Demetrios Antoniades

Concurrence of torus palatinus with palatal and buccal exostoses. Case report and review of the literature

Exostoses, also known as hyperostoses, are localized bony protuberances that arise from the cortical plate. These developmental anomalies, or hamartomas, frequently affect the skeletal jaw. Different types of exostoses have been described. Torus palatinus and torus mandibularis are two of the most common intraoral exostoses. Other types of exostoses, affecting the palatal aspect of the maxilla (palatal exostoses) or the buccal aspects of the jaws (buccal exostoses), are less commonly encountered. Concurrence of different forms of exostoses in the same individual is very rare. A 48-year-old woman manifesting excessive palatal exostoses, torus palatinus, and buccal exostoses is described. We present the clinical and histopathologic features and applied therapy and provide a comprehensive review of the current features of exostoses.

Pyogenic granuloma of the oral cavity: Comparative study of its clinicopathological and immunohistochemical features

There are two histological types of pyogenic granuloma (PG) of the oral cavity: the lobular capillary hemangioma (LCH) and non‐LCH type. The aim of the present study was to examine and compare the clinical features, etiological factors, diameter of vascular elements and immunohistochemical features of LCH and non‐LCH histological types of PG to determine whether they are two distinct entities. Thirty cases of LCH and 26 cases of non‐LCH PG were retrieved and retrospectively studied. Clinically, LCH PG occurred more frequently (66.4%) as sessile lesion whereas non‐LCH PG occurred as pedunculated (77%). Non‐LCH PG was associated more frequently (86.4%) with etiological factors. The lobular area of the LCH PG contained a greater number of blood vessels with small luminal diameter than did the central area of non‐LCH PG. In the central area of non‐LCH PG a significantly greater number of vessels with perivascular mesenchymal cells non‐reactive for α‐smooth muscle actin and muscle‐specific actin was present than in the lobular area of LCH PG. The differences found in the present study suggest that the two histological types of PG represent distinct entities.

Epidemiologic survey of pemphigus vulgaris with oral manifestations in northern Greece: Retrospective study of 129 patients

Objective  To evaluate the epidemiology of pemphigus vulgaris (PV) in a Greek population and to compare it with other countries.

Pemphigus vegetans of the oral cavity

Background  Pemphigus vegetans, a variant of pemphigus vulgaris, constitutes a rare form of all pemphigus cases, and oral involvement is common. Two clinical subtypes of pemphigus vegetans exist, characterized initially by flaccid bullae and erosions (Neumann) or pustules (Hallopeau). Both subtypes subsequently develop into hyperpigmented vegetative plaques with pustules and hypertrophic granulation tissue at the periphery.

Black hairy tongue in a 2‐month‐old infant

Abstract:  Black hairy tongue (BHT) is an unusual condition in adults, and is characterised by marked accumulation of keratin on the filiform papillae of the dorsum of the tongue resulting in a hairlike appearance. The colour of the papillae may vary from brown to black. We describe a case of BHT in a 2‐month‐old infant. An extended review of the literature suggests that our case is the youngest ever reported. In conclusion, although BHT is considered benign, clinical, haematological and histological, evaluation is recommended to exclude several entities which can present as pigmented lesions of the oral mucosa.

Heat shock protein 70 membrane expression in oral cancer: a possible new target in antineoplastic therapy?

Background: Heat shock proteins (HSPs) are a group of highly immunogenic proteins with an exceptional degree of conservation. Cells or tissues from a wide range of tumors have been shown to express atypical levels of 1 or more HSPs. Experimental evidence suggests that HSPs may promote tumorigenesis by suppressing apoptosis. Aim: The aim of this investigation was to study the expression and the localization of HSP70 in oral squamous cell carcinoma (OSCC) and to compare HSP70 expression between neoplastic, dysplastic lesions and normal oral tissues. Methods: Immunohistochemistry staining was conducted to study HSP70 expression in 50 paraffinized tissue samples: 30 OSCCs, 10 leukoplakias with dysplasia and 10 samples from normal oral tissue. Results: Our results showed that all slides with OSCC intensely expressed HSP70. Dysplastic lesions were positive to a lesser extent for HSP70. Samples from normal oral tissue were all negative for HSP70. Conclusions: It is concluded that increased HSP70 immunoexpression could be a marker for the presence of epithelial dysplasia or epithelial malignant transformation.

Oral Inverted Ductal Papilloma: Report of a Case with Immunohistochemical Study

Oral inverted ductal papilloma (IDP) is a very uncommon lesion of minor salivary gland origin. Forty five cases have been reported in the literature. We describe a case of IDP developed as an asymptomatic submucosal mass in the hard palate of a middle-aged woman. Excisional biopsy was performed, and ten months of patients follow-up showed no evidence of recurrence. The major portion of the tumour was made up of proliferating configurations containing epi- dermoid cells. Some microcysts and crypts were seen. Immunohistochemical analysis of the present case supports the hy- pothesis that IDP arises from excretory duct cells.

Mucosal calcified nodule of the lower lip: report of a case and review of the literature.

helpful. 3,6,7 Nonsteroidal anti-inflammatory drugs, doxycycline, daunorubicin and doxorubicin should be avoided since they reduce the prolidase level. 8 The presented case did not respond to wound dressings, systemic steroids, pentoxyphylline, oral vitamin C and PUVA, and the patient is currently receiving wound care only. Replacement of the deficient enzyme or transfer of the defective gene to the skin fibroblasts via gene therapy may be helpful in the future. 9,10 In summary, we report a case of prolidase deficiency, hemoglobin O trait and microcytic anemia, which together may have contributed to the leg ulceration and delayed wound healing.

Utility of Prostatic Markers in the Differential Diagnosis of Adenocarcinomas Not Otherwise Specified from metastatic Tumours of the Oral Cavity

Objectives: The aim of the present study was to evaluate the expression of prostate-specific antigen (PSA), prostatic acid phosphatase (PAP) and ( alpha)- methylacyl-CoA racemase gene ( P504S) in normal salivary glands and adenocarcinomas not otherwise specified (NOS). Material & Methods: Tissue specimens of 18 normal salivary glands and 22 cases of adenocarcinomas NOS of the oral cavity, formalin-fixed, and paraffin-embedded were studied by using monoclonal antibodies for PSA, PAP and P504S. Results: Positive staining for PSA was detected with one of the two used monoclonal antibodies in normal salivary glands (89%) and adenocarcinomas NOS ( 45.45%) whereas negative staining was observed for PAP and P504S. Conclusions: Our results suggest that the detection of prostatic markers such as PAP, P504s with the use of monoclonal antibodies may offer an adjunctive aid in the differential diagnosis of adenocarcinomas NOS from metastatic carcinomas, when the origin of the primary tumours is unknown.

Immunohistochemical investigation and study of the expression and topography of cell adhesion molecules in cases of acinic cell adenocarcinoma of salivary glands

Background Diagnostic difficulties can arise because of the architectural diversity of acinic cell adenocarcinoma based on both growth—solid, microcystic, follicular, papillary-cystic—and cellular—acinar, intercalated ductal, vacuolated, clear and nonspecific glandular—patterns. Immunohistochemical detection systems may be helpful for the definition of the diagnosis. Cell adhesion molecules participate in tissue development and maintenance by mediating interactions between cells and extracellular matrix. E-Cadherin in epithelial adherens junctions, Dsg-2 in desmosomes, β4 integrin in hemidesmosomes, CD44s in cell-matrix interactions, and ICAM-1 are, mostly, essential for tissue integrity, architecture, and function in normal salivary gland parenchyma. Objective We used immunohistochemical methods to investigate acinic cell adenocarcinoma and to study the expression of cell adhesion molecules in order to understand the structure and the possible interactions between cellular patterns and cell-matrix in different tissue architecture. Study design Immunohistochemistry using a 2-step Envision/HRP detection system was applied to paraffin-embedded specimens of 5 acinic cell adenocarcinomas from parotid. Lobules from 7 cases of normal labial salivary glands were used as controls. Cellular profile was examined by staining with p53, Ki67, Bcl-2, A1AT, CEA, EMA, Vim, SMA, cytokeratins, GFAP, and S-100 protein. We detected cell adhesion by utilizing antibodies against CD44s, E-cadherin, β4-integrin, Dsg-2, and ICAM-1. Results p53, Ki67, and Bcl-2 positivity was associated with the degree of tumor invasion. Neoplastic epithelial cells were positive for A1TA, CEA, CKs (except CK 18), LP34 (not all cases), MNF, S-100, GFAP (locally), and Vim (basal pole). E-Cadherin and β4 integrin were positive in neoplastic epithelium only, upon cell surface (100%); Dsg-2 also was moderately positive but mainly intracellular. In a case of acinic cell adenocarcinoma all neoplastic epithelium was ICAM-1 positive. CD44s was strongly positive in all types of cells and architecture patterns. Conclusions Immunohistochemistry may be a useful tool for the diagnosis of acinic cell adenocarcinoma. On the other hand, the study of cell adhesion explains the origin of neoplastic cells and helps in the describing of the structure of different growth patterns.