Stevan H. Thompson

Ameloblastic sarcoma of the mandible

Malignant ameloblastic odontogenic tumors have traditionally been classified as either ameloblastic fibrosarcomas, dentinosarcomas or odontosarcomas. This separation is based on the presence of either dentine or dentine and enamel in some lesions. To date, 28 cases of ameloblastic fibrosarcoma, one case of ameloblastic dentinosarcoma, and seven cases of ameloblastic odontosarcoma have been reported in the literature. An additional case of ameloblastic dentinosarcoma is reported in this paper together with a critical review of the clinicopathologic features of previously reported cases of malignant ameloblastic neoplasms. The presence of dental matrix material is not specific and is found in a wide variety of odontogenic tumors in variable amounts. This study supports the concept that the presence of dental matrix material does not alter the basic biologic characteristics of these neoplasms. Accordingly, to simplify a confusing nomenclature, we suggest that malignant tumors of this type be referred to collectively as ameloblastic sarcomas.

Plasmacytoid myoepithelioma of a minor salivary gland

Plasmacytoid myoepitheliomas are rare salivary gland neoplasms that probably represent a variant of the pleomorphic adenoma. They appear to occur more frequently in the minor salivary glands of the mouth. The mean average age at time of diagnosis of intraoral lesions is 18.8 years. Cytologic pleomorphism is a frequent histologic feature, which has led to a questionable diagnosis of malignancy in five out of ten cases. Caution is advocated in the evaluation of a salivary gland neoplasm with such features, and confusion with primary squamous cell or undifferentiated carcinoma of the salivary glands should be avoided. Patients who have cytologically pleomorphic lesions should be assessed for evidence of metastases. Rapid growth, neurologic evidence of sensory or motor dysfunction, and bone invasion should be regarded as ominous clinical parameters. Therapy should be directed toward complete surgical extirpation.

Correlation of subclinical candidal colonization of the dorsal tongue surface with the Walter Reed staging scheme for patients infected with HIV-1

The correlation between subclinical candidal colonization of the dorsal tongue surface and the Walter Reed staging scheme for patients positive for human immunodeficiency virus (HIV-1) antibody is reported. Of 76 cytologic smears of the dorsal tongue surface, 12 (16.2%) demonstrated subclinical colonization. The mean peripheral helper T-lymphocyte count for patients with subclinical colonization was 304 +/- 226 cells/mm3 and was not significantly different from seropositive patients without colonization (411 +/- 209 cells/mm3). The Walter Reed scheme for assessing progressive immunodysregulation did not significantly correlate with the presence of subclinical colonization. This study suggests a more complex pathogenesis for oral candidiasis in HIV-1-infected patients rather than a direct link to peripheral helper T-lymphocyte depletion below a count of 400 cells/mm3.

Features of central giant cell granuloma of the jaws xenografted in nude mice

In order that the growth pattern and histologic and ultrastructural differentiation of the central giant cell granuloma of the jaws be studied, tissue from three lesions was transplanted into nude mice. Xenografts were harvested at 3 weeks, 5 weeks, 8 weeks, and 13 weeks and examined histologically and ultrastructurally. Implants could be identified as firm subcutaneous nodules, but after 3 weeks began regressing. At 13 weeks, almost total regression had occurred. Histologically, grafts were well vascularized and there was no evidence of necrosis. Typical multinucleated giant cells disappeared at an early stage. The ultrastructural features of the grafts showed giant cells lying in close association with uninuclear cells, features suggestive of a fusion process. Many cells containing microfilaments at their periphery were identified in the original lesional tissue as well as in the xenografts. These cells strongly resembled myofibroblasts. Collagen bundles were seen within the cytoplasm of stromal cells. The observations suggest that the multinucleated giant cells represent a stimulus-dependent, differentiated end-stage cell population.

Reactive lymphoid hyperplasia of the hard palate

Extranodal oral lymphomas appear most frequently as soft tissue swellings involving the masticatory mucosa. Non-Hodgkin’s lymphoma of the B-cell type is the most commonly occurring neoplasm. ’ ,2 The purpose of this report is to discuss an unusual case of palatal lymphoid hyperplasia and provide clinical and laboratory guidance for the clinician involved in the evaluation of oral lymphoid infiltrates.

Myoglobin content of granular cell tumor of the tongue: An immunoperoxidase study

Myoglobin is a protein with a molecular weight of 16,900 daltons that is normally found in adult and fetal striated and cardiac muscle cells. Its synthesis relates to the total ATP requirements of the muscle cell. The histogenesis of the granular cell tumor is controversial, but an origin from striated muscle has been postulated. Seven cases of tongue GCT were evaluated for the presence of myoglobin using the unlabeled antibody (PAP) technique. Normal human striated muscle was used for both positive and negative controls. None of the tumors showed positive staining of the granular cells. Positive controls showed specificity of staining for skeletal muscle. The negative controls did not stain. Granular cell tumors of the tongue do not appear to contain myoglobin. This suggests that either the GCT is not of muscle origin or that, if it is, there may be a metabolic change in the granular cells so that myoglobin is not synthesized. It may be possible that a change in the antigenic determinant has occurred.

Treatment of Human Immunodeficiency Virus-Associated Facial Lipodystrophy Syndrome With Dermafat Graft Transfer to the Nasolabial Fold Areas: A Case Report and Review of the Literature

1932 IV-positive patients had a bleak prognosis, but now IV infection has been transformed into a chronic isease with an extended life expectancy due to treatent options with the multiple antiviral medications ow available. Oral and maxillofacial surgeons are outinely providing cosmetic corrections of facial deormities and should be familiar with the pathogeneis and treatment options available for HIV-associated acial lipodystrophy. Currently, a combination of protease inhibitors PIs), reverse-transcriptase inhibitors, and nucleoside nalogs are being used to control the progression of his disease. The prolonged course of medical therapy as led to a group of secondary side effects maniested as body fat dystrophy and other metabolic isorders. HIV-associated lipodystrophy has been reorted in up to 83% of individuals treated with curent antiviral treatments, specifically protease and nuleoside reverse-transcriptase inhibitors (NRTIs). The physical findings associated with the lypodysrophy syndrome include fat wasting of the facial reas (specifically in the nasolabial folds) and the xtremities. Adipose tissue hypertrophy is noted in he cervicodorsal area (ie, “buffalo hump”) and the bdomen. Numerous treatment options have been reorted in the surgical literature for treatment of HIVssociated lipodystrophy, including augmentation of fattrophied areas with alloplastic and autogenous graft aterial, and liposuction or surgical excision of fat from he hypertrophied dorsocervical areas.