Primary cutaneous CD8+ cytotoxic T-cell lymphoma of the face with intraoral involvement, resulting in facial nerve palsy after chemotherapy.

The primary cutaneous (PC) CD8+ T-cell lymphoproliferative disorders (LPDs) comprise clinically and histopathologically heterogeneous entities including mycosis fungoides, lymphomatoid papulosis, hydroa-vacciniforme-like LPD, subcutaneous panniculitis-like T-cell lymphoma (TCL), PC acral CD8+ TCL, PC CD8+ aggressive epidermotropic cytotoxic TCL, and PC peripheral TCL, not otherwise specified (PTCL-NOS). We describe a 33-year-old man who presented with progressive facial swelling and lower lip involvement 1 year ago. Microscopy revealed an atypical small to medium-sized lymphoid proliferation exhibiting perivascular accentuation, adnexotropism, and apoptotic cell debris, without surface epithelium involvement. The tumor cells were positive for CD3, CD8, granzyme B, perforin, MUM1/IRF4, and TCR-BF1. The Ki-67 labeling index was 48%. EBER1/2 was negative. Additional studies confirmed localized disease. The diagnosis favored PC-PTCL-NOS. Two months after completing chemotherapy, right-sided facial nerve palsy was diagnosed. CD8+ T-cell LPDs should be considered in the differential diagnosis when assessing facial swelling with intraoral involvement.

Squamous cell carcinoma antigen as a prognostic marker and its correlation with clinicopathological features in head and neck squamous cell carcinoma: Systematic review and meta-analysis.

BACKGROUND: Several studies investigate the prognostic value of squamous cell carcinoma antigen (SCC-Ag) in head and neck squamous cell carcinoma (HNSCC) patients, with contradicting findings. Considering this, the aim of this study was to evaluate the prognostic value of high SCC-Ag levels and its association with clinicopathological features of HNSCC. MATERIAL AND METHODS: PubMed, SCOPUS, and Cochrane Library were searched for relevant studies up to December 2015. English-language publications assessing clinicopathological features of HNSCC and the prognostic significance of SCC-Ag in this disease were included. A meta-analysis was performed using Review Manager 5.3 and STATA version 14 software to clarify a possible association between SCC-Ag and clinical outcomes. RESULTS: A total of 11 studies met inclusion criteria, comprising 1901 cases of HNSCC. The results of the meta-analysis showed that there was significant correlation between high SCC-Ag levels and males (odds ratio [OR]=2.99, 95% CI: 1.18-7.57, P=.02 fixed-effect), and advanced TNM stages (OR=3.18, 95% CI: 1.88-5.38, P<.0001 random-effect). The survival meta-analysis showed a pooled hazard ratio for disease-free survival (DFS) and overall survival (OS) of 1.01 (95% CI: 0.70-1.31) and 0.86 (95% CI: 0.54-1.17), respectively. CONCLUSION: Our meta-analysis suggests that elevated SCC-Ag levels have a significant correlation with males and TNM stage, but may not be used as predictive marker for OS and DFS in HNSCC patients.

Synchronous Polymorphous Adenocarcinoma and Canalicular Adenoma on the Upper Lip: An Unusual Presentation and Immunohistochemical Analysis.

Multiple salivary gland tumors (MSGTs) are most common in the major than minor salivary glands. The most MSGTs are synchronous, either benign or malignant. A 61-year-old woman was referred presenting nine submucosal nodules, firm to fluctuant, being five nodules on the right side and four nodules on the left side of the upper lip. An incisional biopsy was performed. Hematoxylin and eosin staining was performed in 5-µm sections for histopathologic analysis. Immunohistochemical reactions were carried out in 3-µm sections in accordance with manufacturer's instructions. The histopathological analysis showed focal area containing low-grade polymorphous adenocarcinoma (PAC) and multiple canalicular adenomas (CAs). Immunohistochemical analysis for each lesion was carefully investigated. Here, we present an unusual case of synchronous PAC and multiple CAs of the minor salivary glands, affecting the upper lip, which appears to be the first case showing PAC and CA.

Oral Intravascular Papillary Endothelial Hyperplasia Associated with an Organizing Thrombus: Case Report and Immunohistochemical Analysis.

Intravascular papillary endothelial hyperplasia (IPEH) is a benign lesion of the skin and mucosa of vascular origin characterized by reactive proliferation of endothelial cells. A 76-year-old woman was referred presenting a painless nodule on the lip. Intraoral examination revealed bluish submucosal nodular proliferation, measuring 10 × 5 × 5 mm, affecting the lower labial mucosa. The lesion had a firm consistency and it was not fixed to the adjacent tissues. The main differential diagnoses were mucocele/mucus retention cyst, sialolith, or salivary gland neoplasia. An incisional biopsy was performed and during the intraoperative procedure an encapsulated red-bluish nodular mass was observed. Microscopic analysis revealed papillary endothelial proliferation in the center of the lesion and fibrin admixed with inflammatory cells in organization peripherally. There was no nuclear atypia, mitotic figures, or necrosis. The endothelial cells were CD34 positive, with low Ki-67 proliferation index (4%). α-SMA highlighted the vessel walls, whereas negativity for D2-40 excluded lymphatic origin. Final diagnosis was IPEH associated with an organizing thrombus. Dentists should be aware about this rare benign vascular lesion, whose final diagnosis is achieved only after histopathology analysis. Surgical removal is the treatment of choice and no recurrence is expected.