Evanthia Chrysomali

Immunohistochemical evaluation of cell proliferation antigen Ki-67 and apoptosis-related proteins Bcl-2 and caspase-3 in oral granular cell tumor

PURPOSE We sought to evaluate the cell proliferation activity and immunohistochemical expression of proteins that promote or inhibit apoptosis in oral granular cell tumor (GCT). STUDY DESIGN Immunohistochemistry for Ki-67, a cell proliferation marker; Bcl-2, an anti-apoptotic protein; and caspase-3, a protein implicated in the execution of apoptosis, was performed on tissues from 12 patients with GCT of the tongue. RESULTS Nuclear immunostaining for Ki-67 was observed only in isolated GCs (less than 2%). All patients exhibited cytoplasmic immunoreactivity for Bcl-2 in the majority of tumor cells. Cytoplasmic staining for caspase-3 was also present in more than 50% of GCs in all tumors. CONCLUSIONS GCT cells display low proliferation activity, a finding possibly related to their benign behavior. Caspase-3 expression suggests activation of the apoptotic cascade in the GCs, but persistence of the cells in the tissues could be attributed to the expression of Bcl-2 protein, a molecule that functions as a survival factor.

Effect of autologous platelet-rich plasma in combination with a biphasic synthetic graft material on bone healing in critical-size cranial defects.

Purpose The aim of the study was to investigate the effect of autologous platelet-rich plasma (PRP) on the osteogenic potential of a biphasic synthetic graft material composed of hydroxyapatite and beta-tricalcium phosphate (HA/&bgr;-TCP) in critical-size cranial defects in rabbits. Materials and Methods Three circular bicortical critical-size cranial defects were created in each of 18 rabbits. The first of the defects was grafted with autologous PRP and HA/&bgr;-TCP, the second was grafted with HA/&bgr;-TCP without PRP, and the third was left unfilled as a negative control. Animals were euthanized at 2, 4, and 6 weeks after surgery. Harvested tissue specimens were evaluated histologically and histomorphometrically. Several parameters associated with osteoclastic and osteoblastic activities were measured and calculated. The results were statistically analyzed using the 1-way analysis of variance statistical method. Results Histologic analysis of the samples showed bone tissue formation at all experimental sites including untreated control defects. A statistically significant difference in new bone formation between the defects treated with HA/&bgr;-TCP + PRP and defects treated with HA/&bgr;-TCP alone was not observed. Control untreated defects showed the greatest bone regeneration. Conclusions In this animal model, autologous PRP had no effect on bone healing in addition to a biphasic HA/&bgr;-TCP synthetic graft material after 2, 4, and 6 weeks of implantation.

Oral nodular fasciitis: report of a case of the buccal mucosa.

Nodular fasciitis is a benign, reactive, proliferative spindle-cell lesion, usually located at the subcutaneous tissues or muscle fascia. Clinically, it manifests as a soft-tissue mass with well-defined margins and fixed to the adjacent structures. Because of its rapid growth rate, rich cellularity and relatively high mitotic activity, nodular fasciitis is sometimes misdiagnosed as a sarcoma. Accurate diagnosis is based only on histopathological examination. A rare case of nodular fasciitis of the buccal mucosa in a 50-year-old female patient is presented.

Evaluation of lateral thermal damage and reepithelialization of incisional wounds created by CO2-laser, monopolar electrosurgery, and radiosurgery: a pilot study on porcine oral mucosa

OBJECTIVE This study aims to compare lateral thermal damage (LTD) produced by CO(2)-laser, monopolar electrosurgery (MES), and radiosurgery (MRS) and its effects on the reepithelialization of oral mucosa incisional wounds. STUDY DESIGN Five adult swine were submitted to standardized incisions at the tongue and gingiva by MES, MRS, CO(2)-laser and scalpel. Full-thickness specimens were harvested sequentially on days 1 and 3. All specimens were formalin fixed, paraffin embedded, cut, and stained with hematoxylin-eosin to quantify LTD extent. Sections of day 3 were stained for Ki-67 to assess epithelial proliferation at the incision margins. A multiple linear regression model and an analysis of variance were used to determine the correlation of each instrument with LTD extent and Ki-67 expression respectively. RESULTS LTD was most extensive in the CO(2)-laser but did not differ between the MES and MRS groups. No statistically significant differences regarding reepithelialization were noted among the investigated instruments. CONCLUSIONS CO(2)-laser produced more extensive LTD, without evident impact on reepithelialization.

Increased TNF-α, IL-6 and decreased IL-1β immunohistochemical expression by the stromal spindle-shaped cells in the central giant cell granuloma of the jaws

Objectives: the exp ress ion of the osteoclastogenic cytokines TNF-α, IL-6 and IL-1β were immunohistochemically evaluated in periph eral (PGCG) and central (CGCG) giant cell granulomas of the jaws in order to determine diff erences between these two lesions and between the two distinct tumor cell populations (multinucleated giant cells, MGCs and stromal sp indle-sh aped cells). Study Design: Paraffin-embedd ed tiss ue sections from 40 PGCG and 40 CGCG were immunohistochemically stained using antibodies against TNF-α, IL-6 and IL-1β. The percentage of positively stained cells and the staining intensity were ass ess ed to provide a combined immunoreactivity score value. Results: TNF-α, IL-6 and IL-1β were exp ress ed in all lesions. The CGCG compared to the PGCG sh owed significantly increased exp ress ion of TNF-α and IL-6 and decreased exp ress ion of IL-1β by the sp indle-sh aped cells and increased exp ress ion of IL-1β by the MGCs. The MGCs demonstrated in comparison to the stromal sp indlesh aped cells significantly increased exp ress ion of all three cytokines in both PGCG and CGCG. Conclusions: The proinflammatory cytokines TNF-α, IL-6 and IL-1β seem to be involved in the growth process of PGCG and CGCG of the jaws. A poss ible alteration in the sy nthesis or/and activity of these cytokines by the stromal sp indle cells in the CGCGs may enhance osteolys is through the stimulation of osteoclast progenitor cells, given the fact that the intraoss eous lesions cause bone resorption. Key words: Giant cell granuloma, giant cell tumor, multinucleated giant cells, jaw, TNF-alpha, IL-6, IL-1beta, immunohistochemistry.

Comparison of lateral thermal injury and healing of porcine skin incisions performed by CO2-laser, monopolar electrosurgery and radiosurgery: a preliminary study based on histological and immunohistochemical results.

Background  Despite the wide application of lasers and electrosurgery in dermatology, the pertinent literature provides conflicting data regarding the lateral thermal injury (LTI) associated with these instruments and its effects on wound healing. This study aims to quantitate the LTI produced by CO2‐laser, monopolar electrosurgery (MES), and radiosurgery (MRS) and determine its effects on the healing process (re‐epithelialization and inflammatory response) of incisional wounds.

A comparative study of bone remodeling molecules expression in different types of jaw ameloblastoma.

BACKGROUND Solid ameloblastoma demonstrates a more invasive behavior compared to unicystic. The follicular ameloblastoma is referred that may present a higher recurrence potential compared to the plexiform variant. In this study, the different ameloblastoma clinical types and histopathological variants were examined regarding the expression of bone remodeling-related molecules OPG, RANKL, and TRAIL. METHODS Immunostained sections of 29 solid and 11 unicystic ameloblastoma cases were semi-quantitatively evaluated and analyzed using Mann-Whitney or Kruskal-Wallis tests. RESULTS Solid ameloblastoma showed a significantly increased OPG expression (P = 0.004) associated with the follicular (P < 0.05) than the plexiform or mixed pattern. Lack or low immunoreactivity for RANKL was noted in 79.3% of the solid tumors. A statistically significant result (P < 0.05) was found in the unicystic ameloblastoma for differences by the histopathological pattern (no RANKL expression when plexiform pattern was seen compared to follicular). Comparison between the clinical types showed differences regarding the ratio of OPG/RANKL and TRAIL/RANKL expression. Higher OPG expression over RANKL was observed in 86.2% of the solid compared to 36.4% of the unicystic type. There was no difference in the ratio of TRAIL/RANKL expression in the unicystic, whereas 55.2% of the solid ameloblastomas showed a greater TRAIL expression over RANKL. CONCLUSIONS Our results suggest OPG overexpression and RANKL underexpression in solid ameloblastoma; this may reflect a possible prevalence of the OPG/TRAIL over the OPG/RANKL signaling pathway, resulting in inactivation of TRAIL-induced apoptosis in ameloblastic cells. In unicystic ameloblastoma, the RANKL/OPG expression immunoprofile among histological variants is compatible with the reported biologic behavior.

Hybrid odontogenic ghost cell tumor and cutaneous pilomatrixoma: a highly unusual coexistence.

This article describes the first published case of coexistence in a child of a rare hybrid odontogenic ghost cell tumor and a solitary cutaneous pilomatrixoma. An 11-year-old boy presented with a large well-defined unilocular radiolucent lesion in the right posterior mandible. Marsupialization followed by enucleation of the remaining lesion at a later period was the treatment of choice. Histopathologic analysis revealed a hybrid tumor demonstrating areas identical to calcifying cystic odontogenic tumor, ameloblastoma, ameloblastic fibro-odontoma, ameloblastic fibromyxoma, and adenoid odontogenic tumor. A cutaneous nodule was also removed from the facial area and demonstrated classic features of pilomatrixoma on histopathology. Sixteen cases of hybrid calcifying cystic odontogenic tumor associated with odontogenic tumors other than ameloblastomas and odontomas are referred in the literature to date. Young males are frequently affected, and the mandible is the most common site of involvement. The occurrence in the same patient of 2 distinctive entities, which both demonstrate ghost/shadow cells, may be a coincidental finding or suggest a common origin regarding the histogenesis of these cells. Alternatively, future molecular studies may clarify possible genetic or/and predisposing factors for the development of these lesions.

Oral acanthosis nigricans in chronic hepatitis B with a 21-year follow up.

Acanthosis nigricans is a rare mucocutaneous disorder of unknown etiology that manifests as hyperpigmented velvety plaques, most often on intertriginous areas such as the neck and axillae as well as on mucosal sites such as the oral cavity. The disorder presents either as a paraneoplastic manifestation of an underlying malignancy, especially gastrointestinal adenocarcinomas or in association with obesity, administration of drugs or endocrinopathies, most commonly insulin‐resistant diabetes mellitus. In the present article, a case of acanthosis nigricans with oral and cutaneous manifestations in a male patient with chronic hepatitis B infection is described. To the best of our knowledge, this is the first case of benign oral acanthosis nigricans associated with chronic hepatitis B.

Atypical methotrexate ulcerative stomatitis with features of lymphoproliferative like disorder: report of a rare ciprofloxacin-induced case and review of the literature

Methotrexate (MTX) is an established immunomodulating agent used in low doses (LDMTX) to treat several autoimmune diseases. Ulcerative stomatitis (US) may be observed as a long-term LDMTX adverse effect showing a wide histopathologic spectrum. A 73-year old female presented with painful oral ulcers of 5 days duration. The patient had been under treatment for rheumatoid arthritis with LDMTX, while one week before presentation she was prescribed ciprofloxacin for a urinary infection. Histopathologic examination of a lingual ulcer revealed a polymorphous lymphohistiocytic proliferation with scattered binucleated atypical lymphocytes. Immunohistochemically, most cells were of T-cell lineage while the EBER test was negative and a diagnosis of MTX-induced reactive ulceration was rendered. MTX cessation resulted in complete resolution of the ulcers with no recurrences reported so far. The clinical and histopathologic features of MTX-induced oral ulcers are not always diagnostic and a detailed history and an extensive clinicopathologic investigation may be needed to exclude a lymphoproliferative disorder. Key words:Atypical oral ulcers, ciprofloxacin, lymphoproliferative disorders, methotrexate.