K. Shyamala

Risk of tumor cell seeding through biopsy and aspiration cytology

Cancer cells, besides reproducing uncontrollably, lose cohesiveness and orderliness of normal tissue, invade and get detached from the primary tumor to travel and set up colonies elsewhere. Dislodging neoplastically altered cells from a tumor during biopsy or surgical intervention or during simple procedure like needle aspiration is a possibility because they lack cohesiveness, and they attain the capacity to migrate and colonize. Considering the fact that, every tumor cell, is bathed in interstitial fluid, which drains into the lymphatic system and has an individualized arterial blood supply and venous drainage like any other normal cell in our body, inserting a needle or a knife into a tumor, there is a jeopardy of dislodging a loose tumor cell into either the circulation or into the tissue fluid. Tumor cells are easier to dislodge due to lower cell-to-cell adhesion. This theory with the possibility of seeding of tumor cells is supported by several case studies that have shown that after diagnostic biopsy of a tumor, many patients developed cancer at multiple sites and showed the presence of circulating cancer cells in the blood stream on examination. In this review, we evaluate the risk of exposure to seeding of tumor cells by biopsy and aspiration cytology and provide some suggested practices to prevent tumor cell seeding.

Neural crest: The fourth germ layer.

The neural crest cells (NCCs), a transient group of cells that emerges from the dorsal aspect of the neural tube during early vertebrate development has been a fascinating group of cells because of its multipotency, long range migration through embryo and its capacity to generate a prodigious number of differentiated cell types. For these reasons, although derived from the ectoderm, the neural crest (NC) has been called the fourth germ layer. The non neural ectoderm, the neural plate and the underlying mesoderm are needed for the induction and formation of NC cells. Once formed, NC cells start migrating as a wave of cells, moving away from the neuroepithelium and quickly splitting into distinct streams. These migrating NCCs home in to different regions and give rise to plethora of tissues. Umpteen number of signaling molecules are essential for formation, epithelial mesenchymal transition, delamination, migration and localization of NCC. Authors believe that a clear understanding of steps and signals involved in NC formation, migration, etc., may help in understanding the pathogenesis behind cancer metastasis and many other diseases. Hence, we have taken this review to discuss the various aspects of the NC cells.

Salivary gland choristoma on tonsil – A case report and review

The salivary choristoma or heterotopic salivary gland is defined as a tumor-like growth of otherwise normal salivary gland found in an abnormal location. Although histologically there is evidence of hetertopic salivary gland tissue in palatine tonsil rarely it manifests as visible mass with only isolated case reports having been found. In this article, we present a case with salivary gland choristoma on palatine tonsillar wall and a brief review.

Correlation between transforming growth factor-beta expression and mast cell count in different grades of oral submucous fibrosis

Background and Objectives: In India, oral submucous fibrosis (OSF) is a commonly encountered precancerous disorder. It is a disease with a protracted course and characteristic clinical features caused by the habit of consuming areca nut. Histologically, the main pathology is extensive fibrosis of the mucosa. OSF can be categorized into four grades based on histology. Inflammatory cells and keratocytes are stimulated by the areca nut alkaloids, and they release transforming growth factor-beta (TGF-β). It has been advocated to play a major role in OSF pathogenesis by increasing collagen synthesis and preventing collagen degradation. Mast cells (MCs) are the additional key players in the pathogenesis of OSF. There is confusion regarding the functional relationship of MC with TGF-β. Few studies have shown TGF-β can repress MC function, whereas other studies have established that TGF-β is a chemotaxin for MCs. However, there is dearth in literature regarding their interaction in OSF. Hence, this study attempted to show a relationship between TGF-β and MC in different grades of the disease, so as to further explicate the pathogenesis of OSF. Materials and Methods: A total of 48 OSF cases were stained using TGF-β antibody. Its staining intensity and staining area were calculated. Sections from same blocks were also stain MCs using 1% toluidine blue. The number of MCs was counted for all the cases. Expression of TGF-β was correlated with MC count in all OSF grades. Results: On correlating TGF-β and MC between the histologic grades, there was a strong negative correlation for Grade I, moderately positive for Grade II and no correlation for Grade III OSF. Interpretation and Conclusions: Among the different grades of OSF, the correlation between MC and TGF-β varies, depending on the severity of inflammation, and the concentration of TGF-β and further investigation in this field may elucidate their role in determining the severity of OSF.

Primary Tuberculous Glossitis: Report of a Case and Review

Tuberculosis (TB) is a chronic granulomatous disorder caused by Mycobacterium tuberculosis (M.Tb) with a worldwide prevalence and varying clinical manifestations. In the primary form, the clinical spectrum ranges from usual lung involvement to very rare occurrence in the oral cavity. In secondary TB, the oral lesions are accompanied by lesions in the lungs, lymph nodes, or any other organ system of the body. Even though TB lesions of the oral cavity are uncommon especially the primary form, it can pose diagnostic problems. In this paper, we present a case of primary oral TB involving right ventral surface of anterior two-thirds of the tongue in a 54-year-old male patient with review of literature and emphasis on pathogenesis behind more common tongue involvement.