The central odontogenic fibroma (COF) is a rare benign odontogenic mesenchymal tumor of jaw bones. The World Health Organization (WHO) recognizes two variants of COF namely: 1) Epithelial-rich type (WHO) and 2) epithelial-poor type (simple type). Rare variants like ossifying COF, COF associated with giant cell lesions, and amyloid have been documented. This article presents a case of an epithelial-rich variant of COF in a 24-year-old female. It presented as a bony swelling of the maxilla and appeared as a mixed lesion in radiographs. Histopathology showed a highly cellular fibrous connective tissue stroma with plump fibroblasts and long strands of odontogenic epithelium exhibiting mild eosinophilic to clear cytoplasm. Numerous cementum-like hematoxyphilic calcifications of various sizes akin to dentin or acellular cementum were observed. We believe that clinical and radiographic features of this case may add valuable knowledge to the already existing literature.
The orderly increase in the expression of iNOS from normal, through precancer, to OSCC suggests the essential role played by iNOS in epithelial transformation and tumour formation.
Paraneoplastic neurological syndromes (PNS) are rare, remote effects of cancer that are usually caused by an altered immune response to the tumor and not due to the tumor mass, metastasis, infection, ischemia, or metabolic derangements. PNSs can affect any area of the central, the peripheral, and the autonomic nervous systems. These are rare in lymphomas compared with solid tumors attributed to their presentation even in late stages and the absence of onconeural antibodies. We present a child with stage IIB Hodgkin lymphoma who presented with dual PNS, achalasia cardia, and Holmes Adie pupil occurring synchronously with the cancer.
Context:Inducible nitric oxide synthase (iNOS) is a cytoplasmic enzyme which plays a crucial role in the pathogenesis of oral carcinomas and sarcomas.Aims:The objective of this study was to analyze the immunohistochemical expression of iNOS in carcinomas and sarcomas affecting the oral cavity in order to understand the possible role of iNOS in their biologic behavior and to correlate iNOS expression with lymph node metastasis in carcinomas and sarcomas.Settings and Design:Patients, who attended the oral diagnosis department of Vinayaka Missions Sankarachariyar Dental College, were screened, for the purpose of the study. Besides these, paraffin-embedded tissue blocks were also retrieved from archives of the Oral and Maxillofacial Pathology Department. A total of 40 cases (20 carcinomas and 20 sarcomas) were selected for the study.Subjects and Methods:A total of 40 cases (20 carcinomas and 20 sarcomas) were selected for the study. Five apparently normal tissues were obtained from the tumor adjacent normal tissue to be used as a control. These were subjected to immunohistochemical staining using antibody to iNOS and evaluated.Statistical Analysis Used:The results were analyzed using the Chi-square test.Results:Among the 20 carcinomas 19 showed a positive immunoreactivity for iNOS and 1 case was negative. Among the 19 immunopositive iNOS cases of carcinomas, 15 cases showed positive lymph node metastasis. Among the sarcomas, positive immunoreactivity for iNOS was seen in 10 hard tissue sarcomas, while the remaining 10 soft tissue sarcomas were negative for iNOS expression. The results were analyzed using the Chi-square test.Conclusions:iNOS is a reliable marker for lymph node metastasis in carcinomas irrespective of the histologic grade. The high expression in carcinomas shows that the carcinomas elaborate more angiogenesis for growth compared with the sarcomas with the exception of hard tissue sarcomas.
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