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1.
J Oral Pathol Med ; 50(6): 613-621, 2021 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-34089204

RESUMO

BACKGROUND: Plasma cell neoplasms are characterized by the proliferation of a single clone of plasma cells with production of a monoclonal immunoglobulin. They can manifest as a single lesion (plasmacytoma) or as multiple lesions (multiple myeloma). METHODS: Paraffin-embedded tissue blocks of patients microscopically diagnosed with plasma cell neoplasms in the jaws were retrieved from five pathology files. Data including clinical, radiographic, microscopic and immunohistochemical findings, treatment employed and follow-up status were retrieved from the pathology reports. RESULTS: Fifty-two cases were retrieved (mean age: 59.4 years) without sex predilection. The mandible was the most affected site (67.3%), usually associated with pain and/or paresthesia (53.8%). Lesions in other bones besides the jaws were reported for 24 patients (46.2%). Radiographically, tumours usually presented as poorly defined osteolytic lesions with unilocular or multilocular images, while microscopy revealed diffuse proliferation of neoplastic plasma cells with nuclear displacement and abundant eosinophilic cytoplasm. Two cases were classified as anaplastic, and amyloid deposits were found in two other cases. Immunohistochemistry was positive for plasma cell markers and negative for CD20 and CD3, and monoclonality for kappa light chain predominated. The overall survival rate after 5 years of follow-up was 26.6%. CONCLUSION: Plasma cell neoplasms are aggressive tumours with a poor prognosis and involvement of the jaws may be the first complaint of the patient. Thus, oral pathologists, head and neck surgeons and dentists should be aware of their clinical, radiographic and microscopic manifestations.


Assuntos
Mieloma Múltiplo , Neoplasias de Plasmócitos , Plasmocitoma , Humanos , Imuno-Histoquímica , Arcada Osseodentária/diagnóstico por imagem , Pessoa de Meia-Idade , Mieloma Múltiplo/diagnóstico por imagem , Neoplasias de Plasmócitos/diagnóstico por imagem , Plasmocitoma/diagnóstico por imagem
2.
Int J Surg Pathol ; 29(3): 263-272, 2021 May.
Artigo em Inglês | MEDLINE | ID: mdl-32734791

RESUMO

Mucosal melanomas are aggressive tumors, rarely observed in the oral cavity. The diagnosis is based on the clinical and microscopical features. Often these tumors had variable amounts of melanin pigmentation. However, when melanin is absent, the tumors are denominated amelanotic, presenting a tendency to misdiagnosis and delayed treatment. The aim of this study was to describe the clinicopathologic features of a series of oral amelanotic melanomas (OAM). Records of all cases of OAM were retrospectively retrieved from oral pathology services from January 2002 to January 2019. Data regarding the clinical features, morphological aspects, immunohistochemical reactions, treatment, and follow-up status were collected. Eight cases of OAM were included, 6 in men and 2 in women (ratio of 3:1) ranging in age from 33 to 77 years (mean 53.6 years). Clinically, the tumors presented as masses or ulcerated swellings. The most common intraoral locations of the tumors were gingiva and palate. Cervical lymph node metastasis was detected in 3 patients at the first examination. All but one patient died from complications of the tumors after a mean follow-up period of 8.5 months. In conclusion, OAM is a very aggressive malignant tumor, and when melanin is absent, an immunohistochemical panel comprising S100, melan A, HMB45, and SOX10 should be performed.

3.
Artigo em Inglês | MEDLINE | ID: mdl-32482537

RESUMO

OBJECTIVE: The aim of this study was to describe the clinicopathologic features of a series of gnathic epithelioid osteoblastomas. As high levels of Proto-oncogene c-Fos proteins resulting from FOS-FOSB translocation were recently demonstrated in osteoblastomas, we also evaluated the immunoexpression of these proteins. STUDY DESIGN: Records of all cases of epithelioid osteoblastoma of the jaws were retrieved from oral pathology services, and their clinicopathologic and immunohistochemical data were collected. Immunohistochemistry was also performed by using anti-FOS and anti-FOSB antibodies. RESULTS: Six cases of epithelioid osteoblastomas were obtained, 4 in men and 2 in women, and they were mainly located in the posterior body of the mandible (n = 4). Radiographically, the tumors showed mixed radiolucent and radiopaque images, most with poorly defined margins. Microscopically, large epithelioid cells with eccentrically located nuclei predominated among osteoid and immature bone trabeculae. Sharp delineation from adjacent normal bone was observed in all cases. FOS immunostaining was diffuse and strong in the cytoplasm and nucleus of neoplastic cells in all cases, whereas FOSB was only focally positive, with few epithelioid osteoblasts showing nuclear staining. CONCLUSIONS: Although epithelioid osteoblastomas of the jaws are locally aggressive, widespread metastasis does not occur, and, as with conventional osteoblastomas, there is wide expression of the FOS protein.


Assuntos
Neoplasias Ósseas , Osteoblastoma , Feminino , Humanos , Imuno-Histoquímica , Masculino , Proteínas Proto-Oncogênicas c-fos
4.
J. appl. oral sci ; 22(2): 131-137, Mar-Apr/2014. tab, graf
Artigo em Inglês | LILACS | ID: lil-704194

RESUMO

Central giant cell lesion (CGCL) and peripheral giant cell lesion (PGCL) are non-neoplastic proliferative processes of the jaws. PGCL is a reactive process induced by irritant local factors and CGCL is an intra-osseous lesion of unknown etiology. Both lesions exhibit similar histologic features showing abundant mononuclear cells, admixed with a large number of multinucleated giant cells and a rich vascularized stroma with extravasated erythrocytes, hemosiderin deposition, and blood-filled pools. Recent studies have linked fatty acid synthase (FASN) with angiogenesis. Objective: To evaluate angiogenesis and lymphangiogenesis and their relationship with FASN expression in CGCL and PGCL. Material and Methods: Thirteen CGCL and 14 PGCL of the jaws were selected for immunoexpression of FASN; CD34 and CD105 (to assess blood microvessel density [MVD] and microvessel area [MVA]); and D2-40 (to assess lymphatic MVD and MVA). Results: Within PGCL and CGCL, MVD-CD34 was signifcantly higher than MVD-CD10S, followed by MVD-D2-40. Moreover, a signifcantly higher number of FASN-positive multinucleated giant cells than mononuclear cells were observed. Between PGCL and CGCL, only MVD-CD34 and all MVA were signifcantly higher in PGCL. Positive correlation between MVA-CD10S with FASNpositive mononuclear cells in both lesions was observed. Conclusions: Our results show both lesions exhibiting similar levels of FASN expression and neoangiogenesis, suggesting constitutive processes that regulate tissue maintenance. .


Assuntos
Adolescente , Adulto , Feminino , Humanos , Masculino , Adulto Jovem , Ácido Graxo Sintase Tipo I/análise , Células Gigantes/patologia , Doenças Maxilomandibulares/patologia , Linfangiogênese/fisiologia , Neovascularização Patológica/patologia , Antígenos CD/análise , /análise , Biópsia , Imuno-Histoquímica , Microvasos/patologia , Estudos Retrospectivos , Receptores de Superfície Celular/análise , Estatísticas não Paramétricas
5.
J Appl Oral Sci ; 22(2): 131-7, 2014 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-24676584

RESUMO

UNLABELLED: Central giant cell lesion (CGCL) and peripheral giant cell lesion (PGCL) are non-neoplastic proliferative processes of the jaws. PGCL is a reactive process induced by irritant local factors and CGCL is an intra-osseous lesion of unknown etiology. Both lesions exhibit similar histologic features showing abundant mononuclear cells, admixed with a large number of multinucleated giant cells and a rich vascularized stroma with extravasated erythrocytes, hemosiderin deposition, and blood-filled pools. Recent studies have linked fatty acid synthase (FASN) with angiogenesis. OBJECTIVE: To evaluate angiogenesis and lymphangiogenesis and their relationship with FASN expression in CGCL and PGCL. MATERIAL AND METHODS: Thirteen CGCL and 14 PGCL of the jaws were selected for immunoexpression of FASN; CD34 and CD105 (to assess blood microvessel density [MVD] and microvessel area [MVA]); and D2-40 (to assess lymphatic MVD and MVA). RESULTS: Within PGCL and CGCL, MVD-CD34 was signifcantly higher than MVD-CD10S, followed by MVD-D2-40. Moreover, a signifcantly higher number of FASN-positive multinucleated giant cells than mononuclear cells were observed. Between PGCL and CGCL, only MVD-CD34 and all MVA were signifcantly higher in PGCL. Positive correlation between MVA-CD10S with FASNpositive mononuclear cells in both lesions was observed. CONCLUSIONS: Our results show both lesions exhibiting similar levels of FASN expression and neoangiogenesis, suggesting constitutive processes that regulate tissue maintenance.


Assuntos
Ácido Graxo Sintase Tipo I/análise , Células Gigantes/patologia , Doenças Maxilomandibulares/patologia , Linfangiogênese/fisiologia , Neovascularização Patológica/patologia , Adolescente , Adulto , Antígenos CD/análise , Antígenos CD34/análise , Biópsia , Endoglina , Feminino , Humanos , Imuno-Histoquímica , Masculino , Microvasos/patologia , Receptores de Superfície Celular/análise , Estudos Retrospectivos , Estatísticas não Paramétricas , Adulto Jovem
6.
Med. oral patol. oral cir. bucal (Internet) ; 19(1): e32-e38, ene. 2014. ilus, tab
Artigo em Inglês | IBECS | ID: ibc-118250

RESUMO

OBJECTIVES: To describe the clinicopathologic and immunohistochemical features of Burkitt's lymphoma of the jaws in 7 patients of Northern Brazil. Study DESIGN: Clinical data concerning gender, age, affected site, clinical presentation, symptomatology and follow-up were collected from the clinical files. Histopathology was complemented with a broad immunohistochemical panel and in situ hybridization for Epstein-Barr virus (EBV).RESULTS: Most of the patients were infants and 5 out of 7 were males. The mandible was affected in 5 cases and all patients also presented abdominal involvement. All cases were positive for CD45, CD20, CD79a, CD10, Bcl-6 and EBV. Ki-67 proliferative index was approximately 100%. Six patients were treated with R-CHOP (Rituximab + Cyclophosphamide, Doxorubicin, Vincristine and Prednisolone) chemotherapy, and 2 of these died of the disease. One young adult patient refused treatment and died 3 months after initial diagnosis. CONCLUSIONS: Burkitt's lymphoma of the jaws diagnosed in the Amazon region of Brazil present similar clinico-pathologic features to those described in endemic areas of Africa, including EBV positivity


No disponible


Assuntos
Humanos , Linfoma de Burkitt/epidemiologia , Neoplasias Mandibulares/epidemiologia , Distribuição por Idade e Sexo , Brasil/epidemiologia
7.
Med Oral Patol Oral Cir Bucal ; 19(1): e32-8, 2014 Jan 01.
Artigo em Inglês | MEDLINE | ID: mdl-23986017

RESUMO

OBJECTIVE: To describe the clinicopathologic and immunohistochemical features of Burkitt's lymphoma of the jaws in 7 patients of Northern Brazil. STUDY DESIGN: Clinical data concerning gender, age, affected site, clinical presentation, symptomatology and follow-up were collected from the clinical files. Histopathology was complemented with a broad immunohistochemical panel and in situ hybridization for Epstein-Barr virus (EBV). RESULTS: Most of the patients were infants and 5 out of 7 were males. The mandible was affected in 5 cases and all patients also presented abdominal involvement. All cases were positive for CD45, CD20, CD79a, CD10, Bcl-6 and EBV. Ki-67 proliferative index was approximately 100%. Six patients were treated with R-CHOP (Rituximab + Cyclophosphamide, Doxorubicin, Vincristine and Prednisolone) chemotherapy, and 2 of these died of the disease. One young adult patient refused treatment and died 3 months after initial diagnosis. CONCLUSION: Burkitt's lymphoma of the jaws diagnosed in the Amazon region of Brazil present similar clinicopathologic features to those described in endemic areas of Africa, including EBV positivity.


Assuntos
Linfoma de Burkitt/patologia , Neoplasias Maxilomandibulares/patologia , Adolescente , Adulto , Brasil , Criança , Pré-Escolar , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Adulto Jovem
8.
Braz Dent J ; 24(3): 284-8, 2013.
Artigo em Inglês | MEDLINE | ID: mdl-23969921

RESUMO

Extranodal natural killer (NK)/T-cell lymphoma is an aggressive malignant tumor with distinctive clinicopathological features, characterized by vascular invasion and destruction, prominent necrosis, cytotoxic lymphocyte phenotype and a strong association with Epstein-Barr virus. Here is reported an extranodal nasal NK/T-cell lymphoma case, involving the maxillary sinus, floor of the orbit, and interestingly extending to the oral cavity through the alveolar bone and buccal mucosa, preserving the palate, leading to a primary misdiagnosis of aggressive periodontal disease. Moreover, this work investigated for the first time the immunohistochemical expression of fatty acid synthase (FASN) and glucose transporter 1 (GLUT-1) proteins in this neoplasia. FASN showed strong cytoplasmatic expression in the neoplastic cells, whereas GLUT-1 and CD44 were negative. These findings suggest that the expression of FASN and the loss of CD44 might be involved in the pathogenesis of the extranodal nasal NK/T-cell lymphoma, and that GLUT-1 may not participate in the survival adaptation of the tumor cells to the hypoxic environment. Further studies with larger series are required to confirm these initial results.


Assuntos
Ácido Graxo Sintase Tipo I/análise , Neoplasias Gengivais/diagnóstico , Transportador de Glucose Tipo 1/análise , Receptores de Hialuronatos/análise , Linfoma Extranodal de Células T-NK/diagnóstico , Neoplasias do Seio Maxilar/diagnóstico , Neoplasias Orbitárias/diagnóstico , Adulto , Erros de Diagnóstico , Evolução Fatal , Feminino , Gengivite Ulcerativa Necrosante/diagnóstico , Humanos
9.
Braz. dent. j ; 24(3): 284-288, May-Jun/2013. tab, graf
Artigo em Inglês | LILACS | ID: lil-681865

RESUMO

Extranodal natural killer (NK)/T-cell lymphoma is an aggressive malignant tumor with distinctive clinicopathological features, characterized by vascular invasion and destruction, prominent necrosis, cytotoxic lymphocyte phenotype and a strong association with Epstein-Barr virus. Here is reported an extranodal nasal NK/T-cell lymphoma case, involving the maxillary sinus, floor of the orbit, and interestingly extending to the oral cavity through the alveolar bone and buccal mucosa, preserving the palate, leading to a primary misdiagnosis of aggressive periodontal disease. Moreover, this work investigated for the first time the immunohistochemical expression of fatty acid synthase (FASN) and glucose transporter 1 (GLUT-1) proteins in this neoplasia. FASN showed strong cytoplasmatic expression in the neoplastic cells, whereas GLUT-1 and CD44 were negative. These findings suggest that the expression of FASN and the loss of CD44 might be involved in the pathogenesis of the extranodal nasal NK/T-cell lymphoma, and that GLUT-1 may not participate in the survival adaptation of the tumor cells to the hypoxic environment. Further studies with larger series are required to confirm these initial results.


O linfoma de células natural killers (NK)/T extranodal é um tumor maligno agressivo com características clinicopatológicas distintas, caracterizadas por invasão e destruição vasculares, necrose proeminente, fenótipo linfocítico citotóxico e uma forte associação com o vírus Epstein-Barr. Relatamos aqui um caso de linfoma de células NK/T nasal extranodal, envolvendo o seio maxilar, assoalho de órbita, e interessantemente estendendo-se para a cavidade oral através do osso alveolar e mucosa vestibular, preservando o palato, levando a um diagnóstico inicial equivocado de doença periodontal agressiva. Ainda, nós investigamos pela primeira vez a expressão imunoistoquímica das proteínas Fatty acid sinthase (FASN) e glucose transporter 1 (GLUT-1) nesta neoplasia. FASN revelou uma forte expressão citoplasmática nas células neoplásicas, enquanto GLUT-1 e CD44 foram negativas. Estes achados sugerem que a expressão de FASN e a perda de CD44 podem estar envolvidas na patogênese do linfoma de células NK/T nasal extranodal, e que GLUT-1 não deve participar da adaptação das células tumorais ao ambiente de hipóxia. Estudos adicionais com séries maiores são necessários para confirmar nossos resultados iniciais.


Assuntos
Adulto , Feminino , Humanos , /análise , Ácido Graxo Sintase Tipo I/análise , Neoplasias Gengivais/diagnóstico , Transportador de Glucose Tipo 1/análise , Linfoma Extranodal de Células T-NK/diagnóstico , Neoplasias do Seio Maxilar/diagnóstico , Neoplasias Orbitárias/diagnóstico , Erros de Diagnóstico , Evolução Fatal , Gengivite Ulcerativa Necrosante/diagnóstico
10.
Rev. cir. traumatol. buco-maxilo-fac ; 12(2): 37-42, Abr.-Jun. 2012. ilus
Artigo em Português | LILACS-Express | LILACS | ID: lil-792238

RESUMO

entre os cistos odontogênicos, temos o cisto radicular, considerado uma lesão frequentemente encontrada nos maxilares, associado ao ápice de um dente com necrose pulpar. Frequentemente, são assintomáticos, apresentam crescimento lento e são descobertos em radiografias de rotina. No presente estudo, é relatado um caso de um paciente de 55 anos com dois cistos radiculares, sendo um com aproximadamente 4 X 2 cm associado a raiz residual na região molares inferiores do lado direito e outro com aproximadamente 1,7 x 1,3 cm associado à raiz residual na região de pré-molares inferiores do lado esquerdo. Foram feitas as exodontias e as remoções cirúrgicas dos cistos. O exame histopatológico confirmou o diagnóstico clínico.


among the odontogenic lesions, radicular cysts are frequently found in the jaws and are associated with the apex of a tooth with necrotic pulp. They are often asymptomatic, of slow growth, and are diagnosed on routine radiographs. This case report presents two radicular cysts in a 55-year-old patient. One of the cysts measured approximately 4 x 2 cm and was associated with a residual root in the right mandibular molar area. The other cyst measured approximately 1.7 x 1.3 cm and was associated with a residual root in the left mandibular premolar area. The residual roots and cysts were surgically removed. Histopathological examination of the lesions confirmed the clinical diagnosis.

11.
Odontol. pediatr. (Lima) ; 11(1): 18-26, ene.-jun. 2012. graf, tab
Artigo em Espanhol | LILACS, LIPECS | ID: lil-661356

RESUMO

Objetivo: determinar el predominio de la caries dental en niños de 6 a 12 años de edad que viven en las zonas urbanas y rurales en una pequeña ciudad en Brasil, así como comprobar la relación entre aspectos demográficos y la experiencia de caries. Materia y Métodos: el estudio transversal se llevó a cabo con una población de 185 estudiantes que residen en la ciudad de Patis, estado de Minas Gerais, Brasil, siendo 72 de 6 años de edad y 113 de 12 años de edad. Después del cepillado supervisado, los niños fueron examinados. Resultados: se observó que el predominio de caries en dentición primaria en los niños de 6 años de edad fue 87,5% y el índice de ceod de 5,2 y 74,4%, y CPOD de 2,8 entre los estudiantes de 12 años. El predominio de caries dental fue elevada entre los niños de 6 a 12 años de edad, residentes en las zonas rurales con un predominio del componente cariado de los índices ceod y CPOD. Conclusiones: los resultados han demostrado que existe una necesidad de tratamiento acumulado y una baja cobertura de servicios dentales locales, lo que sugiere la importancia de centralizar los esfuerzos para adoptar mejores estrategias para cambiar la situación existente.


Objectives: the aim of this study was to evaluate the prevalence of dental caries in schoolchildren between 6 and 12 years old living in urban and rural areas of a small city of Brazil, to investigate the relationship between demographics and caries experience. Methods: we conducted cross-sectional study population of 185 children living in the city of Patis, Minas Gerais State. Seventy two children were 6 years- old and 113 were 12 12 year old. Children were examined after supervised toothbrushing. Results: it was observed that the prevalence of caries in primary teeth in 6 year old school children was 87.5% and the dmft index was5.2 and in the 12 year old group, a prevalence of 74.4%, and DMFT of 2.8. The prevalence of dental caries was higher in 6 than in 12 year old children, living in rural areas with a predominance of the decay component of the results showed the need for accumulated treatment and low coverage of the local dental service, suggesting the importance to centralize efforts to adopt more appropiate strategies to reverse the deficit situation.


Assuntos
Humanos , Masculino , Feminino , Criança , Brasil , Cárie Dentária , Educação em Saúde , Higiene Bucal , Promoção da Saúde , Estudos Transversais
12.
Braz. dent. j ; 23(2): 91-96, Mar.-Apr. 2012. ilus, tab
Artigo em Inglês | LILACS | ID: lil-626294

RESUMO

A high proliferative activity of the odontogenic epithelium in ameloblastoma (AM) and keratocystic odontogenic tumor (KOT) has been demonstrated. However, no previous study has simultaneously evaluated cell proliferation and apoptotic indexes in AM and KOT, comparing both lesions. The aim of this study was to assess and compare cell proliferation and apoptotic rates between these two tumors. Specimens of 11 solid AM and 11 sporadic KOT were evaluated. The proliferation index (PI) was assessed by immunohistochemical detection of Ki-67 and the apoptotic index (AI) by methyl green-pyronine and in situ DNA nick end-labelling methods. KOT presented a higher PI than AM (p<0.05). No statistically significant difference was found in the AI between AM and KOT. PI and AI were higher in the peripheral cells of AM and respectively in the suprabasal and superficial layers of KOT. In conclusion, KOT showed a higher cell proliferation than AM and the AI was similar between these tumors. These findings reinforce the classification of KOT as an odontogenic tumor and should contribute to its aggressive clinical behavior.


Uma elevada atividade proliferativa do epitélio odontogênico em ameloblastoma (AM) e tumor odontogênico ceratocístico (TOC) tem sido demonstrada. Entretanto, não há estudos prévios avaliando simultaneamente os índices de proliferação celular e apoptótico em AM e TOC, comparando ambas as lesões. O objetivo desse estudo foi avaliar e comparar os índices de proliferação celular e apoptótico entre esses dois tumores. Onze amostras deAM sólido e 11 amostras de TOC esporádico foram avaliadas. O índice de proliferação celular foi avaliado por meio da imunomarcação para o antígeno Ki-67 e o índice apoptótico pelas técnicas demetyl-green-pironina e TUNEL. O TOC apresentou um índice de proliferação celular maior que o AM (p<0,05). Nenhuma diferença estatística foi encontrada no índice apoptótico entre AM e TOC. Os índices de proliferação celular e apoptótico foram maiores nas células da camada periférica do AM e, respectivamente, nas camadas suprabasal e superficial do TOC. Em conclusão, o TOC apresentou proliferação celular maior que o AM e o índice apoptótico foi similar entre estes tumores. Estes achados reforçam a classificação do TOC como um tumor odontogênico e podem contribuir para o seu comportamento clínico agressivo.


Assuntos
Humanos , Apoptose , Ameloblastoma/patologia , Proliferação de Células , Neoplasias Maxilomandibulares/patologia , Cistos Odontogênicos/patologia , Epitélio/patologia , Doenças Maxilomandibulares/patologia , /análise
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