Robert A. Vickers

THE CALCIFYING ODONTOGENIC CYST: A POSSIBLE ANALOGUE OF THE CUTANEOUS CALCIFYING EPITHELIOMA OF MALHERBE

Abstract The existence of a new odontogenic lesion—the calcifying odontogenic cyst—is documented by fifteen examples and its histogenesis is described. There appears to be no predilection for sex, age, or location. In only one case has there been a recurrence. The similarity of this cyst to the cutaneous calcifying epithelioma of Malherbe and other lesions is discussed.

Multiple mucosal neuromas, pheochromocytoma and medullary carcinoma of the thyroid—a syndrome

An analysis of 17 cases of the syndrome of multiple mucosal neuromas, pheochromocytoma and medullary carcinoma of the thyroid is presented and its relationship to similar syndromes discussed. The mucosal neuromas primarily involve the lips, anterior tongue, conjunctiva and nasal and laryngeal mucosa. Medullated corneal nerve fibers traverse the cornea and anastomose in the pupillary area. A Marfanoid build and diverticulosis may be associated findings.

Ameloblastoma: Delineation of early histopathologic features of neoplasia

Relatively little has been documented concerning the specific histologic alterations associated with neoplastic transformation of ameloblastomatous epithelium or the histopathology of ameloblastomas early in their development. Ten examples of cystic jaw lesions that manifested an apparently distinctive altered epithelium were analyzed and were compared with published photomicrographs of early ameloblastomas, mural ameloblastoma, and examples of ameloblastoma arising in association with dental cysts. While the 10 specimens had all been considered cystic, 3 histopathologic alterations were consistently observed that delineated them from dental cysts. The histopathologic changes were: 1. hyper‐chromatism of basal cell nuclei of the epithelium lining the cystic cavities; 2. palisading and polarization of basal cell nuclei of the epithelium lining the cystic cavities, and 3. cytoplasmic vacuolization of, especially, basal cells of cystic linings. Cystic lesions manifesting these histologic changes, in the present analysis and the literature, have been associated with ameloblastoma in a high percentage of instances.

Malignant melanotic neuroectodermal tumor of infancy. A clinical, pathologic, ultrastructural and tissue culture study

The melanotic neuroectodermal tumor of infancy is an uncommon neoplasm typically of early childhood which has a predilection for the head and neck region, particularly the maxilla. Except for one previous example in the literature, this tumor has consistently behaved in a benign fashion. This study documents the clinical course and pathologic findings of a tumor which began in the maxilla of a 4‐month‐old boy, followed by a local recurrence, metastasis to a cervical lymph node and finally, widespread dissemination and death at 18 months, 24 months and 38 months, respectively. The tumor was initially composed of nests consisting of melanin‐containing cells and small dark cells. An elevated vanillylmandelic acid level was recorded during the course of the disease. At autopsy, the tumor in lymph nodes, liver, bone and soft tissues had a monotonous pattern of small dark cells similar to a conventional neuroblastoma. Previous ultrastructural studies indicate that the melanotic neuroectodermal tumor of infancy is composed of melanocytes and neuroblast‐like cells. Our case provided the unique opportunity to examine in sequence the ultrastructural and in vitro characteristics of a recurring and eventually metastasizing melanotic neuroectodermal tumor. Although the neuroblast‐like cells were initially difficult to identify by electron microscopy, a melanin‐producing cell line and a separate nonpigmented cell line were successfully isolated from various tumor explants. Various stages of melanosome development were identified in the pigmented cells from the local recurrences and in vitro. Dibutyryl cAMP accentuated the formation of pigment and dendritic development in the melanocytes and dendrites only in the small nonpigmented cells. Electron dense granules were observed in the cultured smaller cells and also in the lymph node and soft tissue metastases. Tyrosine hydroxylase activity was demonstrated in the neuroblast‐like cells. In the final biopsy and autopsy material, only the neuroblast‐like cells remained and the tumor resembled a conventional neuroblastoma.

Lymphoepithelial lesions of the oral cavity: Report of four cases

Abstract Lymphoepithelial lesions constitute a group of conditions almost exclusively discussed in connection with tumors and tumorous diseases of the parotid salivary gland and swellings of the lateral neck. The present report has dealt with the clinical, microscopic, and etiological features of four similar examples originating in oral mucosa. A review of the literature has revealed seven similar conditions in this apparently unusual location, including three uncommonly described cases of papillary cystadenoma lymphomatosum (“adenolymphoma”). Anatomic evaluation of oral lymphatic tissue, together with publication of similar lymphoepithelial lesions would, we believe, reveal a more common entity. In addition, such studies would aid in our understanding, classification, and treatment of such processes. Microscopic differentiation of such lesions from oral manifestations of lymphatic neoplasia remains of practical importance.

Experimental Carcinogenesis in Submandibular Glands of Hamsters

The literature concerning experimental induction of tumors in salivary glands of animals has been recently reviewed by Standish.1 Steiner2 conducted the first well-planned investigation into the comparative pathology of induced tumors of the salivary glands in different animals. By employing hydrocarbon carcinogens like methylcholanthrene, 1,2,5,6-dibenzanthracene, and 3,4,-benzpyrene in the form of pellets, he was able to induce metaplasia of the glandular epithelium, epidermoid cysts, squamous-cell carcinoma, and adenocarcinoma. He found that methylcholanthrene produced more sarcomas and a greater variety of mixed tumors in mice than did dibenzanthracene. Bauer and Byrne,3 using the same type of carcinogens and the same method of administration, were also able to produce epithelial malignant tumors. Standish studied histologically the evolvement of these tumors. His findings were similar to those of Steiner. He also noted that methylcholanthrene induced sarcomas more frequently than did 7:12 dimethylbenz (a) anthracene. The present investigation was undertaken to study the effects of a single injection of a hydrocarbon carcinogen on the different tissue components of salivary glands and the subsequent tumor formation. Furthermore, it is to be used as a tool for future investigations for the understanding of some of the intricate mechanisms underlying cancer in general. The experimental analysis was concerned with (1) the histopathologic changes in the submandibular glands at certain slated time intervals following a single injection of a hydrocarbon carcinogen; (2) the effects of different concentrations of a carcinogen injection on the number of tumors induced; and (3) the effects of the animal age on the tumor yield.

An Investigation Concerning Inducibility of Lymphoepithelial Cysts in Hamsters by Autogenous Epithelial Transplantation

SYNOPSIS IN INTERLINGUA UN INVESTIGATION CONCERNENTE LE INDUCIBILITATE DE CYSTES LYMPHOEPITHELIAL IN HAMSTERS PER LE TRANSPLANTATION DE EPITHELIO AUTOGENE.—Vinti mascule Syrian hamsters auree de 6 septimanas de etate esseva dividite in duo gruppos experimental. Epithelio de glandula salivari o del sacco buccal esseva transplantate autogenemente ad in submandibular nodos lymphatic al latere dextere de 10 del animales cata-un. Le mesme typo de intervention instrumental esseva applicate al structuras submandibular al latere sinistre sin effectuar ulle transplantation. Le animales esseva sacrificate 30 dies plus tarde. Le transplantate epithelio del sacco buccal experientiava proliferation cystic in 7 del 9 supervivente animales, durante que epithelio del glandula salivari esseva observate histologicamente in 2 de 9 nodos lymphatic. Le observation corrobora previe conclusiones relative al etiologia de cystes lymphoepithelial.

An unusual ostensible example of intraoral basal cell carcinoma

An example of oral basal cell carcinoma is presented originating on the posterior mandibular mucosa and gingiva of a 67‐year‐old female. Histologically, it featured a multifocal pattern. It recurred eight times in a period of 20 years. Tissue samples of the tumor were evaluated with monoclonal antibody Ber‐EP4 and were compared with examples of oral mucosa, skin, oral and cutaneous squamous cell carcinoma, peripheral ameloblastoma, ameloblastoma and cutaneous basal cell carcinoma (BCC). Only neoplastic basal cells showed positive immunohistochemical staining. Additionally, microdissected neoplastic areas were evaluated for loss of heterozygosity (LOH) of the PTCH gene with markers D9S303, D9S252 and D9S287. PTCH gene mutations are reported in patients with Gorlin syndrome and sporadic cutaneous BCCs. Loss of one allele was observed with all three markers. Examples of conventional ameloblastomas did not show evidence of LOH. These observations support the inclusion of BCC in the differential diagnosis of appropriate oral mucosal neoplasms.

Clinicopathologic observations in prodromal herpes zoster of the fifth cranial nerve: Report of a case

Abstract It is often difficult to diagnose herpes zoster of the fifth cranial nerve prior to the appearance of the easily recognized cutaneous manifestations. In the case reported here, the disorder first appeared as an oral white patch.

The surface of genetically determined hypoplastic enamel in human teeth

Abstract A localized form of hypoplastic amelogenesis imperfecta was compared to a form of febrile hypoplastic enamel to ascertain the potential for alternative surface enamel morphologies predicated on differing influences during development. Surface observations with the scanning electron microscope (SEM) in febrile altered enamel revealed surfaces resembling that of developing enamel. The genetically determined form of the defect suggested that other influences rather than alteration of ameloblasts were included in the phenotype; these were suggested to be vascular in origin.