A Comparative Clinicopathological Study of Giant Cell Tumour (GCT), Central Giant Cell Granuloma (CGCG) and Peripheral Giant Cell Granuloma (PGCG).

Objective: To evaluate and compare the clinicopathological features of giant cell tumour (GCT), central giant cell granuloma (CGCG) and peripheral giant cell granuloma (PGCG). Material and methods: From 2006 to 2016, all histopathologically diagnosed cases of GCT were retrieved from the Department of Pathology, T.N.M.C, Mumbai and CGCG and PGCG were retrieved from the Department of Oral Pathology, Nair Hospital Dental College, Mumbai. Statistical analysis of the clinicopathological features was done using SPSS v 21.0, IBM. Intergroup comparison of all variables was done using t test for two groups, whereas, Kruskal-Wallis test and one-way ANOVA were done for more than two groups. Results: Twelve cases of GCT, 31 cases of CGCG and 39 cases of PGCG were reported over 11 years. The mean age of occurrence for GCT, CGCG and PGCG was 30.41 years, 27.69 years and 34.03 years, respectively. GCT was seen in long bones and CGCG and PGCG showed mandible predilection. Histologically, GCT showed evenly distributed giant cells with aggregated nuclei, whereas CGCG and PGCG showed aggregated giant cells with evenly distributed nuclei. The mean value of the number of giant cells and nuclei within giant cells was maximum in GCT (27.33, 33.50) followed by CGCG (23.56, 15.51) and PGCG (21.45, 11.32). Conclusion: The clinicopathological differences between GCT, CGCG and PGCG suggest that each one of these entities represent biologically different lesions. Supplementary Information: The online version contains supplementary material available at 10.1007/s12663-022-01724-3.

Understanding the approach to interpretation and challenges in measurement of pathological depth of invasion in oral squamous cell carcinoma: A cross-sectional survey of oral and maxillofacial pathologists in India.

Objectives: To understand the approach to interpretation along with challenges encountered in assessing pathological depth of invasion (pDOI) in oral squamous cell carcinoma (OSCC) as per 8th Edition of TNM-AJCC staging among oral and maxillofacial pathologists in India. Method and Materials: A cross-sectional web-based survey was conducted (May 2021-October 2021) with a pre-validated 21-item questionnaire. Responses were stored in a Microsoft Excel worksheet and analysed by descriptive statistics using SPSS v 25.0. Results: About 69.7% of the 267 respondents correctly defined pDOI while 13.1% measured the same from tumour surface. Among those not reporting pDOI, one-third of respondents (36.6%) lacked requisite awareness about 8th edition staging while more than half of them (55.4%) lacked proper tools to measure. The vst majority of the oral pathologists found pDOI measurement practically challenging (85.8%), mostly with difficulty in obtaining adjacent normal mucosa (77.9%). Selection of reference points of adjacent normal mucosa was divided between deepest point of rete ridge (43.1%), the closest rete ridge (28.8%) and the tip of highest submucosal papilla (15%). Conclusion: Underreporting of pDOI was observed owing to inherent challenges in measurement, thus ostensibly substituted with tumour thickness. Elaboration on reference points of adjacent normal mucosa is awaited.

Expression of Minichromosome Maintenance Protein 2 (MCM2) in Oral Epithelial Dysplasia and Oral Squamous Cell Carcinoma: A Systematic Review.

The histopathological investigations of oral lesions are a basic approach for diagnosing ongoing cancer or pre-cancer associated pathological attributes in the dissected biopsy. The early detection and management of potentially malignant disorders of the lip and oral cavity that require intervention may reduce malignant transformations, or in case any malignancy is detected during surveillance, the appropriate treatment may improve survival rates. This would guide the clinicians to decide the appropriate treatment modality or lesion to achieve a more favorable prognosis. MCM2 protein is involved in DNA replication providing additional information about the prognosis of neoplasms. Some authors have pointed out that MCM proteins have been inversely correlated with salivary tumour differentiation and therefore could be an indicator of proliferation potential. Therefore, it is essential to find the expression of the MCM2 gene in oral leukoplakia and oral squamous cell carcinoma. Electronic databases like Ebscohost, Livivo, Google Scholar and PubMed were searched. Based on the inclusion and exclusion criteria, 2 reviewers (MS and SN) independently selected the relevant articles. Any disagreement was discussed until a consensus was reached. We used the QUADAS-2 tool to assess the quality of the included studies over four key domains: patient selection, index test, reference standard and flow and timing of participants through the study. 10 out of 57 titles were found to meet the eligibility criteria. Biopsied tissue with immunohistochemical staining or advanced diagnostic studies were included. A total of 901 samples were included in the study and different groups were normal oral mucosa (NOM), oral epithelial dysplasia (OED) and oral squamous cell carcinoma (OSCC). MCM2 proteins are useful diagnostic markers for distinguishing malignant from benign epithelial dysplasia and for early detection and diagnosis of OSCC as an adjunct to clinicopathological parameters. Supplementary Information: The online version contains supplementary material available at 10.1007/s12070-022-03296-7.

Ossifying Fibromas of the Head and Neck Region: A Clinicopathological Study of 45 Cases.

Ossifying fibromas of the head and neck region are classified as cemento-ossifying fibroma (COF) (odontogenic origin), and two types of juvenile ossifying fibromas: juvenile trabecular ossifying fibroma (JTOF), and juvenile psammomatous ossifying fibroma (JPOF). The potential for recurrence in JTOF and JPOF and the discovery of newer molecular signatures necessitates accurate histological classification. Over 12 years (2005-2017), a total of 45 patients with 51 tumours were retrieved and reviewed for clinic-pathological features from the archives of a tertiary care oncology centre. Of 45 cases, COF, JTOF and JPOF comprised 13 (28.9%), 11 (24.4%) and 18 (40%) cases respectively. Three cases were unclassifiable. M: F ratio was 1:3.3, 1.1:1, 2:1 for COF, JTOF and JPOF respectively with an age range of 6-66 years (mean: 24.6, median; 18.1 years). The most common site for COF was mandible, for JTOF was maxilla, and for JPOF was ethmoid sinus. One case of mixed JTOF and JPOF histology was seen. Aneurysmal bone cyst-like areas were seen in 26.6% of cases, most commonly in JPOF. Follow up was available in 23 cases, and ranged from 4 to 207 months. Three cases of JPOF had a recurrence and one patient with JTOF had residual disease after surgery. One case of COF demonstrated increased parathyroid hormone levels. COF, JTOF, and JPOF are clinically, radiologically and histologically distinct entities. Surgical resection is the mainstay of treatment. JPOF has a higher incidence of recurrence as compared to JTOF and COF and hence needs a more aggressive follow-up.

Mucocele of the tongue: A case report and review of literature.

Mucoceles are common cystic lesions in the oral cavity. It may occur in different locations in the oral mucosa due to trauma or obstruction of minor salivary gland ducts with the lower lip as the predominant site. However, mucoceles located on the ventral surface of the tongue originating from the anterior lingual salivary glands are extremely rare and often overlooked during screening procedures because of their asymptomatic nature. Here, we report an interesting case of mucocele on the anterior ventral surface of the tongue in an 11-year-old female based on the clinical and histopathological diagnosis. Moreover, mucoceles should be considered as one of the differential diagnoses while evaluating a growth involving the ventral surface of the tongue in young female children.

Demographic study of 366 cases of oral leukoplakia and immunohistochemical analysis - An institutional study.

Background: It has been reported that oral squamous cell carcinoma (OSCC) is associated with the presence of potentially malignant disorders (PMDs) in 15%-48% of cases. Among PMDs, oral leukoplakia (OL) is the most common, with 16%-62% of cases associated with OSCC. Hence, in the present study, we have analyzed demographic data and re-evaluated immunohistochemical (IHC) data of OL cases and aimed to correlate the clinical, histopathological and IHC aspects of OL. Materials and Methods: The data of histopathologically diagnosed cases of OL were retrieved from the archives. These data were further evaluated for age, gender, duration, site, size, side, habits, clinical staging and histopathological grading. IHC re-evaluation of OL tissues was done using epithelial cadherin (E-cadherin), n = 20; human MutL homolog 1 (hMLH1), n = 30; CD1a (n = 30); vimentin (n = 30); Ki-67 (n = 30); heat shock protein-70 (HSP-70), n = 30; p16INK4, n = 20; and mucin-1 (MUC1), n = 30. All the results and observations were subjected to descriptive statistical analysis. Results: The male: female ratio was 7.5:1; right side and buccal mucosa were more commonly affected. The duration of the lesion ranged from 1 to 30 years. One hundred and twelve patients were habituated to tobacco chewing, while 171 patients came with a combined habit of smoke and smokeless tobacco usage. Clinically, most of the lesions were of stage 2 while histopathologically they were of mild dysplasia. There was a decrease in the immunoexpression of E-cadherin, hMLH1 and CD1a, while there was an increase in the immunoexpression of vimentin, Ki-67, HSP-70, MUC1 and p16INK4. Conclusion: The study of different biomarkers such as cytoplasmic, membranous and nuclear in OL will help in better understanding and application of a reliable marker for diagnostic and prognostic purpose.

A Comparative Analysis of p63 Expression in Giant Cell Tumour (GCT), Central Giant Cell Granuloma (CGCG) and Peripheral Giant Cell Granuloma (PGCG).

Giant cell tumour (GCT) is locally aggressive benign neoplasm of long bones whereas giant cell granulomas; central giant cell granuloma (CGCG) and peripheral giant cell granuloma (PGCG); are tumour-like conditions of the oral cavity. This study aimed to evaluate and compare the immunohistochemical expression of p63 in GCT, CGCG, PGCG and determine whether p63 can be used as a diagnostic, prognostic and differential biomarker between these entities. Histopathologically diagnosed 10 cases of GCT, 20 cases of CGCG and 20 cases of PGCG were subjected to p63 immunohistochemical staining. The percentage of p63-positive cells was semi-quantitatively assessed on the whole section. Intergroup comparison was done using Kruskal-Wallis test and one-way ANOVA. The value p < 0.05 was considered to be statistically significant and value p < 0.01 was considered to be statistically highly significant. p63 immunoexpression was seen in 100% (10/10) cases of GCT whereas CGCG and PGCG revealed the complete absence of p63 immunopositivity. These results showed a highly significant difference in p63 expression between GCT, CGCG and PGCG (p < 0.01). No difference was noted between CGCG and PGCG. GCT is a distinct entity when compared with CGCG and PGCG. Even aggressive CGCG also did not show p63 immunopositivity, so it is not a prognostic marker. Also, p63 cannot differentiate between CGCG and PGCG.

Intraoral salivary duct cyst: Report of rare entity.

Salivary duct cysts (SDCs) are true cysts caused by obstruction of the salivary ducts and are rare in minor salivary glands. A 62-year-old male reported with a painless swelling in the left buccal mucosa for 2 years. Excision of the entire lesion was performed under local anesthesia following which histopathological examination was performed. Microscopically, a dilated salivary gland duct composed of 1-2 layers of cuboidal cells with intraluminal mucous plug was observed. Cystic lumen lined by mucous cells, squamous cells and ciliated cells was seen. Oncocytic metaplasia was also present at various places. Histopathologically, it was consistent with the diagnosis of SDC. Intraoral SDCs and mucoceles clinicopathologically mimic salivary gland neoplasms, making diagnosis difficult and subject to errors in treatment. It is important for oral and maxillofacial surgeons to include SDC in the differential diagnosis of swelling affecting buccal mucosa.