Background: Researchers have struggled to understand the natural history of lesions presenting with both lichenoid features and epithelial dysplasia. Thus the present study was designed to differentiate between OLP, OLP with dysplasia, epithelial dysplasia and epithelial dysplasia with lichenoid features based on the expressions of ki-67, p53, COX-2, and α-SMA. Materials and methods: Formalin-fixed paraffin-embedded archival specimens of OLP, OLP with dysplasia, epithelial dysplasia and epithelial dysplasia with lichenoid features were subjected to immunohistochemical staining with ki-67, p53, COX-2, and α-SMA. Results: Ki-67 exhibited strong positivity in 100% (6/6) of epithelial dysplasia cases, 71.4% (5/7) of lichenoid dysplasia cases, 57.1% (4/7) of OLP cases and 60% (3/5) of OLP with dysplasia cases. Strong p53 staining was evident in more cases of lichenoid dysplasia [42.8% (3/7)], while moderate staining was more frequent in OLP cases [42.8% (3/7)] and OLP with dysplasia cases [42.8% (3/7)] and mild intensity was more frequent in epithelial dysplasia cases [50% (3/6)] followed by lichenoid dysplasia cases [42.8% (3/7)], OLP cases [28.5 (2/ 7)] and OLP with dysplasia cases [40% (2/5)]. COX-2 strong positivity was more frequent in cases of epithelial dysplasia cases [57.1% (4/7)] and OLP [50% (3/6)]. Strong α-SMA staining was noted more frequently in lichenoid dysplasia cases [71.4 (5/7)], followed by OLP cases [42.8% (3/7)] and OLP with dysplasia cases [60% (3/5)]. Conclusions: Ki-67, p53, α-SMA and COX-2 expression do not differentiate between OLP, LP with dysplasia and epithelial dysplasia with lichenoid features.
Oral vegetable granuloma represents an inflammatory lesion of foreign body origin resulting from the implantation of vegetable matter. Controversy regarding its pathogenesis is reflected by the various terminologies used to describe the lesion. Its diverse clinical presentations are due to variations in the antigenic potential of the vegetable material and the host response. As the diagnosis is solely histopathological, it is critical to differentiate vegetable granuloma from other oral granulomatous lesions like tuberculosis, sarcoidosis and Wegner’s granulomatosis. Here, we report six cases with the varied clinicopathological presentation of hyaline ring granulomas in association with different pathological lesions.
Tumor related tissue eosinophilia (TATE) is a known phenomenon but its role in prognostics and correlation with size of the primary tumor is still controversial. Using a stain, like Carbol chromotrope, that targets eosinophils exclusively and vividly, offers an advantage over haematoxylin and eosin, which was used in most of the studies. Forty-nine cases of oral squamous cell carcinoma, where the TNM staging has been recorded in their history, was taken and stained with Lendrum's carbol chromotrope. Significant difference in the eosinophil count with varying size of the tumor and a parallel increase in the number noted, with increase in size. There is a corresponding increase in the number of eosinophils infiltrating the tumor with increase in size of oral squamous cell carcinoma.
Introduction: Oral HPV infections affect 1 to 50% of the general population. Naturally, about 90% of HPV is eliminated by the immune system, but the ones that persist may result in serious diseases. Human papillomavirus is the main cause of cancer at various body sites, such as cervix, uterus, oropharynx, head and neck. The prevalence of oral HPV infections in India ranges from 15 to 16%. About 80% of HPV infections are present with koilocytosis as an important morphological marker.Aim: This review focuses on the importance of koilocytes and its early detection to alert malignant risk for facilitating human papillomavirus (HPV)-targeted therapeutic strategies.Results: Research in the past has primarily focused on cervical cancer, as >99% of them harbor HPV. It has been observed that the incidence of HPV-associated cancers may be minimized by effective preventive and targeted therapeutic modalities. Although oral HPV infections have been minimally researched lesions such as verruca vulgaris, squamous papilloma, focal epithelial hyperplasia and condyloma acuminatum are significantly prevalent in India. The characteristic cell observed in all these HPV-associated lesions is koilocytes as demonstrated using immunohistochemistry (IHC) with p16 antibody. Although advanced techniques, such as polymerase chain reaction (PCR), deoxyribonucleic acid (DNA) breakage detection fluorescence in situ hybridization (DBD-FISH), and comet assay may confirm their presence, they are cumbersome and not economical. Conclusion:Detection of malignancy-prone oral HPV infections by the demonstration of koilocytes showing positivity to p16 IHC stain has shown promising avenues in the field of research for the prediction of diagnosis and prognosis of oral squamous cell carcinomas (OSCC).Clinical significance: Koilocytic cells are pathognomonic of HPV infection. Identification of koilocytes in histopathologic sections alerts the pathologist to suspect any underlying HPV infection and directs the surgeon for appropriate treatment. Human papillomavirus infection affects the function or host gene expression that is marked by cellular changes, and unmasking of such changes has an important role in the identification and follow-up of such patients.
Aim:The diagnosis of odontogenic tumors and other fibroosseous lesions could be challenging. Use of routine histological staining procedures like hematoxylin and eosin (H&E) may not aid in providing insight into the nature and character of the hard tissues, thereby require advanced diagnostic aids like immunohistochemistry (IHC), which is technique-sensitive and expensive. Masson's trichrome (MT) stain and modified Gallego's (MG) stain can differentially stain hard tissues, such as tooth, bone, and other pathologic calcifications. The study aims to differentially stain various hard tissue structures present in normal teeth and hard tissue pathologies and compare between the routine stain H&E, MT, and MG stains. Study of oral hard tissues, comparing H&E, MT, and MG stains is the first of its kind according to our knowledge. Materials and methods:A total of 30 paraffin-embedded tissues were taken from the archives of the Department of Oral Pathology and Microbiology including 15 normal hard tissue structures comprising of 5 decalcified sections of teeth, 5 ground sections of teeth and 5 decalcified section of normal bone. Fifteen histopathologically diagnosed cases of hard tissue lesions/odontogenic lesions (odontome 3, cemento-ossifying fibroma 5, cementoblastoma 5, and central ossifying fibroma 2) were taken. Three sections were taken from each tissue block and subjected to H&E, MT, and MG stains.Results: Slides when stained with MG stain, enamel stains pink, dentine stains light green, cementum stains red, and bone stains dark green. Clinically significant result was obtained in case of modified Gallego's stain (0.001). MG > MT > H&E: 75 > 50 > 45% respectively, in comparison with other two stains. The shade of color differs with the amount of mineralization of the hard tissues. For statistical analysis, chi-square test was employed. Conclusion:Among H and E, MT, and MG stains, MG stain could be a promising differential stain in hard tissue pathologies and other fibro-osseous lesions with diagnostic dilemmas.Clinical significance: MG stain helps in diagnosis of ambiguous lesions, detection of origin/nature of lesions, differentiation of aggressive and nonaggressive lesions, thus enabling clinicians to know their biological behavior and plan adequate treatment.
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