies giving an agreement of 74.5%, while dentigerous cyst and AOT failed to do so. In comparison with FNAC, additionally 5 cases of OKC and 1 of MEC could be detected, and in ameloblastoma, out of 8 cases, only 3 yielded a concordant diagnosis through the cell block technique. CONCLUSION: In comparison with FNAC, the architectural pattern and the morphology of the cells were better preserved by the cell block technique. This substantiates that cell block could be used as an ancillary technique to aid in definitive diagnosis of head and neck swellings.

PTEN and α-SMA Expression and Diagnostic Role in Oral Submucous Fibrosis and Oral Squamous Cell Carcinoma with Concomitant Oral Submucous Fibrosis.

OBJECTIVES: The diagnostic role and correlation between phosphatase and tensin homologue and alpha-smooth muscle actin in oral submucous fibrosis and oral squamous cell carcinoma with concomitant oral submucous fibrosis was analysed by this case control study. The mechanism by which phosphatase and tensin homologue controls myofibroblast expression was also evaluated. MATERIAL AND METHODS: Overall, 10 normal mucosa, 30 oral submucous fibrosis (OSF) and 30 oral squamous cell carcinoma (OSCC) with OSF were stained immunohistochemically with phosphatase and tensin homologue (PTEN) and alpha-smooth muscle actin (α-SMA). Percentage positivity, pattern of expression was statistically compared using Pearson's Chi-square and Fischer exact tests. The correlation between markers was analysed using Spearman correlation. RESULTS: OSF and OSCC affected males predominantly with majority below 40 years and above 40 years of age respectively. Percentage of PTEN positive cells was statistically significant with gender (P = 0.024) and α-SMA distribution of pattern showed a significant correlation with habits (P = 0.018). A significant decrease in nuclear PTEN positivity (P < 0.001) and a gradual increase in α-SMA cytoplasmic expression was noted from NM to OSF and OSCC. A statistically significant weak inverse correlation existed between PTEN and α-SMA. CONCLUSIONS: A reduced phosphatase and tensin homologue expression in oral submucous fibrosis makes it more prone for malignant transformation. An increase in stromal desmoplasia modifies differentiation, invasive and proliferative capacity of tumour cells. As phosphatase and tensin homologue functions through P-Akt pathway, P-Akt with phosphatase and tensin homologue could be a therapeutic target.

p16 as an independent marker for detection of high-risk HPV in oral submucous fibrosis and oral squamous cell carcinoma.

BACKGROUND: An alarming increase in incidence of high-risk human papillomavirus (HPV) positive tumors in head and neck squamous cell carcinoma (HNSCC) by 25% and 70% in oropharyngeal HNSCC cannot be ignored. The early oncogenes of HPV, E6, and E7 play a key role in carcinogenesis. HPV associated tumors have a better clinical outcome and a favorable prognosis. The p16 expression has high concordance with other methods of HPV detection, ascertaining p16 as a surrogate marker for HPV. OBJECTIVE: To assess the immunohistochemical expression of p16 in oral submucous fibrosis (OSF) and oral squamous cell carcinoma (OSCC) with and without coexistent OSF as a marker for high-risk HPV detection. Materials and. METHODS: Tissue blocks of 70 cases including normal, OSF, OSCC with and without OSF were subjected to IHC staining with a p16INK4A monoclonal antibody. (Biogenex, San Roman). The p16 expression was noted according to percent positivity and pattern. The data were tabulated, statistically analyzed using the Chi-square test and the P value was assessed. RESULTS: The percentage of p16 positive cells raised from normal to OSF to OSCC with and without OSF. In addition, a shift from nuclear to cytoplasmic expression from normal to OSCC was noted with a statistical significance (P < 0.001). However, no statistical significance was established with any clinicopathologic parameters except age (P = 0.012) and habits (P= 0.023). CONCLUSION: The presence of HPV using p16 was not detected in OSF but was positive in OSCC. Altered pattern of expression from normal to OSF to OSCC indicates promising use of p16 as a diagnostic marker.

Natural stains Zingiber officinale Roscoe (ginger) and Curcuma longa L. (turmeric) - A substitute to eosin.

BACKGROUND: Stained slides are of the utmost source of information in pathology. The routine stains utilize synthetic dyes which pose various health hazards which necessitate the importance of natural extracts as a histological stain. AIMS: The aim of this study is to compare the efficacy of ginger and turmeric extracts as histological dyes in tissues keeping eosin as standard. OBJECTIVES: The objective of this study is to compare the staining potential, intensity, specificity, and shelf life of ginger and termuric extract dyes. MATERIALS AND METHODS: Extracts of fresh rhizomes of Zingiber officinale Roscoe and Curcuma longa L. were obtained by dissolving them in alcohol, which was used to stain sections of 25 cases. Observer 1 compared the staining intensity, while observers 2 and 3 assessed preset parameters at regular intervals and subjected to Kappa statistics and Mann-Whitney U-test. RESULTS: Z. officinale and C. longa solutions had pH 4-5 and temperature 24°C-27°C. Z. officinale showed better staining intensity and specificity to the cytoplasm and basic components of connective tissue as compared to C. longa. Crispness (P = 0.01) and background staining (P = 0.05) showed a significant difference. Shelf life of Z. officinale was better than C. longa. CONCLUSION: Z. officinale gave a better staining than C. longa and was found to be closest to eosin and is easily available, cost-effective and biodegradable.