Leon Eisenbud

Oral presentations in non-Hodgkin's lymphoma: A review of thirty-one cases

Thirty-one patients with oral manifestations of non-Hodgkins lymphoma have been studied with reference to age, sex, race, location of lesion in oral cavity, stage of disease on presentation, duration of disease at time of presentation, histologic type, modes of treatment, and survival. There were 6 children and 25 adults, ranging in age from 3 to 89 years. Only 2 of the 31 patients were black. Sex incidence was almost equal, with 17 females and 14 males. In 12 cases the oral findings alone represented the initial presentation of lymphoma. The maxilla, mandible, and palate accounted for 24 of the 31 cases. The preponderance of diffuse histologic patterns was striking (77.4 percent). Eighteen cases (58.0 percent) presented in Stage I or Stage II, indicating relatively limited extent of disease. More generalized involvement was found in the remaining thirteen cases (41.9 percent). Thus, although NHL may appear in the oral region as the first detected evidence of disease, in many patients a work-up will show that the process is widespread in distribution. In this brief series survival data coincide with the established principles that a poorer prognosis is associated with the diffuse histologic pattern, as well as certain identified histiocytic and poorly differentiated lymphocytic subtypes.

Oral presentations in non-Hodgkin's lymphoma: A review of thirty-one cases: Part II. Fourteen cases arising in bone

In a series of 31 patients with NHL presenting in the oral region, nine lesions were in the maxilla and 5 were in the mandible, for a total of 14 (45%) lesions that arose in bone. The most common locations were the posterior regions of the maxilla (7 cases) and mandible (4 cases). Diffuse subtypes clearly predominated, 13 out of 14 cases demonstrating this pattern. Six of the cases were in children, and 4 of these qualified as Burkitts lymphoma. In general, it was found that the statistics relating to survival of patients with jawbone lymphoma correspond closely to the findings reported for skeletal lymphomas. Despite the high incidence of diffuse patterns, 6 of these 14 patients with NHL in bone were alive with no evidence of disease 3 years or longer.

Biopsies of normal-appearing palates of patients with known sarcoidosis: A preliminary report

Abstract In a group of patients with known sarcoidosis, palatal biopsies of clinically normal areas showed sarcoid granulomas in 38 per cent of the total. Loss of integrity and pooling of the acini of palatal mucous glands were observed in a number sufficiently large to exclude coincidence. This finding bears further investigation. It is suggested that palatal biopsy may be a useful diagnostic tool in patients with sarcoidosis, especially those for whom confirmatory evidence may be of value.

Garré's proliferative periostitis occurring simultaneously in four quadrants of the jaws

Typically, Garrés osteomyelitis affecting the jaws is unilateral and is restricted to the mandible. We are reporting a case in which all four quadrants were involved, an occurrence which we believe must be extremely unusual and has not been reported previously. Conservative management over a period of 3 years resulted in complete resolution, with return of normal facial and osseous contours.

Analysis of Oral Reactions to Dilantin-Sodium

The more widespread use of dilantin-sodium in the treatment of convulsive disorders has stimulated a demand for dental consultations to interpret the significance of the oral reactions encountered. That dilantin often produces changes in the gingival tissues is unchallenged, but no uniformity of opinion exists concerning their incidence, categories, or the features that distinguish them from other abnormalities of the gingivae. This report, based on a two year study of 62 patients in the Neurologic Clinic of the Mount Sinai Hospital, and on an analysis of the literature, is intended to assist the dental clinician by clarifying these points. A working classification of the lesions produced by dilantin is offered, and the essentials of differential diagnosis, the role of aggravating factors and the indicated scope of treatment are discussed. When, in 1938, Merritt and Putnam (1) introduced dilantin-sodium for the treatment of epilepsy, certain toxic reactions of the drug were already recognized, which resembled those following the administration of other barbiturates. Kimball and Horan (2) divided these manifestations into (a) acute toxic reactions, notably cutaneous rashes and evidences of damage to the nervous system, and (b) late reactions due to chronic irritation, of which the most prominent were gingival hypertrophy, and recurrent gastritis. The incidence of gingival changes as reported by several investigators shows a striking disparity (Table I), readily explained by two persisting variables. Statistics were compiled largely by internists rather than stomatologists, and therefore finely shaded differences in the gingival picture may easily have been overlooked. Secondly, observations in no instance were based on patients selected according to the period of time covered by the administration of dilantin. Yet in our studies, the percentage of gingival alterations noted, in fact, the entire clinical picture, often changed after prolonged dosage. Many patients were observed who showed little alteration after one year, but developed marked hypertrophy during the second year of treatment. Carrying this point to a legitimate conclusion, inasmuch as the maximum period that any patient has received dilantin does not yet exceed four years, it is probable that changes in greater degree will be noted in the future.

Tuberculous osteomyelitis of the mandible

An unusual case of tuberculous involvement of the mandible in a 22-month-old African girl is presented. Other tissues involved included the small bones of the hands and feet and pulmonary, cervical, and submental lymph nodes. A short discussion of the pathogen involved is offered.An unusual case of tuberculous involvement of the mandible in a 22-month-old African girl is presented. Other tissues involved included the small bones of the hands and feet and pulmonary, cervical, and submental lymph nodes. A short discussion of the pathogen involved is offered.

Palatal biopsy as a diagnostic aid in the study of connective tissue diseases

Abstract Palatal biopsies from eighty patients with known connective tissue disease were examined to determine the incidence of focal lymphocytic sialadenitis. Lymphocytic aggregates were demonstrated in 82 per cent, compared to 6 per cent in a control series of eighty ostensibly healthy patients. The palatal biopsy is innocuous, simple to perform, requires no suturing, and yields tissue of diagnostic quality.

Oral manifestations in Crohn's disease. Report of a case.

Abstract Since its original description, in 1932, as regional ileitis, numerous reports have established the protean nature of Crohns disease. In addition to widespread involvement of the gastrointestinal tract, extraintestinal manifestations have been described, including cutaneous, articular, hepatic, and other visceral localization. It is now clear that Crohns disease may be encountered in the mouth as well. This case report is added to those which have recently alerted the dental profession to this newly documented oral manifestation of systemic disease.

Oral presentations in non-Hodgkin's lymphoma: a review of thirty-one cases. Part III. Six cases in children.

This is the third in a series of articles dealing with oral presentations in non-Hodgkins lymphoma. In this section the authors discuss the clinical and microscopic features of six cases occurring in children, four of which qualified as Burkitts lymphoma.

Radiation-induced pseudosarcoma of the tongue☆

Abstract An 88-year-old man received radiation therapy for squamous-cell carcinoma of the right maxillary buccal vestibule. Four years later a polypoid lesion arose on the right lateral border of the tongue. The mass was removed by conservative wedge resection and there has been no recurrence in the ensuing 4 years. Our search of the literature has failed to reveal a similar recorded occurrence in this location.