Silvia Paula De Oliveira

Prevalence of oral hairy leukoplakia and epithelial infection by Epstein-Barr virus in pregnant women and diabetes mellitus patients: cytopathologic and molecular study

Oral hairy leukoplakia (OHL) is generally reported in patients with severe immunosuppression, except for a few cases in individuals with moderate degree of immunodeficiency. It is a white lesion that appears mainly in the lateral border of the tongue, caused by Epstein-Barr virus (EBV). The nuclear changes caused by EBV (Cowdry A inclusion, ground glass and nuclear beading), observed in cytopathology, are specific and enough for the definitive diagnosis of OHL, independent of the identification of the virus. Here we investigated the prevalence of OHL and the presence of EBV-DNA in the lateral borders of the tongue from 90 pregnant women, 90 diabetes mellitus (DM) patients, 30 healthy individuals (negative group) and 30 HIV+ with OHL (positive group). Smears were analyzed by cytopathology and polymerase chain reaction (PCR). A case of subclinical OHL and candidiasis was identificated in a DM patient by cytopathologic analysis. PCR results demonstrated EBV-DNA in 65% of the pregnant women, in 35% of DM patients, and in 20% of the healthy individuals. We concluded that DM patients can develop OHL with a low prevalence. Furthermore, the prevalence of the EBV in lateral border of the tongue is larger in pregnant women than in healthy individuals.

Infecção oral pelo HPV e lesões epiteliais proliferativas associadas

Papillomaviruses belong to the family Papillomaviridae and their life cycle is directly linked to the differentiation of host epithelial cells. They have six genes that are expressed earlier and two genes that are expressed later in their life cycle, named respectively E (early) and L (late). Host cell viral DNA can take two forms: episomal and integrated. The human papillomavirus (HPV) targets the basal cells of squamous epithelia, particularly from the genital area, which is associated with uterine cervix carcinoma. In the oral area HPV is associated with oral squamous papilloma, condyloma acuminatum, verruca vulgaris, and focal epithelial hyperplasia. However, its role in oral carcinogenesis is still controversial. Moreover, it has identified as an etiological agent of some head and neck squamous cell carcinomas. HPV infection may act synergistically with carcinogens such as tobacco and alcohol. At least 150 different subtypes of HPV have been identified, of which 25 types have been detected in oral lesions. Considering the relevance of the topic for better understanding of HPV oral infection, the objective of this update is to review relevant aspects of HPV biology, with emphasis on HPV-keratinocytes relationship and the importance of clinical and histopathological aspects in the diagnosis of oral lesions possibly associated with HPV.

Solitary fibrous tumor of the floor of the mouth

Background A solitary fibrous tumor (SFT) of the oral cavity is an extremely rare entity. Its diagnosis is complicated because of its diverse morphology and similarity to other mesenchymal diseases. Case Report A rare case of SFT involving floor of the mouth is presented. The tumor was well circumscribed and almost spherical, measuring approximately 3 cm in diameter. Patient was submitted to biopsy and histopathologic examination showed a tumor composed of spindle to epithelioid cells showing pale to eosinophilic cytoplasm, oval or elongated nuclei with inconspicuous nucleoli. Tumor cells showed strong positivity for CD34, vimentin and Bcl-2. SFTs may present as a diagnostic challenge. The patient was followed for 8 years without recurrences. Results SFT is an uncommon disease in maxillofacial region; however it should be considered in the differential diagnosis of spindle cell neoplasms with oral manifestation. Only a few cases have been reported in the floor of mouth. We describe a new case of SFT arising at this location. Key words:Solitary fibrous tumors, mouth floor, oral diagnosis.