Co-overexpression of Bag-1 and heat shock protein 70 in human epidermal squamous cell carcinoma: Bag-1-mediated resistance to 5-fluorouracil-induced apoptosis.

BACKGROUND: The aim was to determine whether Bcl-2-associated athanogene-1 (Bag-1) and/or its binding protein heat shock protein-70 (Hsp70) exhibit deregulated expression in epidermal squamous cell carcinoma (SCC) and whether Bag-1 confers apoptosis resistance. METHOD: Immunohistochemistry for Bag-1 and Hsp70 was performed on 60 epidermal SCC and 10 normal skin samples. The epidermal SCC cell line SCC-13 was treated with 5-fluorouracil (5-FU) after Bag-1 knockdown to determine whether high Bag-1 levels contribute to growth and/or apoptosis resistance. RESULTS: Normal epithelium expressed primarily nuclear Bag-1. Most tumours showed reduced nuclear Bag-1 staining, but a subset exhibited strong Bag-1 staining, with cytoplasmic Bag-1 staining intensity correlating with cytoplasmic Hsp70 staining intensity (r(s)=0.462; P<0.001) and less differentiation (P<0.001). Bag-1 knockdown resulted in markedly reduced SCC-13 cell yield, increased spontaneous apoptosis and enhanced sensitivity to 5-FU-induced apoptosis. Apoptosis induced by 5-FU in the Bag-1-knockdown cells was significantly greater than the additive apoptotic effect of 5-FU or Bag-1 knockdown alone. CONCLUSIONS: Overexpression of Bag-1 and Hsp70 in poorly differentiated SCC may confer both enhanced tumour cell growth and apoptosis resistance. Bag-1 may contribute to the resistance of more advanced epidermal SCC to chemotherapy.

Parotid Warthin's tumour Bristol Royal Infirmary (1985-1995): a study of histopathology in 33 cases.

This is a study of 33 (32 patients) confirmed Warthin's tumours (adenolymphomas) treated surgically at Bristol Royal Infirmary (1985--1995) focussing specifically upon 17 salient histopathological features together with capsular measurement by micrometry. Twenty-four out of 33 tumours had 'thin' capsules (< or = 200 microm), whereas 5/9 'thick' capsules were associated with gross tumour degeneration. The degenerative features including cystic change, squamous metaplasia, corpora amylacea like bodies, etc. were quantified. Tumours were classified into subtypes (typical, stroma poor, etc). These variations were not associated with age or sex. In 20/33 tumours a marginal sinus suggested a lymph node origin. Fine needle aspiration cytology (FNA) smears showing degeneration features are a diagnostic problem, but histopathological features are reflected in such smears and their recognition enhances diagnostic precision, enabling controlled surgical enucleation, the ideal operation, to be performed in most cases. In this study only 12 tumours were so treated; 11 others received parotidectomy. The theories of histogenesis are reviewed and discussed.

Oral epithelial dysplasia: clinical characteristics of western European residents.

To detail the clinical presentation of oral epithelial dysplasia in a large cohort of residents in western Europe. Descriptive statistical analysis of the data were calculated using chi-square and Fisher's exact tests. Oral epithelial dysplasia manifested typically as a white or mixed red and white lesion on the tongue, buccal mucosa or floor of mouth. The peak age of presentation of oral epithelial dysplasia was the 6th decade. Most clinically detected lesions had only mild oral epithelial dysplasia. Although uncommon, lesions with severe dysplasia were most likely to arise on the floor of mouth or lateral border of tongue. Oral epithelial dysplasia is likely to manifest as a solitary white patch, but it is not possible to accurately predict the likely degree of dysplasia from the clinical features of such lesions.

Oral mucosal non-Hodgkin's lymphoma--a dangerous mimic.

Reports of T-cell lymphomas in the oral cavity are rare. Most have presented as a persisting ulcerated swelling. This paper reports two men, one of whom presented with a short history of increasing facial swelling and pain apparently related to a lower premolar tooth, and the other who had recurrent oral ulceration in several sites over a period of years. These types of cases are likely to present initially to general dental practitioners.

Recurrent compound naevus of gingiva.

A case is described of a compound naevus of the gingiva. It was unusual in that it showed a number of recurrences and these appeared to be related to the hormonal status of the patient.

Erythema multiforme involving gingiva.

Erythema multiforme is a vesiculobullous condition that may affect skin and/or mucosa. Oral lesions are characterized by hemorrhagic crusting of the lips and ulceration mainly of the non-keratinized mucosa. This paper describes a patient who presented with gingival lesions as well as the more typical oral signs of erythema multiforme.

WHO International Histological Classification of Tumours. Tentative Histological Classification of Salivary Gland Tumours.

The principles of the proposed modified WHO Histological Typing of Salivary Gland Tumours are based on the following: 1) The classification of tumours is oriented to the routine work of the practicing surgical pathologists, those who do not see tumours of the salivary glands very often. The inclusion of rare, but clearly defined tumour entities should be helpful to surgical pathologists consulting with clinical specialists. 2) The different types of carcinomas must be distinguished not only by precise histopathological definitions, but also considering differences in prognosis and treatment. For example, the polymorphous low-grade adenocarcinoma and the epithelial-myoepithelial carcinoma are characterized by a relatively good prognosis in contrast to the salivary duct carcinoma. 3) Special points of discussion are: subclassification and grading of carcinomas (e.g. acinic cell carcinoma, mucoepidermoid carcinoma and adenoid cystic carcinoma), the classification of basal cell tumours (basal cell adenoma, basal cell carcinoma, solid type of adenoid cystic carcinoma), malignant tumours in pleomorphic adenomas and the differential diagnosis between primary tumours and metastases.

Granulomatous disorders of the oral mucosa.

A wide variety of granulomatous disorders can involve the orofacial tissues. As in other sites, appropriate clinicopathologic correlations are needed to reach a definitive diagnosis. The clinical and pathologic features of some of the more common oral granulomatous disorders are considered, including idiopathic conditions, foreign body lesions, and infectious lesions.

Giant cell lesions complicating fibro-osseous conditions of the jaws.

Three patients who presented with giant cell lesions complicating ossifying fibroma, Paget's disease, and cherubism are reported. The giant cell lesions complicating ossifying fibroma and cherubism were diagnosed as giant cell granuloma (GCG), whereas the lesion complicating Paget's disease demonstrated more aggressive clinical and histologic features. The possible therapeutic and prognostic implications of these findings are discussed.

Focal acantholytic dyskeratosis arising in an intraoral skin flap.

A case is described of a patient with a myocutaneous pectoralis major flap who presented with an oral lesion of focal acantholytic dyskeratosis that was clinically suspicious of recurrent tumour.

Adenosquamous carcinoma of the mouth: a rare variant of squamous cell carcinoma.

Adenosquamous carcinoma is a rare tumour in the oral cavity and is characterised histologically by carcinomatous change in surface epithelium, in association with adenocarcinoma affecting the ducts of minor salivary glands. Only a dozen cases have previously been reported in the oral cavity, but all have shown an aggressive course with 60% of patients dying of disease. We report three further cases and review the literature, which suggests that this lesion should be regarded as a high-grade variant of squamous cell carcinoma.

Salivary duct carcinoma in five cats.

Carcinomas of salivary gland ducts are described in five cats. The typical histological pattern was the formation of large cell aggregates resembling dilated ducts, often with central necrosis and a looping pattern. All tumours were labelled with antibody to cytokeratins (CKs) 5, 6, 8, 14, 17 and 19. Labelling of tumour cells with CK14 suggested basal cell differentiation. All tumours stained with Jack bean (Canavalia ensiformis) agglutinin (Con A); this is a feature of normal salivary gland ducts but is seen in other salivary gland tumours. Staining of tumour cells at the luminal surface of ductal structures with wheat germ (Triticum vulgaris) agglutinin (WGA) in the cat tumours was similar to that seen in ducts of normal cat salivary glands but occurs in other cat tumours. Other immunohistochemical staining results were unremarkable. 1999 Harcourt Publishers Ltd.

Multiple idiopathic internal resorption.

A very rare case is presented of multiple idiopathic internal resorption, which progressively involved all the mandibular incisor teeth.

Oral manifestation of Rett's syndrome.

Severe dental attrition has several causes but may be the result of bruxism in neurological or psychological disturbances. Rett's syndrome is an uncommon but increasingly recognised neurological disorder, characterised by acquired microcephaly, progressive dementia, bruxism, and loss of purposeful movements of the hands. A patient with Rett's syndrome who demonstrated masseteric hypertrophy, bruxism, and severe attrition is reported.

Adenomatoid hyperplasia in the palate: another sheep in wolf's clothing.

Adenomatoid hyperplasia is a rare idiopathic non-inflammatory, non-neoplastic and benign lesion of minor salivary glands, that typically presents with a tumour-like mass in the palate. A 77-year-old patient is described.

Munchausen's syndrome: oral presentations.

Munchausen's syndrome is a rare psychiatric disorder in which patients repeatedly confabulate so as to cause unnecessary investigations and operative treatments to be carried out on them. Two cases are reported and the literature reviewed. The first patient complained of repeated dental pain and subsequently underwent repeated endodontic treatment; the second had salivary gland pain and glossopharyngeal neuralgia. Munchausen's syndrome can only be diagnosed by the exclusion of organic and other disease.

Adenoid cystic carcinoma of the sublingual salivary gland in a 16-year-old female--report of a case and review of the literature.

Tumours of the sublingual salivary gland are exceptionally rare. The present case report describes an adenoid cystic carcinoma of the sublingual salivary gland occurring in a 16-year-old girl, in itself an uncommon event. In addition, an interesting feature of the presentation was obstruction of the ipsilateral submandibular gland due to involvement of Wharton's duct.

Intramuscular capillary hamartoma of the tongue.

Intramuscular vascular lesions in the tongue are rare and are usually the capillary form of haemangioma. A case is described of a lingual mass that resembled intramuscular haemangioma but had unique histological features that do not appear to have been described previously. The term intramuscular capillary hamartoma is suggested to describe it.

Papillary adenocarcinoma of the middle ear.

A case of papillary adenocarcinoma of the middle ear is presented. The patient had an unusually short history of otalgia, aural discharge and facial palsy, and, at presentation the tumour was too large for surgical resection to be a feasible option. The management of this rare tumour is discussed and the relevant literature reviewed.

Solitary infantile myofibromatosis.

Infantile myofibromatosis is an uncommon, benign, probably hamartomatous proliferation of myofibroblasts. Its growth is typically self-limiting but histologically it can simulate a sarcoma. A rare case of solitary infantile myofibromatosis presenting as an intraoral mass in a 10-year-old girl is reported.