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INTRODUCTION: Oral squamous cell carcinoma (OSCC) accounts for about 90% to 95% of all malignancies of the oral cavity.The majority of OSCCs are preceded by oral potentially malignant disorders (OPMDs). Podoplanin (PDPN) is a mucin-like small transmembrane glycoprotein. Alterations in PDPN immunoexpression have been reported in OPMDs and OSCCs. OBJECTIVE: The objectives of this study were to evaluate the role of PDPN immunoexpression in oral leukoplakia (OL) and different histological grades of OSCC and to assess the role of PDPN as a potential biomarker for predicting the risk of malignant transformation. MATERIALS AND METHODOLOGY: Immunohistochemical analysis for PDPN was performed in 45 histologically confirmed cases of formalin-fixed, paraffin-embedded specimens of different grades of OSCCs and 15 cases of OLs with 15 cases of the normal oral mucosa (NOM) as controls. The expression and distribution of this marker were analyzed in these lesions. RESULTS: The immunoexpression of PDPN showed a significant increase in the expression of the percentage of positive cells, staining intensity, location of staining in the epithelium, tumor islands, and within the cells, as well as the mean lymphatic micro vessel density between NOMs, OLs, and different grades of OSCCs. CONCLUSION: Upregulation of PDPN can be related to the malignant transformation of OLs and biological aggressiveness of OSCCs. The enhanced immunoexpression of PDPN signifies that this immunomarker can have a role in tumor cell differentiation and the neoplastic progression of OSCCs. Increased density of lymphatic vessels suggested an important role of lymphangiogenesis in tumor progression and also as a prognostic factor for lymph nodal metastasis.
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Small cell neuroendocrine carcinoma (SNEC) was first described in the 19th century which is usually seen in association with lung cancer and is very rare in the oral cavity. Here, we report one such case in a 39-year-old male patient who presented with swelling on the left middle third of the face for 6 months. This is the 12th SNEC of oral cavity case so far reported in the English literature and the third case to be present on buccal mucosa. It presented as a nodular swelling over the buccal mucosa and was clinically diagnosed as a traumatic fibroma. The histopathological sections showed diffuse sheets of round cells with granular chromatin. Immunohistochemical findings helped us arrive at a final diagnosis. SNECs are highly proliferative tumors characterized by early and widespread metastases through the vascular channels. Hence, the diagnosis and appropriate management of these lesions is important to decrease the morbidity and mortality rate.
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BACKGROUND: Oral squamous cell carcinoma (OSCC) accounts for 3% of all malignant neoplasms and is the fifth most frequent cancer in the world. They usually spread by hematogenous or lymphatic spread, and perineural invasion (PNI) is considered an alternate method of tumor spread where it is described as the tumor affinity toward a neural tissue. AIM AND OBJECTIVES: The present study aims to evaluate the biological behavior of OSCC with respect to PNI and to evaluate the importance of PNI with respect to different histopathological grades and variants, tumor stage and lymph node status of OSCC. PNI was also assessed with respect to its frequency, patterns, types and number in various grades of OSCC. MATERIALS AND METHODS: This retrospective, double-blind study was conducted on 148 histopathologically proven cases of different histopathological grades and variants of OSCC. The tissue sections were examined for PNI and its patterns and were further compared with habit history, site of the lesion, tumor staging, grading and lymph node status. RESULTS: A Chi-square test was performed. A percentage positivity of 45.27% (67 cases) among 148 cases was found. PNI positivity of 63.6% and 50% was observed in T4 and T3 tumor stages, respectively, with high significance. Seventy percent of cases belonging to poorly differentiated squamous cell carcinoma showed positivity for PNI, which was statistically significant. PNI positivity with respect to lymph node status is nonsignificant. CONCLUSION: The present study showed that there is a direct proportionality between PNI and different grades and stages of OSCC. Given this context, a histopathologist ought to examine for PNI and make it mandatory to report the same to the clinician for better treatment and follow-up of the patient.
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BACKGROUND: Routinely, naked eye and a magnified glass are used to observe the specimens during grossing procedure. Stereomicroscope is a significant adjuvant to examine a variety of specimens and it enables us to examine the surface details of the specimen efficiently. AIMS AND OBJECTIVES: To assess the role of stereomicroscope in macroscopic examination and its effectiveness in the study of surface details of the specimen, thereby evaluating its role as an effective tool in grossing and histopathological diagnosis. MATERIALS AND METHODS: The study sample consisted of routine specimens received by the Department of Oral and Maxillofacial Pathology, Government Dental College and Hospital, Hyderabad, between July 15, 2018, and September 15, 2018. All the specimens were photographed under direct daylight ad later examined under stereomicroscope. The images were compared and grossing was carried out. The grossed specimen were processed using standard procedure and histopathological diagnosis was made. RESULTS: Compared to naked eye, the stereomicroscopic observation of specimens showed better details which helped in proper orientation of the specimen. CONCLUSION: Stereomicroscope aids as an adjuvant for proper orientation of the specimen which helps in arriving at an accurate final diagnosis.
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INTRODUCTION: Oral squamous cell carcinoma (OSCC) is the most common malignancy of oral cavity and is commonly preceded by oral potentially malignant disorders. Glucose transporter-1 (GLUT-1) protein expression is upregulated in malignant cells that show increased glucose uptake. Alterations in GLUT-1 expression have been reported in several potentially malignant and malignant lesions. AIMS AND OBJECTIVES: The aims and objectives of this study were to analyze and assess the role of GLUT-1 immunomarker in oral epithelial dysplasia (OED) and OSCC, to demonstrate and analyze the presence, location and intensity of GLUT-1 immunomarker in low-risk and high-risk OEDs and in different grades of OSCC and to correlate the expression of GLUT-1 immunomarker between normal oral mucosa (NOM), OED and different grades of OSCC. MATERIALS AND METHODOLOGY: A total of ninety paraffin-embedded tissue blocks, 15 each of NOM; low-risk and high-risk OED and well, moderately and poorly differentiated OSCC were stained with the immunomarker GLUT-1. RESULTS AND OBSERVATION: GLUT-1 immunoexpression was statistically significant in terms of number of positive cells, staining intensity, IRS score and level of staining within the epithelium and also within the cell between NOM, OED and OSCC. CONCLUSION: Increased GLUT-1 expression has a consistent role in the malignant transformation of OED and aggressiveness of OSCC.
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Myofibromas are benign uncommon fibroblastic tumors of the soft tissue, bone, or internal organs affecting all ages. These lesions histopathologically may mimic many other soft tissue tumors of the oral cavity such as spindle cell tumors of neurogenic and smooth muscle cell origin, thus leading to misdiagnosis and mistreatment. This case report describes a rare benign tumor, which presented as a soft tissue swelling on posterior gingiva. Surgical excision of the lesion was carried out under local anaesthesia. Histopathologic and immunohistochemical examination confirmed the diagnosis of myofibroma. Myofibroma should be included in the clinical differential diagnosis of masses of the oral soft tissues; however immunohistochemical examination is essential to establish an accurate diagnosis.
