RESUMEN
Calcifying epithelial odontogenic tumor (CEOT) is an extremely rare, benign neoplasm, accounting for approximately 1% of all odontogenic tumors. Peripheral CEOTs commonly resemble oral hyperplastic or reactive lesions and are histologically similar to their intraosseous counterparts. We report an unusual case of multifocal peripheral CEOT. A 40-year-old female presented with bilateral soft, painful, erythematous, gingival swellings localized in premolar areas of the mandibular gingiva. The presumptive diagnosis was bilateral pyogenic granuloma. The masses were surgically excised under local anesthesia without bone curettage and both recurred 12 months later. Morphologic features, and histochemical and immunohistochemical tests revealed bilateral peripheral calcifying odontogenic epithelial tumor. There is no clinical or radiographic evidence of recurrence 3.5 years after excision. This multifocal phenomenon has been reported previously only for intraosseous CEOT. Gingival masses must be carefully evaluated for clinical and histologic evidence of neoplasia.
Asunto(s)
Neoplasias Gingivales/diagnóstico , Recurrencia Local de Neoplasia/diagnóstico , Tumores Odontogénicos/diagnóstico , Adulto , Diagnóstico Diferencial , Femenino , Estudios de Seguimiento , Enfermedades de las Encías/diagnóstico , Granuloma Piogénico/diagnóstico , Humanos , InmunohistoquímicaRESUMEN
Quantification of immunostaining is a widely used technique in pathology. Nonetheless, techniques that rely on human vision are prone to inter- and intraobserver variability, and they are tedious and time consuming. Digital image analysis (DIA), now available in a variety of platforms, improves quantification performance: however, the stability of these different DIA systems is largely unknown. Here, we describe a method to measure the reproducibility of DIA systems. In addition, we describe a new image-processing strategy for quantitative evaluation of immunostained tissue sections using DAB/hematoxylin-stained slides. This approach is based on image subtraction, using a blue low pass filter in the optical train, followed by digital contrast and brightness enhancement. Results showed that our DIA system yields stable counts, and that this method can be used to evaluate the performance of DIA systems. The new image-processing approach creates an image that aids both human visual observation and DIA systems in assessing immunostained slides, delivers a quantitative performance similar to that of bright field imaging, gives thresholds with smaller ranges, and allows the segmentation of strongly immunostained areas, all resulting in a higher probability of representing specific staining. We believe that our approach offers important advantages to immunostaining quantification in pathology.
Asunto(s)
Procesamiento de Imagen Asistido por Computador/métodos , Inmunohistoquímica/métodos , Patología/métodos , Proteína 1 de Intercambio de Anión de Eritrocito/análisis , Antiportadores/análisis , Carcinoma de Células Escamosas/patología , Humanos , Antígeno Ki-67/análisis , Reproducibilidad de los ResultadosRESUMEN
Introdução: a sífilis é uma doença infecto-contagiosa que se apresenta epidemiologicamente ascendente na saúde pública brasileira. Todos os profissionais da área de saúde devem estar atentos para as manifestações desta doença e para os possíveis locais de acometimento de lesões sifilíticas, inclusive manifestações bucais. Objetivo: relatar um caso clínico de sífilis recente que foi diagnosticado a partir de lesões intra-orais. Métodos: foram feitas a análise clínica e histopatológica das lesões do paciente, bem como exames laboratoriais (VDRL). Resultados: a associação dos achados anátomo-patológicos com o resultado positivo do VDRL confirmou a hipótese diagnóstica de sífilis. Conclusão: o conhecimento das manifestações orais da sífilis em todos os seus estágios por profissionais de saúde é de fundamental importância, para que os mesmos estejam capacitados a executar um diagnóstico correto e tratamento adequado.