Dendritic cell subpopulations in carcinoma ex-pleomorphic adenoma: A multicenter study.

OBJECTIVE: Carcinoma ex-pleomorphic adenoma (CEXPA) represents a malignant transformation from a recurrent or primary pleomorphic adenoma (PA), and the immune response may be essential in this process. Therefore, in this study, we aimed to identify and quantify subpopulations of dendritic cells (DCs) in CEXPA, residual PA in CEXPA (rPA), and PA. MATERIALS AND METHODS: A multicenter study was performed collecting salivary gland tumor (SGT) samples from three Oral and Maxillofacial Pathology Centers. A tissue microarray containing 41 samples of CEXPA and 22 samples of PA was included in this study and submitted to immunohistochemical reactions against CD1a, CD83, CD207, and Ki67 antibodies. RESULTS: Both PA and rPA showed a higher quantification of CD207+ and CD83+ cells when compared to CEXPA (p < 0.001 and p < 0.01, respectively). There was also a difference when comparing the cell proliferation index between PA/rPA and CEXPA using the Ki-67 marker (p = 0.043). However, there was no difference in the DC population regarding clinical parameters such as sex, anatomical location, size, and metastases (p > 0.06). CONCLUSIONS: Immunohistochemical profile of DC subpopulations and cell proliferation biomarkers in SGTs can contribute as an important tool in the differentiation of benign and malignant tumors or detection of initial areas with malignant transformation.

Traumatic ulcerative granuloma with stromal eosinophilia mimicking a squamous cell carcinoma.

Traumatic ulcerative granuloma with stromal eosinophilia (TUGSE) is a rare lesion of a traumatic-reactive nature of the oral mucosa that can clinically mimic an oral carcinoma. A 59-year-old male patient presented painful ulceration with indurated margins on the base of the tongue, extending to the floor of the mouth. The use of ill-fitting denture hurting the mucosa of the region was reported by the patient. The evolution time was 45 days. The presumptive diagnoses were oral squamous cell carcinoma and chronic ulcer. An incisional biopsy revealed an ulceration associated with an eosinophil-rich inflammatory infiltrate and a bed of proliferating histiocyte-like cells in either diffuse or fasciculate arrangement. There was diffuse immunopositivity for CD3, but focal for CD68 and α-SMA, and negativity for CD30. The final diagnosis was TUGSE. The use of the ill-fitting dental prosthesis was suspended and the lesion had complete spontaneous remission three weeks later. TUGSE is an uncommon traumatic self-limiting lesion that must be included in the differential diagnosis of ulcerative lesions resembling oral cancer. The correlation of clinical and histopathological findings is pivotal for a proper diagnosis, avoiding unnecessary aggressive surgical approaches. Key words:Oral ulcer, eosinophilia, immunohistochemical, differential diagnosis.

Oral granular cell tumor: a collaborative clinicopathological study of 61 cases.

BACKGROUND: Granular Cell Tumor (GCT) is an uncommon benign lesion in the oral cavity whose pathogenesis remains poorly understood. Due to their infrequent occurrence and similarity to other oral lesions, they are often forgotten during the initial clinical diagnosis. Therefore, understanding its prevalence, clinical and pathological characteristics is crucial for an accurate diagnosis and adequate management. METHODS: All cases diagnosed as GCTs in six Brazilian and Argentinian oral diagnostic centers were re-evaluated by HE staining, and clinical, demographic, and histopathological data were collected and evaluated. RESULTS: The series comprised 45 female (73.8%) and 16 male (26.2%), with a 2.8:1 female-to-male ratio and a mean age of 35.3 ± 16.9 years (range: 7-77 years). Most cases occurred on the tongue (n = 49; 81.6%) and presented clinically as asymptomatic papules or nodules (n = 50; 89.3%) with a normochromic (n = 25; 45.5%) or yellowish (n = 11; 20.0%) coloration and sizes ranging from 0.2 to 3.0 cm (mean ± SD: 1.40 ± 0.75 cm). Morphologically, most tumors were characterized by a poorly delimited proliferation (n = 52; 88.1%) of cells typically rounded to polygonal containing abundant, eosinophilic, finely granular cytoplasm. Pustulo-ovoid bodies of Milian were identified in all lesions (n = 61; 100%). Entrapment of skeletal striated muscle (n = 44; 72.1%) and nerve fibers (n = 42; 68.9%) were common findings. Pseudoepitheliomatous hyperplasia (PEH) was observed in 23 cases (39.0%). In only 27.7% of cases (n = 13) there was agreement between the clinical and histopathological diagnosis. Outcome information was available from 16 patients (26.2%), with clinical follow-up ranging from 4 to 36 months (mean 13.3 months), and none developed local recurrence. CONCLUSIONS: The clinical and histopathological features of GCTs were consistent with those described in previous studies. In general, these lesions have a predilection for the lateral region of the tongue in adult women. It is essential to consider GCTs in the differential diagnosis of yellow or normochromic papules and nodules in the oral cavity. Histopathological evaluation is essential for the definitive diagnosis and the prognosis is excellent.

Clinicopathologic and imaging features of odontogenic myxomas: a multi-institutional study.

PURPOSE: This study aims to report clinicopathologic and imaging features of odontogenic myxomas (OM), highlighting uncommon findings. METHODS: Clinicopathologic and imaging data of OMs diagnosed in the five Brazilian diagnostic pathology centers were collected and analyzed. RESULTS: The series comprised 42 females (68.9%) and 19 males (31.1%), with a 2.2:1 female-to-male ratio and a mean age of 34.5±15.4 years (range: 4-80). Clinically, most OMs presented as painless intraoral swelling (n = 36; 70.6%) in the mandible (n=37; 59.7%). Multilocular lesions (n=30; 83.3%) were more common than unilocular lesions (n=6; 16.7%). There was no statistically significant difference between the average size of unilocular and multilocular OMs (p=0.2431). The borders of OMs were mainly well-defined (n=24; 66.7%) with different degrees of cortication. Only seven tumors caused tooth resorption (15.9%), while 24 (54.5%) caused tooth displacement. Cortical bone perforation was observed in 12 (38.7%) cases. Morphologically, OMs were characterized mainly by stellate or spindle-shaped cells in a myxoid background (n=53; 85.5%). Surgical resection was the most common treatment modality (n=15; 65.2%), followed by conservative surgery (n=8; 34.8%). Outcomes were available in 20 cases (32.3%). Seven of these patients had local recurrence (35%). Enucleation was the treatment with the highest recurrence rate (4/7; 57.1%). CONCLUSIONS: OM has a predilection for the posterior region of the jaws of female adults. Despite their bland morphological appearance, they displayed diverse imaging features. Clinicians must include the OM in the differential diagnosis of osteolytic lesions of the jaws. A long follow-up is needed to monitor possible recurrences.

Oral mucoceles: A Brazillian Multicenter Study of 1,901 Cases

Abstract Oral mucocele (OM) is the most common lesion of minor salivary glands. The present study aimed to report the clinical and demographic features of a large series of OMs and identify possible predictive variables associated with the recurrence rate of these lesions. A retrospective descriptive cross-sectional study was performed. A total of 43,754 biopsy records from four pathology services in Brazil were analyzed. All cases of OMs were reviewed, and clinical and demographic data were collected. The study comprised 1,002 females (56.2%) and 782 males (43.8%), with a mean age of 19.8±16.4 years (range: 01-87 years) and a 1.3:1 female-to-male ratio. The lower lip (n=1,160; 67.4%), and floor of the mouth (n=172; 10.0%), were the most common affected sites, presenting clinically as nodules (n=978; 79.4%) of smooth surface (n=428; 77.5%) and normal color (n=768, 46.7%). Excisional biopsy was the treatment in most cases (n=1,392; 78.0%). Recurrent OMs represented 6.2% of all diagnosed cases (n=117). OMs recurred more commonly in younger patients (aged<20 years) (p<0.0001), in lesions larger than 2 cm in diameter (p<0.0001), and in those located in the ventral tongue (p=0.0351). Also, recurrence rates were higher significantly in cases treated with laser surgery than in those with conventional surgery (p=0.0005). Patients with OMs should be carefully informed of its possible recurrence, especially when found on the ventral tongue of young patients.

Resumo A mucocele oral (MO) é a lesão mais comum das glândulas salivares menores. O presente estudo teve como objetivo relatar as características clínicas e demográficas de uma grande série de MOs e identificar possíveis variáveis preditivas associadas à taxa de recorrência dessas lesões. Foi realizado um estudo transversal descritivo retrospectivo. Foram analisados 43.754 registros de biópsias de quatro serviços de patologia no Brasil. Todos os casos diagnosticados como MOs foram revisados e dados clínicos e demográficos foram coletados. Participaram do estudo 1.002 mulheres (56,2%) e 782 homens (43,8%), com média de idade de 19,8 ± 16,4 anos (variação: 01-87 anos) e proporção de mulheres para homens de 1,3:1. O lábio inferior (n=1.160; 67,4%) e assoalho da boca (n=172; 10,0%), foram os locais mais acometidos, apresentando-se clinicamente como nódulos (n=978; 79,4%) de superfície lisa (n =428; 77,5%) e coloração normal (n=768, 46,7%). A biópsia excisional foi o tratamento na maioria dos casos (n=1.392; 78,0%). As MOs recorrentes representaram 6,2% de todos os casos diagnosticados (n = 117). As recorrências recorreram mais comumente em pacientes mais jovens (idade < 20 anos) (p < 0,0001), em lesões maiores que 2 cm de diâmetro (p < 0,0001) e naquelas localizadas na superfície ventral da língua (p = 0,0351). Além disso, as taxas de recorrência foram significativamente maiores nos casos tratados com cirurgia a laser do que aqueles com cirurgia convencional utilizando bisturi (p = 0,0005). Pacientes com mucoceles devem ser informados sobre uma possível recorrência, principalmente quando encontrados no lábio ou assoalho bucal de pacientes jovens.

Ameloblastoma em região anterior de mandíbula / Ameloblastoma anterior de la mandíbula / Anterior mandibular ameloblastoma

Introdução: O ameloblastoma é uma neoplasia benigna, mas localmente invasiva, geralmente diagnosticada na quarta e quinta décadas, com relação à localização em 80 porcento dos casos, o tumor está na mandíbula e 20 porcento na maxila. É classificada histopatologicamente como células foliculares, plexiformes, acantomatosas, granulares e basais. O ameloblastoma desmoplásico foi reclassificado como subtipo histológico. Radiograficamente, pode ser mostrado de maneira unicística ou multicística, onde geralmente é descrito como favos de mel ou bolhas de sabão. Objetivo: O objetivo deste trabalho é relatar um caso de ameloblastoma com características clínicas e de imagem incomuns, enfatizando a importância diagnóstico correto como estratégia para garantir tratamento adequado e melhor prognóstico da doença. Apresentação do caso: Paciente branca, 72 anos, moradora da cidade de Itabaiana-Sergipe, queixou-se do aumento de volume na região da mandíbula anterior de desenvolvimento lento. Ela foi encaminhada ao do Campus do Hospital Universitário Prof. João Cardoso Nascimento, Aracaju / Sergipe. A tomografia computadorizada mostrou uma área multilocular hipodensa, localizada na região anterior da mandíbula, e uma biópsia incisional realizada juntamente com exames de imagem, o seguinte diagnóstico de ameloblastoma folicular foi concluído com uma extensa área de degeneração cística. Decidiu-se realizar uma cirurgia para remover completamente a lesão em centro cirurgico, formou-se uma extensa aloja ossea, por isso foi decidido aplicar em sua extensão a solução de Carnoy. Conclusões: Este relato é altamente relevante por apresentar um caso que contradiz os fatos existentes e aumenta a importância de se fazer um diagnóstico correto, é importante enfatizar que, embora o comportamento das lesões que afetam a cavidade oral seja bem conhecido, é extremamente importante estuda-las(AU)

Introducción: El ameloblastoma es una neoplasia benigna pero localmente invasiva, generalmente diagnosticada en las décadas cuarta y quinta. En el 80 por ciento de los casos el tumor está localizado en la mandíbula y el 20 por ciento, en el maxilar. Se clasifica histopatológicamente en folicular, plexiforme, acantomatoso, células granulares y células basales. El ameloblastoma desmoplásico se ha reclasificado como un subtipo histológico. Radiográficamente se puede mostrar de forma unicista o multiquística, donde generalmente se describe como panales o pompas de jabón. Objetivo: Describir un caso de ameloblastoma con características clínicas y de imagen poco comunes. Presentación del caso: Paciente blanca, de 72 años, que vivía en la ciudad de Itabaiana-Sergipe, se quejó del aumento de volumen (de desarrollo lento) en la región de la mandíbula anterior. La tomografía computarizada mostró un área hipodensa, multilocular, ubicada en la región mandibular anterior. Se realizó una biopsia incisional, además de los exámenes por imágenes. Se diagnosticó ameloblastoma folicular con un área extensa de degeneración quística. Se decidió realizar una cirugía de extirpación completa de la lesión, luego de la extracción de la misma se formó un alojamiento óseo circular, por lo que se decidió aplicar la solución de Carnoy. Conclusiones: Este informe tiene una gran relevancia porque presenta un caso que contradice los hechos existentes y plantea la importancia de hacer un diagnóstico correcto. Aunque el comportamiento de las lesiones que afectan la cavidad oral es bien conocido, es extremadamente importante continuar estudiándolas(AU)

Introduction: Ameloblastoma is a benign but locally invasive neoplasm generally diagnosed in the fourth and fifth decades of life. Its location is the mandible in 80 percent of the cases and the maxilla in 20 percent. Histopathologically, it may be classified as follicular, plexiform, acanthomatous, granular cells or basal cells. Desmoplastic ameloblastoma has been further classified as a histological subtype. Radiographically, it presents as either unicystic or multicystic, in which case it resembles a honeycomb or soap bubbles. Objective: Describe a case of ameloblastoma with uncommon clinical and imaging characteristics. Case presentation: A white female 72-year-old patient from the city of Itabaiana, Sergipe, presented with increased volume (of slow development) in her anterior mandibular region. Computed tomography revealed a hypodense, multiloculated area in the anterior mandibular region. Incisional biopsy and imaging tests were performed. The diagnosis was follicular ameloblastoma with a broad area of cystic degeneration. It was decided to perform total excision of the lesion. A circular bone housing was formed, which was treated with Carney's solution. Conclusions: The present report is of great relevance, since a case is described which contradicts the existing facts and points to the importance of making a correct diagnosis. Although the behavior of oral cavity lesions is well known, it is extremely important to continue to study them(AU)

Primary melanoma of the oral cavity: A multi-institutional retrospective analysis in Brazil / Melanoma primario de la cavidad bucal: Un análisis retrospectivo multiinstitucional en Brasil

Background: Melanoma is an aggressive malignant tumor, rarely observed in the oral cavity. The aim of this studywas to describe the clinicopathologic features of a series of oral melanomas.Material and Methods: A retrospective descriptive study was performed. A total of 15,482 biopsy records from twooral and maxillofacial pathology services in Brazil were analyzed. All cases of oral melanomas were reviewed,and clinical, demographic, histopathological data, treatment, and follow-up status were collected. In addition, im-munohistochemistry stains (pan-cytokeratin AE1/AE3, vimentin, α-SMA, CD45, S-100 protein, HMB-45, MelanA, and Ki-67) were performed Results: The series comprised of 5 males (71.4%) and 2 females (28.6%), with a mean age of 58.0 ± 9.2 years (range:45-69 years) and a 2.5:1 male-to-female ratio. The gingiva (n = 3, 42.8%) and hard palate (n = 2, 28.6%) were the mostcommon affected sites, presenting clinically as ulcerated swellings with a brown to black color. Cervical lymph nodemetastasis was detected in three patients during the first examination. Microscopically, 6 cases (85.7%) were mela-notic, and one (14.3%) was amelanotic. Most cases (n = 4, 57.1%) presented a predominance of epithelioid cells. S-100and HMB-45 were positive in all cases (n = 7, 100.0%). In contrast, only 4 cases (57.1%) were positive for Melan-A.The proliferative index with Ki-67 was high, with labeling index ranging from 70.0% to more than 90% of positivecells. Five patients died from complications of the tumors after a mean follow-up period of 7.8 months.Conclusions: Melanoma is an aggressive malignant tumor that rarely occurs in the oral cavity. It occurs mainly inadult and elderly patients and often is diagnosed in advanced stages. The current findings were similar to previousstudies and reflected the characteristics of the services from where lesions were retrieved.(AU)

Generalized hereditary gingival fibromatosis in a child: clinical, histopathological and therapeutic aspects

Hereditary gingival fibromatosis (HGF) is a rare genetic condition characterized by slow and progressive gingival enlargement. The gingival overgrowth often delays teeth eruption and may cause serious functional and aesthetic problems. We reported a case of a 10-year-old female child presenting a generalized gingival enlargement covering almost all the maxillary and mandibular teeth and resulted in problems for swallowing, speaking, and poor aesthetics. An incisional biopsy was performed and revealed a hypocellular and hypovascular dense collagenous tissue covered by squamous epithelium exhibiting acanthosis and elongated rete ridges. The diagnosis was HGF. The treatment instituted was an association of gingivectomy with a rigorous program of oral hygiene and follow-up. Herein, we describe a rare non-syndromic case of generalized HGF, including clinical and microscopical features, as well as highlighting the importance of correct diagnosis of this genetic condition.

Fasceíte necrotizante de origem odontogênica na região cérvico-facial: Relato de caso / Odontogenic cervico-facial necrotizing fasciitis. A case report / Fascitis necrosante cervical-facial originada por infección odontogénica. Reporte del caso

Resumo A fasceite necrotizante é caracterizada como um subconjunto das infecções agressivas da pele e tecidos moles que causam necrose da fáscia muscular e dos tecidos subcutâneos. Tem origem polimicrobiana e apresenta extensa necrose que exibe uma formação gasosa no tecido subcutâneo e fáscia superficial. É fundamental um rápido diagnóstico, seguido de intervenção cirúrgica imediata e antibioticoterapia sistêmica para que se consiga sucesso no tratamento. O objetivo desse artigo é relatar um caso de fasceíte necrotizante em região cérvico-facial com origem odontogênica, ressaltando a importância do diagnóstico e tratamento precoce.

Abstract Necrotizing fasciitis is characterized as a subset of aggressive infections of the skin and soft tissues that cause necrosis of the muscular fascia and subcutaneous tissues. It has a polymicrobial origin and presents an extensive necrosis that exhibits gas formation in the subcutaneous tissue and superficial fascia. The management of infected tissues requires rapid diagnosis, immediate surgical intervention accompanied by extensive debridement and systemic antibiotic therapy. The aim of this paper is to relate a case of an odontogenic necrotizing fasciitis of the cervico-facial region emphasizing the importance of early diagnosis and treatment.

Resumen La fascitis necrotizante es una infección rara y de tejidos blandos caracterizada por una infección de rápida propagación del tejido subcutáneo y, en particular, de la fascia. La fascitis necrotizante tiene un origen polimicrobiano y una necrosis extensa que exhibe formación gaseosa en el tejido subcutáneo y la fascia superficial. El manejo de los tejidos infectados requiere un diagnóstico rápido, una intervención quirúrgica inmediata acompañada de un desbridamiento prolongado y una terapia antibiótica sistémica. El objetivo de este trabajo es relatar un caso raro de fascitis necrotizante de la región cervical-fascial, haciendo hincapié en la importancia del diagnóstico y el tratamiento temprano.

Epidemiologic analysis of salivary gland tumors over a 10-years period diagnosed in a northeast Brazilian population

BACKGROUND: Salivary gland tumors (SGT) correspond to a heterogeneous group of lesions with variable biological behavior. The present study aimed to determine the distribution and demographic findings of salivary gland neoplasms in a northeast Brazilian population. MATERIAL AND METHODS: A retrospective descriptive cross-sectional study was performed. A total of 588 cases of SGT were diagnosed between 2006 and 2016 of 4 pathology services in the state of Sergipe, Brazil. All cases were reviewed, and data such as sex, age, anatomical location, and histopathological diagnosis were collected. RESULTS: A total of 470 (79.9%) tumors were benign and 118 (20.1%) were malignant. The majority of the patients were females (n = 328, 55.8%) with an overall female: male ratio of 1.2:1. The major salivary glands were affected more than the minor glands (69.5% vs. 30.5%). Pleomorphic adenoma (n = 419, 71.3%) and mucoepidermoid carcinoma (n = 29, 4.9%) were the most frequent benign and malignant tumors, respectively. In addition, both benign and malignant tumors occurred more frequently in the parotid gland (n = 300, 51%, p < 0.05). CONCLUSIONS: The epidemiologic profile and clinical characteristics of SGT were similar to those described in other countries and other regions of Brazil. Epidemiological studies of SGT help to understand their clinical and pathological features and are essential to establish the proper management and prognosis

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Assessment of carvacrol paste as endodontic medication associated with laser photobiomodulation in tissue repair: an experimental study in rats / Avaliação da pasta de carvacrol como medicação endodôntica associada à fotobiomodulação a laser no reparo: um estudo experimental em ratos

This study aimed to analyze the tissue reaction caused by carvacrol paste associated or not with laser photobiomodulation (LPBM) at λ660 nm in the subcutaneous tissue of rats. Sixty Wistar rats were divided into four groups and they received the following interventions: subcutaneous implantation of empty polyethylene tubes (CTR), implantation of tubes containing carvacrol paste (CVC), implantation of empty tubes and LPBM (LLLT), and implantation of tubes containing carvacrol paste and LPBM (CVCLT). The animals were euthanized at three, eight, and 15 days after surgery. The inflammatory reaction and fibroplasia were analyzed histomorphometrically. Significant differences among the groups were determined by ANOVA and Tukey's test (p<0.05). In the 3-day period, the CVCLT group had low inflammatory infiltration (p<0.01). In the 8- and 15-day periods, the LLLT and CVCLT groups presented a low amount of lymphocytic inflammatory infiltrate (p<0.01 and p<0.05). Regarding the formation of fibrous tissue, the CVC group had the highest formation of type III collagen in the 8-day period (p<0.001). In the 15-day period, the CVCLT group had a lower formation of type I collagen than the CTR and LLLT groups (p<0.05). The use of the carvacrol paste associated with photobiomodulation optimizes the inflammatory period and tissue repair.

Este estudo teve como objetivo analisar a reação tecidual causada pela pasta de carvacrol associada ou não à fotobiomodulação a laser (LPBM) a λ660 nm no tecido subcutâneo de ratos. Sessenta ratos Wistar foram divididos em quatro grupos e receberam as seguintes intervenções: implantação subcutânea de tubos de polietileno vazios (CTR); implantação de tubos contendo pasta de carvacrol (CVC); implantação de tubos vazios e LPBM (LLLT); implantação de tubos contendo pasta de carvacrol e LPBM (CVCLT). Os animais foram eutanasiados aos 03, 08 e 15 dias após a cirurgia. A reação inflamatória e a fibroplasia foram analisadas histologicamente. Diferenças significativas entre os grupos foram determinadas pelo teste ANOVA e teste de Tukey (p<0,05). No período de três dias, o grupo CVCLT apresentou menor infiltração inflamatória (p<0,01). No período de 8 e 15 dias, os grupos LLLT e CVCLT apresentaram menor quantidade de infiltrado inflamatório linfocitário (p<0,01 e p<0,05). Em relação à formação de tecido fibroso, o grupo CVC apresentou maior formação de colágeno tipo III no período de 8 dias (p<0,001). No período de 15 dias, o grupo CVCLT apresentou menor formação de colágeno tipo I em relação aos grupos CTR e LLLT (p<0,05). O uso da pasta de carvacrol associado à fotobiomodulação a laser otimiza o período inflamatório e o reparo tecidual.

Diagnosis, management, and follow-up of extensive dermoid cyst of the submental region

Dermoid cyst (DC) is a cystic lesion of developmental origin and uncertain etiology that rarely affects the floor of the mouth. We report a case of a large lesion found in the submental and submandibular region in a 25-year-old male patient. Computed tomography revealed extensive hypodense lesion in the submental and submandibular space without peripheral enhancement. The microscopical analysis showed a cystic cavity lined by orthokeratinized stratified squamous epithelium. The cystic capsule was composed of dense fibrous connective tissue containing cutaneous attachments, such as sebaceous and sweat glands. The diagnosis of DC was made. The differential diagnosis of expansive sublingual lesions can be clinically challenging due to the similarity with several lesions frequently observed in this region. Herein, we describe a case of extensive DC arising in the floor of the mouth, presenting clinical, imaging, and microscopical features.

Effects of different protocols of low-level laser therapy on collagen deposition in wound healing

Abstract The low-level laser has proven successful in stimulating the production of collagen in wound healing assays. However, diversity has been observed in the protocols used. This work has evaluated the effects of three protocols of low-level laser therapy (LLLT) in the healing of open wounds in rats. Standard-sized wounds of 1 cm2 were performed with a scalpel in the middorsal region of 60 male Wistar rats weighing 225±25 g, and they were assigned into four groups (n=15): CTR (non-irradiated animals), LT1 (20 J/cm2 daily), LT2 (16 J/cm2 daily) and LT3 (20 J/cm2 daily). After 7, 14 and 21 days, five animals/day were euthanized and the wounds analyzed histologically. Data were subjected to normality analysis of distribution using Shapiro-Wilk test. Gaussian data were analyzed using ANOVA and Bonferroni tests whereas non-Gaussian data were analyzed using Kruskal-Wallis and Dunn tests, considering significant p values less than 0.05. The LLLT in all protocols reduced the inflammation and collagen deposition increased significantly (p<0.05). However, LT2 showed the highest levels of collagen in all phases of the study (p<0.05) induced faster replacement of immature collagen III by mature collagen I in the early stages of repair and early collagen remodeling promoted by providing better organization architectural beams deposited. It was concluded that all protocols induced an increase in collagen scar. However, the protocol 2 (16 J /cm2, daily application) promoted the most significant increases in collagen deposition, accelerated maturation of collagen and showed the best architecture of the final fibrous scarring.

Resumo O laser de baixa potência provou ter sucesso em estimular a produção de colágeno em ensaios de cicatrização de feridas. Entretanto, grande diversidade tem sido observada nos protocolos utilizados. Este trabalho avaliou os efeitos de três protocolos de Terapia a Laser de Baixa Potência (TLBP) na cicatrização de feridas abertas em ratos. Feridas padronizadas com 1 cm2 de tamanho foram realizadas com um bisturi na região do dorso de 60 ratos Wistar machos pesando 225±25g, e foram divididos em quatro grupos (n=15): CTR (animais não irradiados), LT1 (20 J/cm2 diariamente), LT2 (16 J/cm2 diariamente) e LT3 (20 J/cm2 diariamente). Após 7, 14 e 21 dias, cinco animais/dia foram eutanasiados e as feridas analisadas histologicamente. Os dados foram submetidos à análise de normalidade da distribuição pelo teste de Shapiro-Wilk. Os dados gaussianos foram analisados pelos testes ANOVA e Bonferroni, enquanto que os dados não Gaussianos foram analisados pelos testes de Kruskal-Wallis e Dunn, considerando-se valores p significativos menores que 0,05. A TLBP em todos os protocolos reduziu a inflamação e aumentou significativamente a deposição de colágeno (p<0,05). Entretanto, LT2 apresentou os maiores níveis de colágeno em todas as fases do estudo (p<0,05), induzindo a substituição mais rápida do colágeno imaturo III pelo colágeno maduro I nos estágios iniciais de reparo e remodelação precoce do colágeno promovida por melhor organização dos feixes depositados. Concluiu-se que todos os protocolos induziram aumento da cicatriz de colágeno. Entretanto, o protocolo 2 (16 J/cm2, aplicação diária) promoveu os aumentos mais significativos na deposição de colágeno, acelerou a maturação do colágeno e apresentou a melhor arquitetura da cicatriz fibrosa final.

Plasma cell cheilitis: the diagnosis of a disorder mimicking lip cancer

Plasma cell cheilitis (PCC) is an inflammatory disorder of unknown etiology that affects the lip. It is characterized histologically by a dense infiltrate of plasma cells with a variety of clinical features. The response to different therapeutic modalities is controversial, especially regarding the effectiveness of corticosteroids. We present a case of a 56-year-old Caucasian man with a painful ulcerated and crusted area in the lower lip, resembling a squamous cell carcinoma or actinic cheilitis. Topical corticosteroid was used for one week, which resulted in partial regression and motivated a biopsy. The histological examination provided the diagnosis of PCC. The patient has been disease-free for six months. We also provide a discussion on the criteria of differential diagnosis and management of this rare condition.

Late Diagnosis of Oral Melanoma / Diagnóstico Tardío de Melanoma Oral

ABSTRACT: Oral melanoma (OM) is an extremely rare and aggressive malignancy. A 67-year-old patient presented with complains of a slightly symptomatic spot in the mouth since the past 2 years. Extraoral examination revealed left cervical lymphadenopathy, and intraoral examination a blue-black multinodular sessile mass, with irregular margins, involving the attached gingiva of teeth 27 and 28, extending to vestibular sulcus and hard palate, measuring approximately 3.5 cm. The lesion presented focal areas of ulceration. Panoramic radiograph did not show bone involvement. The main diagnostic hypothesis was oral melanoma. Microscopic findings of the incisional biopsy revealed a proliferation of densely pigmented pleomorphic cells, invading the subepithelial connective tissue in sheets or nests showing an organoid pattern. Immunopositivity for S-100, Melan-A and HMB-45 confirmed the diagnosis of melanoma. The patient was referred to an oncology hospital in which multiple metastases were detected, and the patient was subjected to palliative care. Herein we report an OM in advanced clinical stage, and discuss the clinical, morphological and immunohistochemical diagnostic criteria with emphasis on the importance of early diagnosis.

RESUMEN: El melanoma oral (MO) es una malignidad extremadamente rara y agresiva. Un paciente de 67 años acudió a consulta con la queja de una mancha intraoral ligeramente sintomática, presente desde hace dos años. Al examen clínico extraoral, se encontró adenopatía cervical del lado izquierdo, y al examen intraoral, se observó una masa sésil multinodular de color negro azulado, focalmente ulcerada, con bordes irregulares, afectando la encía de los dientes 27 y 28, extendiéndose hasta el surco vestibular y el paladar duro, midiendo aproximadamente 3,5 cm. La radiografía panorámica no mostró involucramiento óseo. La principal hipótesis diagnóstica fue MO. Los hallazgos microscópicos de la biopsia incisional revelaron una proliferación de células pleomórficas densamente pigmentadas, invadiendo difusamente el tejido conectivo en forma de sábanas o nidos con patrón organoide. La positividad inmunohistoquímica para S-100, Melan-A y HMB-45 confirmó el diagnóstico de melanoma. El paciente fue referido a un hospital oncológico, en el cual se le detectaron múltiples metástasis y fue sometido a cuidados paliativos. Este es el reporte de un caso de MO diagnosticado en estado avanzado, en el que se discuten los criterios clínicos, morfológicos e inmunohistoquímicos para su diagnóstico, haciendo énfasis en la importancia del diagnóstico temprano.

Fibroma odontogênico central em mandíbula: relato de caso com breve revisão da literatura / Central odontogenic fibroma in mandible: case report with short literature review

O fibroma odontogênico central é definido como uma neoplasia benigna dos maxilares caracterizada por apresentar uma quantidade variável de epitélio odontogênico inativo em meio a um estroma de tecido conjuntivo fibroso. É considerada uma neoplasia rara que representa de 0% a 5,5% de todos os tumores odontogênicos na maioria dos estudos retrospectivos encontrados na literatura. Acomete pacientes em uma ampla faixa etária com certa predominância em indivíduos do sexo feminino. Apresenta-se, na grande maioria dos casos, como uma lesão de crescimento lento e assintomático que pode promover abaulamento das corticais ósseas adjacentes. Do ponto de vista radiográfico, aparece, tipicamente, sob a forma de uma imagem radiolúcida uni ou multilocular com margens bem definidas, podendo apresentar focos de calcificação em seu interior. O fibroma odontogênico central é subdividido histologicamente em tipo simples (pobre em epitélio) e tipo OMS (rico em epitélio). A lesão responde bem ao tratamento cirúrgico conservador por enucleação associada à curetagem, sendo as recidivas muito incomuns. Esse trabalho tem o objetivo de fazer uma breve revisão de literatura a respeito das características epidemiológicas, clínico-imaginológicas e histopatológicas desta lesão e relatar um caso diagnosticado num paciente do sexo masculino, 13 anos, com queixa de aumento de volume em mento. Os exames de imagem evidenciaram a presença de defeito osteolítico bem delimitado em região de sínfise mandibular associado aos elementos dentários 33 e 43 que se apresentavam inclusos. A lesão foi submetida à enucleação e curetagem. O paciente encontra-se em proservação há dois anos sem sinais de recidiva da lesão.

The central odontogenic fibroma is defined as a benign neoplasm of the jaws characterized by having a variable amount of inactive odontogenic epithelium in the midst of a fibrous connective tissue stroma. It is considered a rare neoplasm that is from 0% to 5.5% of all odontogenic tumors in most retrospective studies found in the literature. Affects patients in a wide age range with a certain predominance in females. , Is shown in most cases, as a slow-growing lesions and asymptomatic which can promote the bulging adjacent cortical bone. The radiographic point of view, appears typically in the form of an image radiolucent uni or multilocular with well-defined margins and may have foci of calcification inside. The central odontogenic fibroma is subdivided histologically in simple type (poor epithelium) and WHO type (rich in epithelium). The injury responds well to conservative treatment by surgical enucleation associated with curettage, and the very unusual relapses. This work aims to make a brief review of literature on the epidemiological, clinical and histopathological imaginological this injury and to report a case diagnosed in a male patient, 13, with volume up complaint ment. Imaging tests showed the presence of well-defined osteolytic defect in mandibular symphysis region associated with dental elements 33 and 43 who performed included. The lesion was submitted to enucleation and curettage. The patient is under observation for two years without signs of recurrence.

Spindle cell carcinoma of the tongue: a case report in a young patient / Carcinoma de células fusiformes da língua: relato de caso em paciente jovem

Spindle cell carcinoma (SpCC) is a rare biphasic tumor of epithelial origin that comprises squamous and sarcomatoid components. The diagnosis may be challenging, particularly when the squamous differentiation is not obvious. SpCC of the tongue has rarely been reported. Here we report a case of SpCC on the right border of the tongue of a 28-year-old male. The diagnosis was based on the correlation of clinical, morphological, and immunohistochemical findings. We describe this rare tumor, present at an unusual location in a young patient to contribute to better understanding and awareness of this rare malignancy.

O carcinoma de células fusiformes (CCF) é um tumor bifásico raro de origem epitelial que compreende componentes escamosos e sarcomatoides. O diagnóstico pode ser desafiador, particularmente quando a diferenciação escamosa não é óbvia. Relatos de CCF em língua são extremamente raros. Aqui é relatado um caso de CCF na borda direita da língua de um homem de 28 anos de idade. O diagnóstico foi baseado na correlação de achados clínicos, morfológicos e imunohistoquímicos. Com a descrição deste caso clínico, em uma localização anatômica incomum e em um paciente jovem, pretende-se contribuir para uma melhor compreensão e conhecimento deste tumor maligno raro.

Effects of the essential oil of Alpinia zerumbet (Pers.) B.L. Burtt & R.M. Sm. on healing and tissue repair after partial Achilles tenotomy in rats

Abstract Purpose: To investigate the cellular response to injury, analyzing histopathologic changes associated with increased cellularity, degeneration and disorganization of collagen fibers. Methods: Thirty wistar rats were divided in two groups after partial Achilles tenotomy: the right hind paw were treated with the essential oil of Alpinia zerumbet (EOAz), diluted to 33% (0.3 mL kg-1), and the left hind paw received sunflower oil for 3, 14, 30 and 90 days. Statistical significance was determined using a Chi-square and Pearson Correlation qualitative variables test. Moreover, Mann-Whitney U-test test for comparison between different groups of the same cell, one-way ANOVA, and Tukey's test of quantitative measurement. Results: A decrease hyperemia (p < 0.001) was observed in the acute phase of inflammatory cell number (p < 0.001), whereas sub-acute phase was marked by significant correlation with macrophages in fibroblasts (r = 0.17, p = 0.03), with probable induction a dense and modeled tissue. At chronic phase, it was found an increase in the number of fibroblasts and a higher percentage of type I collagen fibers (78%) compared with control collagen fibers (55%). Conclusion: Oil of Alpinia zerumbet stimulated the process of maturation, organization and tissue repair which gave it greater resistance.

Experimentation with psychoactive substances by public school students / Experimentação de substâncias psicoativas por estudantes de escolas públicas

ABSTRACT OBJECTIVE To analyze the prevalence of exposure to psychoactive substances in public students of basic education and its association with sociodemographic characteristics. METHODS This is a cross-sectional survey conducted from March to September 2015, involving 1,009 students of the basic and high school education in 20 public schools in the municipality of Aracaju, State of Sergipe, Brazil. The data have been compiled using questionnaires previously applied in national studies of the Brazilian Center for Psychotropic Drugs. The variables have been dichotomized for later logistic regression using the Chi-square test to analyze associations between experimentation with psychoactive substances and other sociodemographic variables; odds ratio and confidence intervals have also been calculated. The level of significance adopted was 5%. RESULTS We have identified that 69.6% of the students have experimented alcohol and 12.4% cigarettes. Age (≥15 years) has shown a significant association with experimentation with alcohol (p=0.01) and cigarettes (p = 0.02), acting as risk factor in both cases (OR = 2.34 and 1, 78, respectively), but it acted as a protective factor for the use of inhalants (p = 0.03 and OR = 0.58) and weight loss medication (p = 0.006 and OR = 0.44). Religious practice had a significant association with experimentation with alcohol (p = 0.01), functioning as a protective factor (OR = 0.56). CONCLUSIONS We have concluded that the psychoactive substance most experienced by students was alcohol, followed by cigarettes, and chance for experimentation increases after the age of 15. Religious practice, in turn, acts as a protective factor for experimentation with alcohol.

RESUMO OBJETIVO Analisar a prevalência de exposição a substâncias psicoativas em estudantes do ensino básico de escolas públicas e sua associação com características sociodemográficas. MÉTODOS Trata-se de um inquérito transversal realizado de março a setembro de 2015, envolvendo 1.009 alunos do ensino fundamental e médio em 20 escolas públicas de Aracaju, São Cristóvão e Nossa Senhora do Socorro. Os dados foram compilados por meio de questionários aplicados anteriormente em estudos nacionais do Centro Brasileiro de Drogas Psicotrópicas. As variáveis foram dicotomizadas para posterior regressão logística com aplicação do teste Qui-quadrado para analisar associações entre a experimentação de substâncias psicoativas e outras variáveis sociodemográficas, e calculada a razão de chances e seus intervalos de confiança. O nível de significância adotado foi de 5%. RESULTADOS Identificamos que 69,6% dos estudantes têm experimentado álcool e 12,4% cigarro. A idade dos alunos (≥ 15 anos) mostrou associação significativa com a experimentação de álcool (p < 0,001) e cigarros (p = 0,02), atuando como fator de risco em ambos os casos (OR = 2,34 e 1,78, respectivamente), mas atuando como fator de proteção para o uso de inalantes (p = 0,03 e OR = 0,58) e remédios para emagrecer (p = 0,006 e OR = 0,44). A prática religiosa apresentou associação significativa com a experimentação de álcool (p = 0,01), funcionando como um fator de proteção (OR = 0,56). CONCLUSÕES Conclui-se que a substância psicoativa mais experimentada pelos estudantes foi o álcool, seguida do cigarro, e que a chance de experimentação aumenta a partir dos 15 anos. A prática religiosa, por sua vez, atua como fator de proteção à experimentação do álcool.

Effect of aqueous extract of the leaves of Baccharis trimera on the proliferation of hepatocytes after partial hepatectomy in rats

Abstract Purpose: To evaluate the effect of aqueous extract of Baccharis trimera leaves on the proliferative capacity of the liver after partial hepatectomy (PH) in rats. Methods: Twenty Wistar rats weighing between 300 and 450g were divided into two groups: control (HP) and test (HP100-rats that received the aqueous extract of Baccharis trimera for four days at a dose of 100 mg / kg / day). On the fifth day, animals from both groups underwent resection of 70% of the liver. Twenty-four hours later, they were sacrificed and the remnant liver was removed and prepared for studied through PCNA immunohistochemistry. Data analysis for comparison between the two groups was made through the non-parametric statistical test Mann-Whitney test. Results: In all the animals studied was found most abundant nuclear immunostaining positive hepatocytes interlobular located in regions of the liver. Quantitative analysis of PCNA-positive cells revealed positivity rate significantly higher mean (p = 0.02) in HP100 group (77.1 ± 13.6) compared to the HP group (45.8 ± 12.9). Conclusion: DAdministration of aqueous extract of the leaves of Baccharis trimera 100 mg/kg of animal has a significant positive effect on liver regeneration in rats, 24 hours after hepatectomy (70%).