Kallikrein-related peptidase 10 expression in salivary gland tissues and tumours.

OBJECTIVES: Kallikrein-related peptidase 10 (KLK10) has been implicated in the development of several types of cancer. The purpose of this study was to analyze the expression of KLK10 in 3 types of salivary gland tumour and normal salivary glands. MATERIALS AND METHODS: A standard immunoperoxidase staining technique was used to assess the immunoexpression profile of KLK10 in normal salivary glands and 3 types of salivary gland tumour: pleomorphic adenoma, adenoid cystic carcinoma and mucoepidermoid carcinoma. RESULTS: Pleomorphic adenomas showed significantly lower KLK10 levels than control tissues. Neither of the malignant tumours (adenoid cystic carcinoma and mucoepidermoid carcinoma) showed a significant alteration in the immunoreactive scores of KLK10 in comparison with the normal salivary gland tissues. KLK10 immunoreactive scores were comparable in adenoid cystic carcinoma and mucoepidermoid carcinoma. Pleomorphic adenoma had significantly lower levels of KLK10 than mucoepidermoid carcinoma. CONCLUSIONS: The finding of lower KLK10 levels in pleomorphic adenoma suggests aberrant expression in a tumour that develops primarily from myoepithelial cells. A kallikrein cascade may play a role in the development and/or outcome of some salivary gland tumours.

Benign Triton tumor of the tongue.

A case of the extremely rare benign Triton tumor of the tongue is presented. This article presents new observations concerning associated hyperelastosis, the recognition of 2 distinct clinicopathological variants, and a new theory concerning pathogenesis that more closely fits current clinical and histopathological observations.

Juvenile spongiotic gingivitis.

BACKGROUND: This article recognizes the microscopic diagnosis of acute spongiotic mucositis as an analog to acute spongiotic dermatitis of the skin and defines a specific clinicopathological entity "juvenile spongiotic gingivitis" within this microscopic spectrum. METHODS: Twenty-four patients, usually juveniles, with patches of bright red, often slightly thickened, painless, and persistent lesions of the attached gingiva, which may or may not involve the marginal gingiva, were identified by clinical and microscopic features. Immunohistochemical studies for cytokeratins 5/6 and 19, estrogen receptors, and progesterone receptors were completed on 10 of these cases. A comparison to puberty gingivitis, which occurs in the same age group, was done. RESULTS: Microscopically, the epithelium exhibited hyperplasia, significant spongiosis, loss of keratinization, and a neutrophilic infiltrate, sometimes with microabscess formation, whereas the underlying connective tissue exhibited an acute on chronic inflammatory infiltrate. Full-thickness epithelial immunostaining for cytokeratins 5/6 and 19 was found, whereas no reactivity was seen for estrogen receptors or progesterone receptors in the specimens. CONCLUSIONS: Juvenile spongiotic gingivitis differs from puberty gingivitis by not needing to show continuity with plaque-related marginal gingivitis, by a lack of response to hygiene procedures, by an occasional occurrence at ages not related to puberty, and by the absence of sex hormone receptors investigated immunohistochemically in 10 of the cases. We propose juvenile spongiotic gingivitis as a distinct clinicopathological entity.

Oral manifestations of gastrointestinal diseases.

The present paper offers a detailed review of the oral manifestations of various gastrointestinal diseases or conditions, with suggestions on how they may be relevant to the practice of gastroenterology. The review includes Crohn's disease, ulcerative colitis, Gardner syndrome, Peutz-Jeghers syndrome, malabsorption conditions related to hematopoesis, gastrointestinal malignancy metastatic to the jaws, jaundice and gastric reflux diseases.

Oral pathology in the dental curriculum: a guide on what to teach.

There has been considerable disagreement among educators on the topics and details of topics that should be included in the teaching of oral pathology to dental students and graduate students in dental specialties. Various authorities have recommended core curricula that range from comprehensive teaching of eighteen categories, each with up to nine subheadings, covering hundreds of entities, to as few as approximately fifty of the most common lesions that affect the oral and maxillofacial region. This article offers a curriculum planning model designed to help faculty make decisions about course content and emphases. The model allows instructors to assess content relevance and priority based on three criteria: 1) commonness, 2) uniqueness, and 3) significance of diseases and conditions. The product of this decision-making process is a relevance score that can serve as a guideline for the choice and details of topics to be included in oral pathology courses.

Management of patients with foreign body gingivitis: report of 2 cases with histologic findings.

Foreign body gingivitis is an inflammation of the gingiva, characterized by foci containing particles of foreign material in the connective tissue, which can have either a granulomatous or a lichenoid microscopic appearance. In clinical terms, it differs from other immune-mediated gingival disorders in its limited involvement of tissues other than the gingiva, as well as its relative resistance to treatment by topical corticosteroids. Two cases are presented, with a review of the clinical features, including characteristic desquamation and mottling of the marginal gingiva and symptoms of localized tenderness and pain; gingival recession was observed in both of the reported cases. Histologic examination revealed damaged epithelium and degeneration of the basal layer, as well as a mixed inflammatory cell infiltrate in the connective tissue with refractile or opaque particles of foreign material. Gingival inflammation and the severity of gingival erosions improved dramatically with careful debridement, improved home care and more frequent, diligent periodontal maintenance therapy. Free gingival grafts, together with excision of affected tissues, served to stabilize and reinforce the marginal tissues, as well as eliminating further clinical signs of the disease; excision alone was not as effective. Patients require careful dental and periodontal management as well as appropriate oral home care to avoid further mechanical damage to the gingiva; in addition, the use of dental abrasives and polishing agents should be restricted, particularly if gingival lesions are present. Home care recommendations include avoidance of dentifrices with certain chemical additives and rinses with a high alcohol content.

Intraoral chondroid lipoma: a case report and immunohistochemical investigation.

Lipomas are common neoplasms of fat in the oral cavity. However, the diagnosis may be difficult for lesions exhibiting unusual histological features. This paper documents the first intraoral report of a chondroid lipoma. The differential diagnosis is discussed. It is important for practicing oral pathologists to recognize rare variants to ensure accurate diagnosis and appropriate treatment for the patient.

Immunohistochemical localization of growth factors fibroblast growth factor-1 and fibroblast growth factor-2 and receptors fibroblast growth factor receptor-2 and fibroblast growth factor receptor-3 in normal oral epithelium, epithelial dysplasias, and squamous cell carcinoma.

OBJECTIVES: Fibroblast growth factors (FGFs) and their receptors (FGFRs) have been identified in a variety of carcinomas, but there are few studies concerning their presence in oral cancers. The objective of this study was to determine whether FGF-1, FGF-2, and high affinity receptors FGFR2 and FGFR3 are present in the pathogenesis of oral epithelial dysplasias and oral squamous cell carcinoma. STUDY DESIGN: Sections from formalin-fixed, paraffin-embedded samples of oral normal mucosa (n = 14), epithelial dysplasia (n = 20), carcinoma in situ (n = 10), and squamous cell carcinoma (n = 12) were tested for cytoplasmic staining by standard in situ immunohistochemistry with antibodies for FGF-1, FGF-2, FGFR2, and FGFR3. RESULTS: Staining for FGF-1 is decreased or lost in the development of epithelial dysplasia and carcinoma. Staining for FGF-2 showed increased intensity (although not statistically significant) in oral epithelial dysplasias and squamous cell carcinomas and showed a significant increased expression in the upper layers of dysplasias and stratum spinosum-like cells in squamous cell carcinomas. Staining for FGFR2 showed a statistically significant increase in intensity in all layers of epithelial dysplasias and squamous cell carcinomas. Staining for FGFR3 was found in the upper stratum spinosum cells of normal and dysplastic epithelium and well-differentiated squamous cells in squamous cell carcinomas, with a statistically significant increase in staining intensity in dysplastic and carcinomatous tissues. CONCLUSIONS: The loss of FGF-1 is consistent with loss of differentiation in dysplasias and some squamous cell carcinomas. Changes in the localization of FGF-2 and FGFR2 into upper epithelial layers with increasing dysplasia suggest increased mitotic potential of high level cells. The co-localization of FGF-2 and its high affinity receptors in neoplastic tissues suggests an autocrine mechanism of influence on carcinogenesis.