Arthur S. Miller

Salivary gland inclusion in the anterior mandible: Report of a case with a review of the literature on aberrant salivary gland tissue and neoplasms

Abstract Although salivary gland tissue inclusions in the mandible are no longer considered rare, inclusion of salivary gland tissue in the anterior portion of the mandible is very unusual. The case presented here brings to six the total number of cases reported in the literature.

Odontogenic myxoma. A clinical and ultrastructural study.

The odontogenic myxoma is an uncommon neoplasm of the jaws that is believed to arise from the primitive, mesenchymal portion of the tooth germ. This study surveys nine cases of odontogenic myxoma of the jaws. Analysis of the clinical material revealed that the myxoma occurred most frequently in the posterior regions of the mandible and will recur if initial therapy is too conservative. The average age of the patients in this series was 26.5 years. Five cases involved females and four involved males. Electron microscope findings revealed that the tumor cells are probably responsible for the secretion of the myxomatous intercellular material of the neoplasm.

Plasmacytoma of the oral cavity and jaws: a clinicopathologic study of 13 cases.

Plasmacytoma of the jaw bones and oral cavity, as in other anatomic sites, comprises three distinct entities: multiple myeloma, solitary plasmacytoma of bone, and extramedullary plasmacytoma. This article is a retrospective study of 13 cases; 9 occurred in the mandible and 4 in the maxilla. The most common radiographic finding was a radiolucency that many times was superimposed on the roots or apices of nearby teeth. The most common symptom was localized pain, and the most frequent clinical sign was a raised red lesion on the alveolar ridge. The disease affects older persons, and the posterior mandible is the most frequently reported location. The degree of dysplasia of tumor cells was evaluated as there is a reported correlation with survival rates.

Lymphangiomas of the oral cavity: A clinicopathologic, immunohistochemical, and electron-microscopic study

PURPOSE This study evaluated the demographics, treatment outcomes, histology, and basement lamina characteristics of a large series of lymphangiomas. MATERIAL AND METHODS Forty-seven lymphangiomas of the oral cavity were evaluated microscopically and representative specimens were also evaluated immunohistochemically (IMH) and by electron microscopy (EM). RESULTS Patients ages ranged from 2 to 84 years. The dorsal surface of the tongue was the most common site. Discontinuities in the basement membrane were detected with IMH and EM. CONCLUSION The discontinuous basement membrane may explain why sclerosing agents have not been effective as a form of treatment for lymphangioma.

Ameloblastic fibro-odontoma. Report of seven cases.

Abstract Seven cases of ameloblastic fibro-odontoma are reported, along with a discussion of the histogenesis of this tumor and its relationship to the ameloblastic odontoma. Our findings confirm that this is a lesion which occurs primarily in persons under 20 years of age and does not recur after adequate surgical curettage.

Eosinophilic ulcer of the oral mucosa: Report of 38 new cases with immunohistochemical observations☆

Eosinophilic ulcer of the oral mucosa (traumatic eosinophilic granuloma) mimics oral cancer clinically and is occasionally misdiagnosed as lymphoma on microscopic examination. Trauma is believed to play a role in its development, but its exact pathogenesis is not known. The demographic, clinical, and histologic features of 38 previously unreported cases of eosinophilic ulcer of the oral mucosa are reviewed. Nine representative cases were studied immunohistochemically. Microscopically, the lesions contained a polymorphic inflammatory infiltrate extending deep into the submucosa, underlying muscle, and salivary glands. Numerous eosinophils and large mononuclear cells with pale nuclei and frequent mitoses were seen in all lesions. Lymphocytes, histiocytes, plasma cells, granulocytes, and mast cells were also present. Immunohistochemical stains showed that the lymphocytic infiltrate was composed predominantly of T cells. T-cell-specific antigen-presenting cells were more numerous than the non-antigen-presenting cell type. The large cells with pale nuclei stained positively only for vimentin; the possible myofibroblastic nature of these cells is discussed. Although trauma might have an etiologic role, the pathogenesis of eosinophilic ulcer of the oral mucosa is probably T cell mediated.

Central granular-cell tumor of the jaws (the so-called granular-cell ameloblastic fibroma)

Four cases of central granular-cell tumor of the jaws were evaluated to determine the clinical parameters of the lesion, and one of these cases was examined with the electron microscope to investigate the nature of the granular cells. The average age of the patients at the time of treatment was 55 years; all four patients were women. Three of the lesions originated in the mandible, and one in the maxilla. Follow-up studies revealed no recurrences. Electron microscopic examination of one case revealed that the granular cells contained many lysosome-like particles and that these cells are identical to those found in the granular-cell myoblastoma.

Acinic cell adenocarcinoma of minor salivary glands.

Nineteen cases identified as acinic cell adenocarcinoma of minor salivary glands from the files of the Armed Forces Institute of Pathology and the Department of Pathology, Temple University School of Dentistry were studied to determine the clinical and histomorphologic parameters of this lesion. One case was examined ultrastructurally. Clinical results show that the tumor is more common in females and the average age of all patients was 42.5 years. The most common sites were upper and lower lips and buccal mucosa. The tumor tends to be locally limited, but recurrence is a distinct possibility. Cytologic features usually associated with malignancies are generally not present. However, perineural space and muscle invasion occur, and it is felt that this tumor should be considered as a low‐grade malignancy. Fine structural observations showed the presence of cells with serous secretory granules and cells with mucous globules. However, the serous secretory granules were not as numerous as those reported in the acinic cell adenocarcinoma of the parotid gland. It appears that these tumors arise from intercalated duct cells or pluripotential duct cells rather from fully differentiated serous cells.

Spindle‐cell carcinoma of the oral mucosa(A light and electron microscopic study of apparent sarcomatous metastasis to cervical lymph nodes)

Two tumors of the tongue, both initially diagnosed as squamous cell carcinoma, recurred as spindle‐cell carcinomas which metastasized to cervical lymph nodes. In each case, a transition from squamous to spindle‐shaped cells was observed at the site of recurrence. However, only spindle‐cell elements were seen in the metastases, together with plasma cells and macrophages. Electron micrographs showed that the tumor metastasis was composed primarily of active fibroblast‐like cells which elaborated large amounts of collagen. The mesenchymal nature of the intercellular material was confirmed histochemically, and areas of calcified osteoid tissue were identified. There was a striking resemblance ultrastructurally between the metastatic tumor and the fibroblastic portion of an osteogenic sarcoma.

Oral granular-cell tumors: Report of twenty-five cases with electron microscopy

Twenty-five cases of granular-cell tumor of the oral cavity are reported. The clinical findings are similar to previously published data. Of five cases studied by electron microscopy, three were processed directly from fresh surgical specimens and two cases were processed following initial formalin fixation. The granules for the most part are morphologically compatible with lysosomes except for a single variety containing viruslike particles. There is increasing evidence in support of a neural origin, but the indications are that more than one cell type may be the progenitor of granular cells of the granular cell tumor.