Tongue Nodule as Primary Manifestation of American Cutaneous Leishmaniasis in an Immunocompetent Patient.

Leishmaniasis is a parasitic disease considered an endemic public health problem in developing countries, where it is a reportable disease. Isolated oral manifestation is rare, and its clinical manifestations are variable. In this paper we describe an unusual case of an immunocompetent patient, 57-year-old man with a painless reddish submucosal nodule located on the tongue dorsum. Microscopical analysis showed chronic inflammatory infiltrate with macrophages containing leishmania in cytoplasmic vacuoles. PCR assays confirmed the diagnosis and patient was treated with meglumine antimoniate for 30 days. Absence of the parasite was confirmed by PCR. Thirteen years after treatment, a scar fibrosis persisted on the tongue dorsum. The case reported reveals that leishmaniasis should be considered in the diagnosis of tongue nodules in immunocompetent patients.

Effects of cachaça, a typical Brazilian alcoholic beverage, on submandibular glands of rats: a histomorphometric and biochemical study.

OBJECTIVE: This study aimed to evaluate the effects of chronic consumption of cachaça, a Brazilian beverage containing alcohol, on submandibular glands (SM) of rats by using histomorphometric and biochemical parameters. MATERIALS AND METHODS: Twenty-four male rats (40 days of age) were assigned into the following four groups (n = 6): two control groups for 75 days (C75) and 105 days (C105), and two experimental groups of cachaça ingestion with ascending concentrations for consecutive 75 days (CA75) and 105 days (CA105). On the right SM glands, the striated, granular and acini ducts were processed for histomorphometric analysis. The left SM glands were weighed and stored at - 80 °C, to evaluate through biochemical tests carried out by spectrophotometric methods, the functional activity of total acid phosphatase (TAP), tartrate-resistant acid phosphatase (TRAP), and alkaline phosphatase (ALP) and to determine the mucin levels. RESULTS: The absolute and relative weights of the SM glands in both experimental groups were reduced in relation to the controls (p < 0.05). The histomorphometric analysis showed a significant reduction of the acini area (p < 0.05) and non-relevant reduction of striated ducts (p > 0.05). The granular ducts did not show a significant increase of the area (p > 0.05). The TAP and TRAP activities were significantly decreased in the experimental groups (p < 0.05), while the ALP functional activity decreased moderately (p > 0.05). Mucin levels also had a significant reduction when compared with the control groups (p < 0.05). CONCLUSIONS: Chronic consumption of cachaça can cause morphological changes associated with glandular atrophy, loss of biochemical functionality of phosphatases, and the reduction of mucin synthesis. CLINICAL RELEVANCE: The consumption of cachaça can compromise the functions of the submandibular glands by altering their morphology and enzymatic activity.

Effects of cyclosporin, nifedipine and phenytoin on gingival myofibroblast transdifferentiation in monkeys.

OBJECTIVE: Myofibroblasts have been associated with the development of several pathologic fibrotic conditions. This longitudinal study aims to assess the proliferative and antiapoptotic effects of cyclosporin, nifedipine and phenytoin on gingival connective tissue cells of nonhuman primate, as well as to analyze a possible role of myofibroblasts in gingival overgrowth. MATERIALS AND METHODS: Gingival samples from the right superior canine area were obtained from 12 male monkeys ( Sapajus spp ) to comprise the control group. After one week, the animals were randomly assigned to three groups, which received daily oral doses of cyclosporin, nifedipine or phenytoin for 120 days. Gingival samples were collected from the left superior canine area of two animals of each group at 52 and 120 days. Histological sections were stained with hematoxylin and eosin, and immunoreacted against α-SMA, Ki- 67 and bcl-2. RESULTS: α-SMA immunoreaction was negative in the control and experimental groups. Similarly, no difference between groups concerning immunostaining against Ki-67 and bcl-2 was observed in connective tissue cells. CONCLUSION: Based on this methodology, it may be concluded that gingival overgrowths induced by cyclosporin, nifedipine and phenytoin are not associated with neither myofibroblast transdifferentiation, proliferation nor apoptosis of gingival connective cells in monkeys.

Stress hormones concentrations in the normal microenvironment predict risk for chemically induced cancer in rats.

Evidence show that stress hormones can influence cancer progression, but its role in carcinogenesis is poorly understood. In this study, we used a new method based on oral carcinogenesis model in rats to test the hypothesis that physiological levels of stress hormones in the normal tissue microenvironment would have significant predictive value for chemically induced cancer occurrence. Male Wistar rats were submitted to a tongue biopsy for measuring not-stress induced levels of norepinephrine, corticosterone, adrenocorticotropic hormone (ACTH) and brain-derived neurotrophic factor (BDNF) in the tissue before carcinogenic induction. Rats were treated with the 4-nitroquinoline-1-oxide (4NQO) chemical carcinogen for twenty weeks and then euthanized for microscopic evaluation of the tongue lesions. Increased pre-carcinogen norepinephrine concentrations and reduced basal corticosterone levels in the normal tissue microenvironment were predictive for oral squamous cell carcinoma (OSCC) occurrence. Likewise, increased pre-carcinogen norepinephrine levels in the normal microenvironment were associated a lower expression of pCDKN2a-p16 in OSCCs. Post-carcinogen levels of corticosterone and BDNF in oral leukoplakia tissues (precursor lesion of OSCC) and post-carcinogen corticosterone concentrations in OSCCs were higher than basal levels in the normal mucosa. Increased norepinephrine concentrations in OSCCs were associated to a greater tumor volume and thickness. Furthermore, higher levels of norepinephrine, ACTH and BDNF in OSCCs were associated to a lesser intensity of the lymphoplasmocytic infiltrate. This study shows that pre-carcinogen stress hormones levels in the normal microenvironment may be predictive for chemically induced cancer in rats. Moreover, chemical carcinogenesis can promote stressor-like effects with hormonal changes in the tissue microenvironment, which may be associated to tumor progression.

Evaluation of the biocompatibility of silicone gel implants - histomorphometric study.

CONFLICT OF INTEREST: NONE DECLARED Breast implants are medical devices that are used to augment breast size or to reconstruct the breast following mastectomy or to correct a congenital abnormality. Breast implants consist of a silicone outer shell and a filler (most commonly silicone gel or saline). Approximately 5 to 10 million women worldwide have breast implants. Histomorphometric study to evaluate the biological tissue compatibility of silicone implants suitable for plastic surgery and the adverse effects and risks of this material. Thirty Wistar white rats received subcutaneous implants and the revestiment of silicone gel Silimed ®®, and randomized into six groups of five animals each, according to the type of implanted material and the time of sacrifice. Eight areas of 60.11mm2 corresponding to the obtained surgical pieces were analyzed, counting mesenchymal cells, eosinophils, and foreign body giant cells, observing an acceptable biocompatibility in all implants, for subsequent statistical analysis by Tukey test. Silicone gel showed inflammation slightly greater than for other groups, with tissue reactions varying from light to moderate, whose result was the formation of a fibrous capsule around the material, recognized by the organism as a foreign body. Despite frequent local complications and adverse outcomes, this research showed that the silicone and top layer presented an acceptable chronic inflammatory reaction, which did not significantly differ from the control group. In general, it is possible to affirm that silicone gel had acceptable levels of biocompatibility, confirmed the rare presence of foreign body giant cells, and when of the rupture, formed a fibrous capsule around the material, separating the material of the organism.

Cementoblastoma: a case report in deciduous tooth.

BACKGROUND: The benign cementoblastoma is an odontogenic tumor originated from neoplastic cementoblasts, a rare lesion mainly associated to impacted and deciduous teeth. It affects mostly young people with an average age of 20 years old, and its preferred location is in the posterior region of the mandible; the lesion will present itself fused both radiologically and microscopically to a root of an erupted permanent tooth, and the anatomopathological diagnosis is obtained through the analysis of the piece sent together with the involved dental element. CASE REPORT: The present study presents a case of cementoblastoma in the mandible involving the second deciduous molar tooth and preventing the eruption of the premolar tooth in a girl aged 11 years old. DISCUSSION: This report discusses relevant aspects concerning clinical, radiographic, and histopathological characteristics and treatments.

Displasia cemento-óssea florida: relato de caso / Florid cemento-osseous dysplasia: case report

Objetivo: Os autores relatam um caso clínico de Displasia Cemento-Óssea Florida em mulher negra, 71 anos, desdentada, portadora de prótese total, com áreas hipercompressivas refletindo reação inflamatória no rebordo alveolar inferior. Descrição do caso: O tecido mole das áreas mucosas de rebordo se mostrava tumefacto difusamente, sugerindo fibromatoses localizadas. Radiograficamente, áreas radiopacas regulares e difusas eram observadas ao longo dos ossos maxilares. Biópsia em uma dessas áreas evidenciou, à microscopia óptica, quadro histopatológico compatível com displasia cementária, o que possibilitou o diagnóstico final de displasia cemento óssea florida, chamada também de cementoma gigantiforme, apesar de não representar uma verdadeira neoplasia. Conclusão: Os autores consideram, ainda, que não há relação com alterações sistêmicas de natureza hormonal ou metabólica e que na proposição do diagnóstico definitivo concorrem as características clínicas, radiográficas e histopatológicas.

Aim: The authors describe a clinical case of Florid Cemento-Osseous Dysplasia in black woman, 71 years old, edentous, bearer of total prosthesis, with areas hipercompressives reflecting inflammatory reaction in the inferior alveolar edge. Case description: The soft tissue of the mucous areas of edge was shown diffuse tumescent, suggesting located fibromatoses. Regular and diffuse radiopac radiographic areas were observed along the bones maxillaries. Biopsy in one of those areas evidenced, to the optical microscopy, histopathological images compatible with cementous dysplasia, what made possible the final diagnosis of Florid Cemento-Osseous Dysplasia, also called gigantiform cementoma, in spite of not representing a true neoplasm. Conclusion: The authors consider also that there is no relation with systemic hormonal or metabolic and the proposition that the definitive diagnosis is based in the clinical, radiographic and histopathologic features.

High incidences of DNA ploidy abnormalities in tongue squamous cell carcinoma of young patients: an international collaborative study.

AIMS: This multi-centre analysis assessed the DNA content of TSCC in 37 young patients (<40 years) and 28 old patients (>50 years) and determined the correlation of DNA ploidy findings with clinicopathological data. METHODS AND RESULTS: Image cytometry was carried out using an automated cellular imaging system on Feulgen-stained histological sections to obtain high-fidelity DNA histograms. Among young patients, 37.8% were females compared to 18.7% in the older group (P=0.002). In total, 48.6% patients were non-smokers and 40.5% were non-drinkers compared to 10.7% non-smokers and non-drinkers in the older group (P<0.0001). TNM, clinical stage of disease and histological grade of differentiation did not differ between groups. Tumour aneuploidy was detected in 86.5% and tetraploidy in 24.3% young patients; this was significantly greater than in the older group where 64.3% were aneuploid (P<0.0001) and 7.2% tetraploid (P<0.0001). The mean values of DNA index (DI) and DNA heterogeneity index as well as the percentage of cells with DI exceeding 5N were higher in young patients (P<0.0001). CONCLUSIONS: Young patients with TSCC represent a distinct clinical entity. The high incidence of DNA ploidy abnormalities suggest that they may have increased genomic instability and indicates underlying genetic differences between TSCC in young and older patients.

Maxillary osteosarcoma in a young patient undergoing postorthodontic treatment follow-up: the importance of ongoing oral examinations.

Osteosarcoma is a common primary malignant tumor in long bones; it generally occurs in young adults. It is considered infrequent in the head and neck regions, where it is usually associated with poor outcomes and rates of survival. From a histopathologic point of view, osteosarcomas are commonly classified as osteoblastic, chondroblastic, or fibroblastic, although several unusual microscopic subtypes have also been reported. The purpose of this article was to present a case report of a maxillary chondroblastic osteosarcoma involving the maxillary sinus and the maxilla of a young woman who was diagnosed during early postorthodontic treatment follow-up. Treatment, prosthetic rehabilitation, and follow-up details are provided. Most importantly, this patient shows the importance of complete and systematic oral examinations during any routine dental treatment.

Análise retrospectiva de 61 casos de paracoccidioidomicose diagnosticados na Faculdade De Odontologia de Araçatuba / UNESP / Retrospective analysis of 69 cases of paracoccidioidomycosis diagnosed in the Dental School of Araçatuba / UNESP

A paracoccidioidomicose é uma micose sistêmica, que exige tratamento prolongado, cuja maior prevalência concentra-se na América Latina, com diversas áreas endêmicas no Brasil. Este estudo teve como objetivo caracterizar os clientes portadores de paracoccidioidomicose cutaneomucosa através da análise de 61 exames histopatológicos de pacientes adultos com diagnóstico de paracoccidioidomicose cutâneo mucosa atendidos na Faculdade de Odontologia de Araçatuba, no período de janeiro de 1989 a dezembro de 2004. Observou-se que a doença ocorreu em 56 (91,81%) homens e 5 (8,19%) mulheres, sendo a raça branca mais prevalente (78,68%), na faixa etária de 40 a 59 anos (62,9%) e a profissão vinculada à agricultura em 17 pacientes (27,86%). Todos os casos apresentavam manifestações estomatológicas, sendo múltiplos sítios e os mais prevalentes a mucosa jugal (31,42%) e rebordo alveolar (17,14%). O cirurgião dentista, enquanto elemento essencial nos serviços de saúde deve conhecer as manifestações clínicas da paracocidioidomicose para realizar o diagnóstico precoce e consequentemente melhorar a qualidade de vida dos pacientes

Paracoccidioidomycosis is a systemic mycosis which requires prolonged treatment. It is highest prevalence in Latin America, with different endemic areas in Brazil. In this study the aim was to characterize clients suffering from mucocutaneous paracoccidioidomycosis by analysis of histopathological examinations of 61 adult patients diagnosed with mucocutaneous paracoccidioidomycosis treated at the Dental School of Araçatuba, from January 1989 to December 2004. It was observed that the disease occurred in 91.81% (56) men and 8.19% (5) women, more prevalent (78.68%) in whites, aged 40 to 59 years (62.9%) and the profession linked to agriculture in 17 patients (27.86%). All patients had oral manifestations, in multiple sites, but it was most prevalent in the oral mucosa (31.42%) and alveolar ridge (17.14%). The dentist as an integral member of the health services, must know the clinical manifestations of paracoccidioidomycosis to achieve early diagnosis and thereby to improve the quality of life of patients

Biocompatibility evaluation of 3 facial silicone elastomers.

The failure of facial prostheses is caused by limitations in the properties of existing materials, especially the biocompatibility. This study aimed to evaluate the biocompatibility of maxillofacial silicones in subcutaneous tissue of rats. Thirty Wistar rats received subcutaneous implants of 3 maxillofacial silicone elastomers (LIM 6050, MDX 4-4210, and industrial Silastic 732 RTV). A histomorphometric evaluation was conducted to analyze the biocompatibility of the implants. Eight areas of 60.11 mm(2) from the surgical pieces were analyzed. Mesenchymal cells, eosinophils, and foreign-body giant cells were counted. Data were submitted to analysis of variance and Tukey test. Initially, all implanted materials exhibited an acceptable tissue inflammatory response, with tissue reactions varying from light to moderate. Afterward, a fibrous capsule around the silicone was observed. The silicones used in the current study presented biocompatibility and can be used for implantation in both medical and dental areas. Their prosthetic indication is conditioned to their physical properties. Solid silicone is easier to adapt and does not suffer apparent modifications inside the tissues.

Avaliação da biocompatibilidade de implantes de silicone gel em subcutâneo de ratos - estudo histomorfométrico / Evaluation of the biocompatibility of silicone gel implants on rat subcutaneous tissue - histomorphometric study

Objetivo: Avaliar histomorfometricamente a compatibilidade biológica tecidual de implantes de silicone indicados para cirurgia plástica. Métodos: Trinta ratos albinos Wistar foram implantados subcutaneamente com silicone gel, da marca Silimed®, e de seu revestimento, sendo distribuídos aleatoriamente em seis grupos de cinco animais cada, de acordo com o tipo de material implantado e data dos sacrifícios. Oito áreas de 60,11 mm2 correspondentes às peças cirúrgicas obtidas foram analisadas, contando-se as células mesenquimais, inflamatórias mononucleares, eosinófilos e as células gigantes do tipo corpo estranho, para posterior análise estatística pelo teste de Tukey. Resultados: O silicone gel apresentou processo inflamatório ligeiramente maior em relação aos outros grupos, com reações tissulares de intensidade leve a moderada, cujo resultado foi uma cápsula fibrosa contornando o material que foi reconhecido pelo organismo como corpo estranho. Conclusão: Pode-se afirmar que o silicone gel apresentou níveis aceitáveis de biocompatibilidade, confirmada pela rara presença de células gigantes do tipo corpo estranho, e que, quando rompido, forma-se uma cápsula fibrosa ao redor do material, funcionando como barreira biológica e separando-o do organismo.

Lymphoepithelial cyst in jugal mucosa / Quiste linfoepitelial en la mucosa yugal

Mouth lymphoepithelial cyst is rare, with few cases reported in literature. The aim of this article is to describe a clinical case, focusing on clinical and diagnostic aspects, treatment and prognosis. The lesion was one year old and had developed as a fibrous nodule in the jugal mucosa of a 71-year-old leucoderma patient. Considering focal inflammatory fibrous hyperplasia, fibroma and mucocele as differential diagnosis, excisional biopsy was carried out. A cystic cavity limited by pseudostratified epithelium without projections into the conjunctive tissue, with lymphoid tissue within, was microscopically identified. Without postoperative adverse events, the one-year clinical followup confirmed the favorable prognosis of this kind of lesion.

Un quiste linfoepitelial bucal es raro, con pocos casos reportados en la literatura. El objetivo de este artículo es describir un caso clínico, centrándose en los aspectos clínicos y diagnósticos, tratamiento y pronóstico. La lesión tuvo un año de evolución, y se había desarrollado como un nódulo fibroso en la mucosa yugal de un paciente de 71 años de edad con leucoderma. Teniendo en cuenta la hiperplasia fibrosa inflamatoria, fibroma y mucocele como diagnósticos diferenciales, se llevó a cabo una biopsia por escisión. Una cavidad quística limitada por epitelio pseudoestratificado sin proyecciones en el tejido conjuntivo, con tejido linfoide en el interior fue identificado microscópicamente. No se observaron eventos adversos postoperatorios, y el seguimiento clínico al año confirmó el pronóstico favorable de este tipo de lesión.

Mucocele of the glands of Blandin-Nuhn--clinical, pathological, and therapeutical aspects.

PURPOSE: This study aims to review anatomical, clinical, and pathological concepts as well as to discuss the most adequate therapeutic approach to the mucoceles of the glands of Blandin-Nuhn. DISCUSSION: The glands of Blandin-Nuhn are localized in the ventral part of the tongue, next to the apex in the lingual median plane. Development of a mucocele in this site is rarely seen; besides, as the glands of Blandin-Nuhn are not encapsulated and are directly overlapped to the muscle tissues, their manipulation tends to be different from the other oral mucoceles. CONCLUSION: As Blandin-Nuhn mucoceles are uncommon and their clinical appearance could be similar to other lesions, it is important that health professionals know their clinical and histopathological features to avoid having them misdiagnosed.

Carcinoma escamoso oral: análise retrospectiva de 185 casos / Oral squamous cell carcinoma: retrospective analysis of 185 cases

O carcinoma escamoso é a neoplasia maligna orobucal mais comum, representando mais de 90% dos cânceres nessa região. Este trabalho objetivou realizar um estudo epidemiológico dos casos de carcinomas escamosos orais diagnosticados pelo Serviço de Patologia do Departamento de Patologia e Propedêutica Clínica da Faculdade de Odontologia de Araçatuba - UNESP, no período entre 1995 e 2005. Foram estudados 185 casos verificando-se que o assoalho bucal e a língua foram os sítios mais afetados, com predomínio no sexo masculino e raça branca, e a faixa etária entre 41 e 60 anos, constatando-se que a maioria dos pacientes eram fumantes. O conhecimento desses dados é importante para que o cirurgião dentista possa atuar preventivamente, contribuindo para o diagnóstico precoce da neoplasia

The squamous cell carcinoma is the most common malignancy in the oral cavity, representing over 90% of cancers in this region. This study aimed to conduct an epidemiological study of oral squamous carcinoma cases diagnosed by the Department of Pathology, Department of Pathology and Clinical Propaedeutics in the Dentistry Faculty of Araçatuba - UNESP, in the period between 1995 and 2005. 185 cases were studied, it was observed that the oral floor and tongue were the sites most affected, with predominance in males, white race and aged between 41 and 60 years, noting that the majority of patients were smokers. Knowledge of these data is important for the dental surgeon to act preventively, contributing to early diagnosis of cancer

Considerações atuais da sialolitíase de ducto de glândula submandibular / Current considerations of sialolithiasis duct of submandibular gland

A sialolitíase é caracterizada pela formação de estrutura calcificada chamada sialolito no interior do sistema ductal salivar. Apesar de sua etiologia ser desconhecida, acredita-se que se origine da deposição de sais de cálcio ao redor de um acúmulo de restos orgânicos no lúmen do ducto, ou ainda ser desencadeada por sialoadenite crônica e obstrução parcial. Neste trabalho, os autores descrevem um caso de um paciente do sexo masculino, 46 anos de idade, cor parda, que apresentou como queixa “dor embaixo da língua”. Ao exame intra-oral foi observada a presença de um nódulo endurecido localizado na prega sublingual esquerda. Considerações atuais sobre características clínicas, radiográficas e tratamento foram abordadas neste trabalho

The sialolithiasis is characterized by the formation of calcified structure called sialolith within the salivary ductal system. Although its etiology is unknown, it is believed that is from the deposition of calcium salts around an accumulation of organic leftovers in the lumen of the duct or be resulted by chronic sialadenitis and partial obstruction. In this study, the authors describe a case of a male patient, 46 years old, brown, who presented the complaint “pain under the tongue.” The presence of a hardened nodule located in the left sublingual fold was observed through intra-oral exam. Current considerations about treatment, clinical and radiographic characteristics were addressed in this work

Osteolipoma of the buccal mucosa

Lipomas are benign mesenchymal neoplasms of soft tissue that can be found in any part of the human body. Conversely,their presence in the oral mucosa is rather uncommon, with approximately 4% of the cases occurring inthe oral cavity. In such cases, they are likely to have originated from mature adipose tissue and to be among severaldescribed histological variants of lipomas, which are identified according to the predominant type of tissue.There is a rare lipoma, known as an osteolipoma or an ossifying lipoma; however, little has been written this typeof lipoma characterized by a classical lipoma with areas of osseous metaplasia. Considering the few cases of oralosteolipomas previously described in the English-related literature and the consequent risk of misdiagnosis andovertreatment, this paper describes an extreme case of an osteolipoma affecting the buccal mucosa of an adult patient.This paper focuses particularly on the pathogenesis of this lesion and the discussion of a correct diagnosis (AU)

Osteolipoma of the buccal mucosa.

Lipomas are benign mesenchymal neoplasms of soft tissue that can be found in any part of the human body. Conversely, their presence in the oral mucosa is rather uncommon, with approximately 4% of the cases occurring in the oral cavity. In such cases, they are likely to have originated from mature adipose tissue and to be among several described histological variants of lipomas, which are identified according to the predominant type of tissue. There is a rare lipoma, known as an osteolipoma or an ossifying lipoma; however, little has been written this type of lipoma characterized by a classical lipoma with areas of osseous metaplasia. Considering the few cases of oral osteolipomas previously described in the English-related literature and the consequent risk of misdiagnosis and overtreatment, this paper describes an extreme case of an osteolipoma affecting the buccal mucosa of an adult patient. This paper focuses particularly on the pathogenesis of this lesion and the discussion of a correct diagnosis.