Fabio Augusto Ito

Clear Cell Variant of Calcifying Epithelial Odontogenic Tumor: Is It Locally Aggressive?

Our biopsy service (Oral Pathology, Piracicaba DentalSchool-UNICAMP, Sao Paulo, Brazil) received a specimenfrom a 65-year-old male of a painless swelling located be-tween the mandibular right lateral incisor and canine thathad been growing slowly for about 3 years. The clinicalinformation sent by the private dentist was of a fibrous,firm, sessile, and painless lesion covered by a smooth andregular mucosal surface in the anterior mandibular gingivabetween the right lateral incisor and canine, which mea-sured nearly 1.5 cm in its maximum dimension. Theperiapical radiograph showed a well-defined unilocularradiolucent lesion with radiopacities dispersed through-out the lesion. In addition, there was resorption of thebone crest between the right mandibular lateral incisorand canine; however, the roots of the adjacent teethwere not displaced, and there was no sign of the rootresorption (Fig 1). The lesion was removed by completesurgical excision.Hematoxylin and eosin-stained sections showed multiplemucosal fragments represented by a dense connective tis-sue that was replaced by irregular strands, cords, and nestsof epithelial cells. The polyhedral epithelial cells dis-closed an abundant and eosinophilic cytoplasm; round-to-oval relatively large nuclei with dense chromatin, andevident intercellular bridges. These cells showed mildpleomorphic and hyperchromatic nuclei. In significant por-tions, the epithelial cells had a clear, foamy, vacuolatedcytoplasm (Figs 2-4). The calcifications areas and Lieseg-ang’s rings were observed, and amyloid-like deposits werenot visualized. However, these amyloid-like deposits couldbe observed in Congo red staining under polarized light (Fig5). The periodic acid Schiff (PAS) showed numerous glob-ules of positive material, which was removed by prior

Immunohistochemical study of androgen, estrogen and progesterone receptors in salivary gland tumors

The aim of this work was to study the immunohistochemical expression of androgen receptor, estrogen receptor and progesterone receptor in pleomorphic adenomas, Warthins tumors, mucoepidermoid carcinomas and adenoid cystic carcinomas of salivary glands. A total of 41 pleomorphic adenomas, 30 Warthins tumors, 30 mucoepidermoid carcinomas and 30 adenoid cystic carcinomas were analyzed, and the immunohistochemical expression of these hormone receptors were assessed. It was observed that all cases were negative for estrogen and progesterone receptors. Androgen receptor was positive in 2 cases each of pleomorphic adenoma, mucoepidermoid carcinoma and adenoid cystic carcinoma. In conclusion, the results do not support a role of estrogen and progesterone in the tumorigenesis of pleomorphic adenomas, Warthins tumors, mucoepidermoid carcinomas and adenoid cystic carcinomas. However, androgen receptors can play a role in a small set of salivary gland tumors, and this would deserve further studies.

Expression pattern of PLUNC proteins as an auxiliary tool for the diagnosis of high-grade mucoepidermoid carcinoma of the salivary gland

BACKGROUND Mucoepidermoid carcinomas are the most frequent malignant neoplasia of the salivary glands and are histologically classified as low, intermediate, and high grade. At present, histochemical stains such as periodic acid-Schiff or mucicarmine are useful tools in making a diagnosis. Recently, expression of the PLUNC proteins has been described in mucin-producing salivary gland tumors, with the suggestion that they could provide a powerful tool for the diagnosis of difficult cases. METHODS This study evaluates the expression of PLUNC proteins in 30 cases of salivary gland mucoepidermoid carcinomas. Tumors were reviewed and classified according to histological grade. Periodic acid-Schiff, mucicarmine, and immunohistochemical staining for SPLUNC1, LPLUNC1, SPLUNC2, and LPLUNC2 were carried out. Immunostaining was classified as positive or negative. RESULTS The majority of the tumors (63%) were classified as low grade, 13% were intermediate grade, and 23% were high grade. SPLUNC1 (90%) and LPLUNC1 (93%) were positive in the majority of cases, mainly in mucous cells, mucin plugs, and intermediate cells. SPLUNC2 and LPLUNC2 did not present significative expression within the tumors; however, LPLUNC2 was found to stain positively in mast cells in 83% of the samples. CONCLUSIONS SPLUNC1 and LPLUNC1 showed a similar pattern of expression and could prove useful in the diagnosis of high-grade cases because of the differential staining in intermediate and epidermoid cells. The expression of LPLUNC2 in mast cells has not previously been reported, but further studies are necessary to validate this finding and to determine its significance.