Jaw actinomycosis-An opportunistic infection: Case series.

Jaw actinomycosis is a quite rare invasive facultative bacterial infection caused by Actinomyces, Gram-positive filamentous bacilli found in human commensal. A break in continuity of epithelium due to surgery, trauma or previous infection can lead to deeper invasion of bacteria causing infection. The risk factors for actinomycosis are trauma, caries, debilitation, and poorly controlled diabetes mellitus. Clinical presentation can mimic other pathologies, such as fungal infection tuberculosis, granulomatous diseases, so the diagnosis of actinomycosis is delayed or misdiagnosed. For the definitive diagnosis of jaw actinomycosis, medical history, dental history histopathological examinations and microbiological culture are important parameters. Actinomycotic bacteria are sensitive to antibacterial agents hence chemotherapeutic agents are used for treatment. This report presents case series of jaw actinomycosis involving mandible and maxilla. The final diagnosis was supported by histopathology.

Histochemical characterization of bone and cementum using modified gallego's iron fuschin stain and van gieson stain and its application in fibro-osseous lesions.

OBJECTIVES: Fibro-osseous lesions (FOLs) of the jaws exhibit an overlapping histomorphologic spectrum with respect to nature of calcifications. Sometimes these calcifications may be difficult to characterize as bone and cementum on routine Hematoxylin and Eosin (H&E) staining. This causes difficulty in assessing the origin and diagnosis of these lesions. Thus the study aimed to characterize bone, cementum, and hard tissue components in FOLs using special stains. METHOD: The study included a histochemical evaluation of 20 samples of bone and cementum and 12 cases each of fibrous dysplasia (FD) and ossifying fibroma (OF). Three consecutive sections of each tissue were stained with H and E, modified Gallego's iron fuschin stain and Van Gieson stain. H and E and modified Gallego's iron fuschin stained sections were analyzed under light microscope whereas Van Gieson stained section was analyzed under polarizing microscope. RESULTS: It was found that cementum stained red and bone stained greenish-yellow in color. The calcifications seen in fibrous dysplasia stained greenish-yellow in color. Three cases of OF showed greenish-yellow calcifications and nine cases showed reddish calcifications. Polarization study of bone showed lamellar pattern and tooth cementum showed quilt pattern. Four cases of FD showed lamellar pattern and eight cases showed haphazard pattern. In OF, three cases showed lamellar pattern and nine cases quilt pattern. CONCLUSION: Calcifications having lamellar pattern and greenish-yellow color suggest their osteogenic origin thus having aggressive nature and requiring aggressive treatment. Calcifications having quilt pattern and reddish color suggest periodontal ligament origin thus having less aggressive behavior and less extensive treatment.

Clear cell odontogenic carcinoma: Case report of a deceptive pathology.

Clear cells are associated with numerous physiological and pathological conditions. Odontogenic cysts and tumors can arise from physiological clear cells like rests of dental lamina. One such clear cell neoplasm is clear cell odontogenic carcinoma (CCOC) that is associated with aggressive clinical behavior, metastasis and low survival rate. With <80 cases reported so far, it is a rare entity. Initially described as a clear cell odontogenic tumor considering it as a benign but invasive neoplasm, it was later termed as CCOC owing to its infiltrative nature with a marked tendency for local recurrence, regional nodal spread and possible distant, mainly pulmonary, metastasis. Reported here is a case of CCOC affecting mandible of a 55-year-old female along with its immunohistochemical workup.

The postoperative fall in platelet count in cancer: Mirroring the catastrophe?

INTRODUCTION: Progression of cancer requires the growth and invasion of the tumor at its parent site as well as metastasis. Recent studies have shown that tumor cells can aggregate platelets in vitro (a process termed tumor-cell-induced platelet aggregation [TCIPA]), and this aggregation correlates with the metastatic potential of cancer cells in vivo. Platelet depletion or even an inhibition of TCIPA reliably diminishes metastasis. Furthermore, tumor cells bind platelet adhesion receptors of circulating platelets to metastasize more effectively. Studies say that malignant tumors to interact with platelets in the above fashion secrete platelet activating factors which raise the platelet count in malignancy. The study undertaken aims at comparing the preoperative and postoperative platelet levels in patients with benign and malignant neoplasms. MATERIALS AND METHODS: With an appropriate sample size of patients with benign or malignant neoplasms as per the inclusion and exclusion criteria, a platelet count presurgically and the 7th day postsurgically was advised. RESULTS: In case of patients with benign neoplasms, the postoperative platelet count showed a significant rise attributed to a normal healing response, while in patients with malignant neoplasms, the platelet count appeared to fall down significantly due to the effect of tumor removal and therefore a diminished production of thrombopoietic cytokines. The results obtained were thus consistent with the theories of tumor cell-platelet interactions proposed in the recent literature so far. CONCLUSION: Postoperatively, the platelet count rises in the patients with the benign tumor as a result of a normal healing response while those in patients with malignant neoplasm apparently appears to fall down due to the effect of tumor removal thus diminishing the production of platelet activating factors.

Acquired arteriovenous malformation of lip occurring as an occupational hazard: A case report with review of literature.

"Vascular malformations" comprise a group of lesions, formed by an anomalous proliferation of angiovascular or lymphovascular structures. Arteriovenous malformations (AVMs) are high-flow malformation, characterized by direct communication between arteries and veins, lacking normal capillary network. AVMs are usually congenital. Acquired AVMs are reported to occur due to trauma or hormonal changes. Acquired AVMs, though rare in oral cavity, when present are persistent and progressive in nature and can represent a lethal benign disease. They are often associated with extensive blood loss, and an incomplete resection frequently leads to regrowth of the lesion often larger than its original size. We present a rare case of an acquired AVM diagnosed on contrast-enhancing computed tomography angiography and histopathology in a 65-year-old professional trumpet blower.

Adenoid cystic carcinoma of palate: Report of a solid variant.

Adenoid cystic carcinomas (ADCCs) are uncommon tumors, comprising < 1% of all head-and-neck cancers and 20%-25% of all salivary cancers. The most common presenting symptom of the lesion is a slowly growing mass followed by pain due to the propensity of these tumors for perineural invasion. The tumor is most often clinically deceptive by its small size and slow growth, which actually overlies its extensive subclinical invasion and marked ability for early metastasis making the prognosis questionable, aptly referred as "wolf in sheep's clothing." Cribriform, tubular and solid are the three recognized histopathological patterns. In ADCC, one of the important prognostic factors is the histological grade determined by the percentage of solid component in the tumor, which in the present study comprise more than 30% of the entire lesion rendering it an unfavorable prognosis.

Serum Cyfra 21-1 levels in oral squamous cell carcinoma patients and its clinicopathologic correlation.

BACKGROUND: Oral squamous cell carcinoma (OSCC) is the most common malignant tumor in the oral and maxillofacial region. The diagnosis in most cases is made at advanced stages with lymph node metastases and thus has a poor prognosis. Evidence suggests that detection of molecular abnormalities might be useful in screening for early malignancy. Cytokeratins (CKs) are part of the epithelial cytoskeleton. In malignancy, some CK filament fragments might be released in the serum. CK19 fragment Cyfra 21-1 is useful tumor marker for squamous cell carcinoma, but its clinical value in OSCC has not been confirmed. Hence, the aim was to investigate the diagnostic value of serum Cyfra 21-1 in OSCC patients. MATERIALS AND METHODS: The preoperative serum Cyfra 21-1 concentration of forty OSCC patients and forty healthy controls was detected by enzyme-linked immunosorbent assay (ELISA) using a commercial Cyfra 21-1 ELISA kit Xema Co., Ltd., Moscow, Russia. All statistical analyses were performed on STATISTICA statistical software (Windows version 6.0). RESULTS: There was a statistically significant difference (P P P = 0.459). CONCLUSION: It could thus be conjectured from the present study that increased serum Cyfra 21-1 level can be used as an adjunctive serological marker for the OSCC disease staging.

Precursor B-cell lymphoblastic lymphoma of oral cavity: A case report with its diagnostic workup.

Lymphoblastic lymphoma (LBL), seen primarily in children or young adults, is a malignant neoplasia that originates from B or T lymphocyte precursors and rarely occurs in the oral cavity. In this localization, neither the clinical features nor the radiologic appearances are pathognomic and can pose significant diagnostic problems. Histopathologically, it presents as a round blue cell tumor. An early and accurate diagnosis of this entity is very important due to its high cure rate. We report a case of B-cell LBL involving oral cavity in a 10-year-old child. The purpose of this report is to explore the diagnostic workup.

Clinical profile of 108 cases of oral lichen planus.

Oral lichen planus (OLP) is a T cell-mediated chronic inflammatory disease with a varied clinical presentation. The present clinical study was carried out to clarify the demographic and clinical profile of 108 patients with OLP. The patients were identified based on the diagnostic criteria proposed by van der Meij et al. (2003) modified from the WHO (1978) clinical and histopathologic definition of OLP. Information such as age, gender, clinical presentation and type of OLP, site of involvement, symptoms, extraoral involvement, history of systemic disease, familial occurrence and risk factors like chewing and smoking tobacco, chewing betel quid, alcohol consumption were obtained. Mean age of OLP patients was 45.4 years, and among the identified patients, 70.4% were females. The most frequent clinical type was the reticular form (80.6%). The OLP lesions were symptomatic in 77.8% of the patients. The buccal mucosa was the most affected site (87.9%) and multiple oral lesions were observed in 41.7% of the patients. Among the OLP patients, 36.1% and 4.7% reported chewing tobacco and smoking tobacco, respectively. Histopathologically, epithelial dysplasia was seen in two cases. The chronic nature of OLP warrants patient education, psychological support and long-term follow up. (J Oral Sci 58, 43-47, 2016).

Bilateral orthokeratinized odontogenic cyst: A rare case report and review.

Orthokeratinized odontogenic cyst (OOC) is a developmental cyst of jaw and was initially considered by the World Health Organization (1992) as the uncommon orthokeratinized variant of odontogenic keratocyst (OKC). However, studies have shown that OOC has peculiar clinicopathologic aspects when compared with other developmental odontogenic cysts, especially OKC. So orthokeratinized odontogenic cyst now stands out to be a distinct entity. Clinically, it occurs as a single cyst, shows a predilection for males and is most often found in the second to the fifth decade. Its bilateral occurrence is extremely rare. The purpose of the article is to present a rare case of bilateral OOC arising in the mandible and review the literature on bilateral occurrence of this lesion.