Belinda K. Bunn

EBV-positive mucocutaneous ulcer of the oral cavity associated with HIV/AIDS.

OBJECTIVE To present 2 cases of Epstein-Barr virus (EBV)-positive mucocutaneous ulcer of the oral mucosa in association with human immunodeficiency virus infection. STUDY DESIGN Two recently diagnosed cases of EBV-positive mucocutaneous ulcer of the oral mucosa in patients with human immunodeficiency virus (HIV) were reviewed with regard to their clinical, histomorphologic, and immunophenotypic features. RESULTS Both cases presented clinically as well-circumscribed ulcers that were histomorphologically characterized by dense superficial polymorphous inflammatory infiltrates. The infiltrates comprised cells with a predominant B-cell phenotype that ranged in size from small to intermediate with occasional large immunoblastic forms. Some of the larger B cells had a Reed-Sternberg-like morphology. The B cells were positive for CD20 and coexpressed CD30 and to a lesser extent CD15. Epstein-Barr virus-encoded small RNA (EBER) positivity was detected in most of the B cells. CONCLUSIONS EBV-positive mucocutaneous ulcer represents an unusual form of lymphoproliferative disorder associated with immune suppression. It should be distinguished from other forms of HIV-associated oral ulceration.

Microscopic diversity in oral Kaposi sarcoma

Kaposi sarcoma is the most common HIV-associated neoplasm, frequently presenting with oral mucosal involvement. This retrospective study aimed to assess and highlight the histomorphological spectrum of oral Kaposi sarcoma. A total of 135 cases diagnosed between 1990 and 2011 were retrieved from the archives of the Oral and Dental Hospital of the University of Pretoria, South Africa. Following histologic review, each case was placed into 1 of 7 categories based on the predominant pattern of growth. These histologic divisions included lesions designated as solid, lymphangioma-like, telangiectatic, desmoplastic, lymphangiectatic, ecchymotic, and anaplastic. The presence of coexistent pathology was identified in 25 cases, largely represented by superimposed candidiasis. Concomitant cytomegalovirus and non-necrotizing granulomatous inflammation were also observed. Although the prognostic significance of these variants is yet to be determined, the appreciation and recognition of such morphologic diversity remains essential in distinguishing these lesions from possible mimickers.

Adenoid dysplasia of the oral mucosa

OBJECTIVE To describe an unusual variant of oral epithelial dysplasia and to provide an appraisal of its immunohistochemical profile. STUDY DESIGN An unusual form of epithelial dysplasia, which we have termed adenoid dysplasia, was evaluated for staining of cytokeratins AE1/AE3, vimentin, E-cadherin, and β-catenin. The immunohistochemical results were compared with those observed in moderate epithelial dysplasia, moderately differentiated squamous cell carcinoma, and acantholytic squamous cell carcinoma. RESULTS The immunoprofile of adenoid dysplasia was similar to that of acantholytic squamous cell carcinoma. Cytokeratin positivity within the acantholytic dysplastic cells confirmed their epithelial nature, and upregulation of vimentin was suggestive of epithelial-mesenchymal transition. The most distinctive finding was a loss of E-cadherin expression within the discohesive cells, accompanied by increased cytosolic expression of β-catenin. CONCLUSIONS This report presents the histomorphologic features of a unique form of oral epithelial dysplasia, termed adenoid dysplasia.

Mixed adenoneuroendocrine carcinoma of the tongue arising within a congenital enteric cyst

Primary intestinal‐type adenocarcinoma of the tongue is rare. This represents the first reported case of a primary mixed adenoneuroendocrine carcinoma (MANEC) of the tongue arising within a congenital enteric cyst.

Massive hemoptysis due to primary mucoepidermoid carcinoma of the lung in a 12-year-old.

Case Report A12-year-old African male patient presented with a history of progressive weight loss of several months duration and a complaint of persistent hemoptysis. Radiological examination (chest X-ray and computerized tomographic scan) confirmed the presence of a mass in the lower lobe of the right lung. Following hospitalization, the hemoptysis intensified and the patient was anesthetized for endobronchial examination and biopsy in order to establish the nature and extent of the pulmonary mass. Shortly after intubation, severe rapid intraparenchymal hemorrhage of the right lung occurred which led to sudden cardiac arrest. The patient was successfully resuscitated and was then admitted to the intensive care unit whilst still intubated. The endobronchosopic examination and biopsy procedure were abandoned and the right lung mass remained undiagnosed. A brain CT-scan performed shortly thereafter confirmed that hypoxic damage was present. The patient showed no improvement and finally succumbed one month later.

The prevalence of second canals in the mesiobuccal root of maxillary molars: A cone beam computed tomography study

The aim of this study was to determine the prevalence of MB2 canals in permanent maxillary molars utilising CBCT; in patients attending a university hospital. A total of 200 patient scans, (100 female and 100 male patients), were enrolled in the study. In total, 800 teeth were analysed, and teeth with additional canals in their MB roots (MB2) were identified. First maxillary molar teeth exhibited the highest prevalence of MB2 canals, 92% and 87%, for teeth 16 and 26, respectively. Second maxillary molar teeth showed a lower prevalence of MB2 canals, 69% and 65%, for the 17 and 27, respectively. There were no associations of significance between the prevalence of MB2 canals and patient age or gender. Root morphology and anatomy of permanent maxillary first and second molar teeth was found to be highly variable. The prevalence of additional canals in the MB roots is a frequent finding which has previously been underreported.