Background Histopathologic grading has been routinely used as a complement for clinical staging in the prognostication of patients with oral tongue squamous cell carcinoma (OTSCC). However, this subject remains contentious because there is no universally accepted grading system. Objectives This study compared the prognostic significance of four histopathologic grading systems in 80 cases of oral tongue squamous cell carcinoma (OTSCC). Methods Clinical and follow‐up information of the patients were obtained from medical records. Histopathologic malignancy grading of the tumor invasive front, Histologic risk assessment (HRA), World Health Organization (WHO) grading system, and Budding and Depth of invasion (BD) model were evaluated in the surgical specimens. Results The HRA, histopathologic malignancy grading and WHO systems did not predict survival. Patients with larger tumor size [Hazard ratio (HR): 2.38; 95% confidence interval (CI): 1.07‐5.27; P = 0.026] and patients with BD model high‐grade tumors (HR: 2.99; 95% CI: 1.03‐8.68; P = 0.034) were significantly associated with a poor 5‐year overall survival rate. In the multivariate analysis, tumor size was identified as the only significant independent prognostic factor (HR: 2.23; 95% CI: 1.00‐4.99; P = 0.050). None of the grading systems studied was associated with 5‐year disease‐free survival rates. Conclusions BD model was the only histopathologic grading system associated with the outcome of patients with OTSCC, indicating its potential value as an effective tool for the prognostication of OTSCC.
The aim of this study was to compare the number of CD57 + natural killer (NK) cells and CD8 + T lymphocytes between periapical granulomas (PGs) and radicular cysts (RCs). Twenty-fives cases of PGs and 25 of RCs were submitted to histological analysis and immunohistochemistry using anti-CD57 and anti-CD8 biomarkers. Positive cells were counted in 10 fields (400× magnification) and the median value was calculated for each case. Statistical tests were used to evaluate differences in the number of CD57+ NK cells and CD8 + T lymphocytes according to type of lesion, intensity of the infiltrate and thickness of the lining epithelium. The number of CD57 + NK cells and CD8 + T lymphocytes was higher in PGs than in RCs (p = 0.129 and p = 0.541, respectively). Comparison of the number of CD57 + NK cells in atrophic and hyperplastic epithelium revealed a larger number of cells in the atrophic epithelium (p = 0.042). A larger number of CD57 + NK cells and CD8 + T lymphocytes were observed in grade III infiltrates compared to grade I/II (p = 0.145 and p = 0.725, respectively). CD8 + T lymphocytes were more prevalent than CD57 + NK cells in most cases when PGs and RCs were analyzed separately or in combination (p < 0.0001). CD57+ NK cells and CD8 + T lymphocytes play a key role in antiviral defense and the presence of these cells supports evidence suggesting the participation of these microorganisms in the pathogenesis of PGs and RCs. The response mediated by CD8 + T lymphocytes was more frequent, indicating greater participation of the adaptive immunity in these chronic lesions.
Angioleiomyoma is a benign neoplasm that was considered a tumor of smooth-muscle origin until the most recent (2013) WHO classification of soft tissue tumors, in which it was reclassified as a tumor of perivascular origin. Angioleiomyomas rarely occur in the oral cavity. These lesions are treated surgically with good prognosis. This article presents a review of reports of oral angioleiomyoma in the literature from the last 5 years and describes the case of a 44-year-old man who presented with an asymptomatic nodule in the upper lip that had developed over a 6-month period. Diagnostic hypotheses of pleomorphic adenoma or canalicular adenoma were raised. Biopsy of the lesion, histopathological and immunohistochemical analysis (S100, CD34, H-caldesmon, and desmin) confirmed a diagnosis of angioleiomyoma. It is noteworthy that immunohistochemistry is an important auxiliary method for differential diagnosis of angioleiomyoma from other tumors, particularly myopericytoma.Keywords: angioleiomyoma; diagnoses; immunohistochemistry. ResumoO angioleiomioma é uma neoplasia benigna que, a partir da nova classificação da OMS (2013) para os tumores de tecidos moles, deixou de ser considerado um tumor de origem muscular lisa, passando a ser considerado um tumor de origem perivascular. Raramente os angioleiomiomas ocorrem na cavidade oral. A lesão é tratada cirurgicamente, com prognóstico considerado favorável. Este trabalho revisa os casos de angioleiomioma oral relatados na literatura nos últimos 5 anos e descreve esse tumor em um homem de 44 anos que apresentou um nódulo assintomático localizado em lábio superior, com evolução de 6 meses. As hipóteses diagnósticas foram de adenoma pleomórfico e adenoma canalicular. A lesão foi submetida a biópsia e análise histopatológica e imuno-histoquímica (S100, CD34, α-SMA, H-caldesmon e desmina) confirmaram o diagnóstico de angioleiomioma. Destacamos a imuno-histoquímica como um importante método auxiliar no diagnóstico diferencial do angioleiomioma com outras lesões e, principalmente, com o miopericitoma.Palavras-chave: angioleiomioma; diagnóstico; imuno-histoquímica.
Peripheral odontoma is a very rare odontogenic hamartoma arising in soft tissues. Here, we report a case of peripheral odontoma in a pediatric patient and review the cases published in the literature. An 11‐year‐old male patient presented a nodular lesion in the anterior region of the palate for over 1 year. Under the clinical hypothesis of fibroma, an excisional biopsy was performed. Histopathological examination revealed the presence of tooth‐like structures, formed by enamel, and dentin matrix, occasionally associated with the dental papilla and surrounding pulp tissue, thus, the histopathological diagnosis of peripheral odontoma was established. The patient has been undergoing follow‐up for 6 months without any signs of lesion recurrence. Peripheral odontomas are uncommon lesions that usually affect young patients and display a preference for the maxilla and limited growth potential. The recognition of the clinical and histopathological features of the peripheral odontoma is indispensable for the establishment of its diagnosis.
Objetivo: Identificar as intercorrências vasculares mais prevalentes pela injeção de ácido hialurônico em harmonização orofacial e descrever as estratégias de intervenção para tratamento dessas complicações. Revisão bibliográfica: A embolização e compressão vascular são as formas mais graves de intercorrência na harmonização orofacial ocasionadas por grandes quantidades de material injetado, desenvolvendo-se quadros de isquemia, necrose e até mesmo cegueira. A aplicação hialuronidase ainda continua off label para degradar ácido hialurônico nos casos de oclusão/compressão vascular, no entanto, esta enzima é até o momento a única opção eficiente para reverter essas complicações, onde seu efeito é incontestável nas melhores evidências disponíveis. Apesar dos preenchedores de ácido hialurônico ser bem tolerados, a compreensão adequada dos critérios clínicos e protocolos de tratamento, domínio e competência técnica para correção das intercorrências são elementos fundamentais para segurança do ácido hialurônico nas harmonizações orofaciais. Considerações finais: O conhecimento da anatomia, o planejamento adequado do tratamento, bem como o diagnóstico precoce e tratamento correto das complicações vasculares (compressão e embolização arterial, necrose, cegueira) faz com que procedimentos em harmonização facial tenham resultados previsíveis e eficientes.
O granuloma piogênico é uma lesão benigna relativamente comum que pode acometer pacientes de todas as idades, sendo mais prevalente em adultos jovens e com predileção pelo sexo feminino, principalmente, no período gestacional. Sua etiologia não é totalmente compreendida, mas parece ter natureza reacional. Normalmente, apresenta-se como um nódulo de crescimento exofítico, coloração, tipicamente, avermelhada, superfície ulcerada, facilmente sangrante. A lesão é tratada convencionalmente através de remoção cirúrgica, sendo essencial a eliminação dos fatores irritativos locais para redução da ocorrência de recidivas. O presente trabalho tem como objetivo relatar um caso de Granuloma piogênico diagnosticado em uma paciente do sexo feminino, 18 anos de idade, que apresentou lesão localizada em papila interdental, entre dentes 12 e 13, com evolução assintomática de, aproximadamente, 6 meses. A lesão foi tratada cirurgicamente e o material removido foi encaminhado ao laboratório de Anatomia patológica para confirmação do diagnóstico. Após 30 dias de acompanhamento pós-operatório, observou-se satisfatório reparo tecidual e a paciente encontra-se há 1 ano sem sinais de recidiva da lesão.
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