Unusual cystic epithelial choristoma in a celiac lymph node.

With the exception of müllerian-like glandular inclusions in women, reports of nonendometriotic benign glandular inclusions in abdominal lymph nodes are uncommon. We report the case of a 50-year-old woman with an apparently unique, non-müllerian, benign cystic epithelial choristoma in a celiac lymph node found incidentally at cholecystectomy. This case further expands the spectrum of benign lesions that must be differentiated from metastatic adenocarcinoma. Possible histogenesis is discussed.

Clinico-pathologic correlation of 385 lesions of marginal destructive periodontitis.

THIS STUDY investigated the relationship between the degree of periodontal destruction present in advanced periodontal lesions and consistently associated infiltrates of lymphocytes and/or plasma cells. A total of 385 biopsy specimens were obtained from the depths of pockets during routine periodontal surgery. The selected lesions were in "established" or "advanced" stages and were classified according to pocket depth as Class I (4-6 mm) or Class II (7-10 mm). The infiltrates attached to the cementum, bone, or lining the pocket soft tissue wall were classified in five types according to the distribution of lymphocytes, plasmocytes, and neutrophils. Statistical evaluation of the findings demonstrates a strong, significant relationship (P less than 0.001) between the degree of destruction of supporting periodontal tissues (Class II) and the predominance of plasma cells in the infiltrate (Type a). A weaker significant correlation (P less than 0.02) was found between predominant lymphocytic populations (Type b) and Class I lesions. The assumption was made that local, specific, cellular infiltrates reflecting immunologic mechanisms are associated with the degree of periodontal destruction in humans.

Cutaneous neosporosis in two adult dogs on chronic immunosuppressive therapy.

Antemortem diagnosis of generalized ulcerative and pyogranulomatous dermatitis with numerous intralesional tachyzoites was made from skin biopsy specimens from 2 adult dogs on chronic immunosuppressive therapy. A 9-year-old Italian Greyhound was on long-term corticosteroid therapy for the treatment of a lupus-like systemic autoimmune disorder, and a 7-year-old Labrador Retriever had received several months of chemotherapy for lymphosarcoma. The tachyzoites were identified as Neospora caninum by immunoperoxidase immunohistochemistry. Both dogs were treated with clindamycin. Lesions in the Greyhound resolved; however, the Labrador Retriever was euthanized because of evidence of neuromuscular disease, despite improvement of the skin lesions. These 2 cases indicate that cutaneous neosporosis can occur in adult dogs on chronic immunosuppressive therapy. The disease may result from reactivation of a congenital infection and/or a recently acquired primary infection.

Computed dental radiography used to reproduce antemortem film position.

Visual comparison of conventional antemortem and postmortem dental radiographs is often included in forensic identification. Ten forensic cases employing dry mandibular and maxillary bones and a dry study skull were exposed using the CDR digital dental X-ray system developed by Schick Technologies, Inc. Exposures of 0.08s at 10 mA and 70 kVp were taken with an INTREX intraoral dental X-ray unit. Digital radiography has the ability to produce an image instantaneously, allowing an operator to retake an incorrectly aligned radiograph almost immediately. It gives the forensic scientist a simplified method for reproducing antemortem radiographic position more efficiently and often with greater accuracy than conventional radiography.

Identification of a foreign body using energy dispersive x-ray analysis.

A foreign object, presumably swallowed during a dental appointment, was recovered by using an esophagoscope and thought to be a piece of dental impression material, probably alginate. It was identified as being of nondental origin by means of visible light and scanning electron microscopy (SEM), the latter coupled to an energy dispersive X-ray analyzer. Histologic examination revealed some amorphous crystalline material surrounded by parakeratin and exfoliated squamous cells. The material was essentially radiolucent. A known dental alginate impression material contained diatomaceous earth filler (siliceous shells of diatoms), but no microscopic symmetrical figures were seen in the foreign body. After dehydration, both materials were carbon-coated and observed in an SEM at 20 kV at magnifications up to 2000 X. The spectrum of secondary X-rays produced by the scanning electron beam revealed only magnesium in the foreign body and mostly silicon in the dental alginate. There are no known dental products that contain magnesium as the only inorganic ingredient and so the foreign body is believed to be not of dental origin. The patient may have had an antacid or laxative having magnesium as a major ingredient in the stomach, and this may have been refluxed from the stomach after stimulation of the normal gag reflex during the dental procedure.

Postmortem examination of incinerated teeth with the scanning electron microscope.

Fragments recovered from the burned wreckage of a gasoline truck and thought to be parts of teeth were confirmed as such after they were examined with a scanning electron microscope. The appearance of the fragments was compared with previously published descriptions of teeth which had been incinerated under laboratory conditions and also examined by scanning electron microscopy.

Identification via dental remains: Pan American Flight 759.

Pan American Flight 759 crashed on takeoff from New Orleans International Airport on 9 July 1982. One-hundred-and-fifty-four persons lost their lives making this the second worst air crash in the United States. A dental identification team was assembled and began working the next morning. Ninety-three victims were positively identified by dental means and twenty-three other victims had strong supporting dental evidence as to their identities. The organization, method used, planning, and problem resolution concerning the dental team for this crash are presented.

False aneuploidy in flow cytometric DNA analysis of paraffin embedded tissue: effects of Carnoy's fixation.

False aneuploidy was detected on flow cytometric DNA analysis of paraffin embedded axillary lymph nodes negative for tumor. It was hypothesized that "clearing" of axillary fat in Carnoy's solution to facilitate lymph node dissection might be responsible for false aneuploidy. Various tissues fixed overnight in Carnoy's were compared to formalin fixed paraffin embedded controls. Under these conditions no false aneuploid peaks were detected, but Carnoy's fixation did shift the G0/G1 histogram peak to the left, increase the G0/G1 CV and increase the S phase fraction relative to formalin fixed controls. It was then hypothesized that partial fixation of nodes in Carnoy's followed by formalin fixation might result in false aneuploid peaks. Twenty-two lymph nodes were partially fixed in Carnoy's for periods ranging from 5 to 60 min followed by complete fixation in formalin. Seven of these nodes did show false aneuploid peaks. By contrast, no aneuploidy was detected in formalin fixed controls. It was concluded that tissues in contact with Carnoy's solution may be a source of false aneuploidy and/or false elevation of S phase fraction. This reinforces the need for matched negative tissue controls for DNA analysis of paraffin embedded specimens whenever possible.

Can dentists recognize their own work? The forensic implications.

After 10 months, 71.4% of a group of dental students were able to recognize amalgam restorations that they had placed in the mouths of manikins. After 24 months, 57.1% of the group were able to recognize their work again. In contrast, only 5.5% of a second group of students, who did not have the interim viewing at 10 months, could recognize their work at 24 months. These results suggest that, with time, dental operators lose the ability to recognize their work but that this ability is prolonged by interim observations of the work. This study underscores the need for dentists to chart and record accurately any artifacts introduced into the patient's mouth, as well as any features that would make the patient unique upon forensic examination.

Morphologic changes in the thyroid after irradiation for Hodgkin's and non-Hodgkin's lymphoma.

Four cases of thyroidectomy for suspected thyroid carcinoma after previous irradiation for Hodgkin's or non-Hodgkin's lymphoma are reviewed. The patients ranged in age from 18 to 33 years at the time of thyroid surgery with an average latency period of 12 years (range, 8-20 years) from radiation therapy to thyroidectomy. All patients had a clinically palpable thyroid nodule, and pathologically showed a pattern of multiple adenomatous nodules with cytologic atypia. The microscopic changes were sufficiently striking to cause the primary pathologist to request consultation to rule out thyroid carcinoma in each case. Fine-needle aspiration was performed in one case and suggested a thyroid neoplasm. The pathologic findings are reviewed and distinction of this lesion from thyroid carcinoma is discussed.

Gardner's syndrome: report of case.

This case graphically illustrates the dental clinician's role in the diagnosis of Gardner's syndrome. Findings in the head and neck in this case led to discovery of the disease. Because of the high incidence of malignant transformation, surgery of the lower intestinal tract is done to remove any polypoid lesions. Normal-appearing tissue from which carcinoma might arise is also removed. Because of the usual occurrence of head and neck lesions in Gardner's syndrome, the clinician can make a major contribution in the diagnosis of this uncommon, but important, disease.