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We report a case of tuberculous lymphadenitis simultaneously detected in the metastatic cervical lymph nodes of a patient with tongue cancer. An 82-year-old woman was operated on for squamous cell carcinoma of tongue (T1 N0 M0) after chemotherapy with a combination of 5-fluorouracil and cisplatin. After 5 months follow-up, bilateral lymph node metastases were detected in the cervical region, and radical neck dissection was performed. Histopathological specimens prepared from the dissected tissue revealed metastasis of squamous cell carcinoma as well as epithelioid granuloma with Langhans' giant cells and caseous necrosis in 3 of 33 lymph nodes examined; 4 lymph nodes free from metastasis showed epithelioid granuloma. In addition to a positive response to tuberuculin antigen, the patient had a history of pulmonary tuberculosis in her late teens, and her chest X-ray film showed multiple areas of calcification at the apexes of both lungs with pleuritic thickening at the apex of the left lung. Although we found no detect evidence of mycobacterium infection on Ziehl-Neelsen staining, PCR analysis of DNA from the cervical lymph nodes, or sputum culture, we concluded this case involved tuberculous lymphadenitis of the metastatic lymph nodes on the basis of theclinicopathological findings.

We report a case of secondary syphilis with various oral manifestations. A 26-year-old woman visited our hospital because of lingual pain. The patient had a red and soft verruca at the left angle of the mouth as well as three oval papules on the right side of the tongue. In addition, oral examination revealed marked swelling and redness of bilateral palatal tonsils along with opaline plaque over the palatoglossal arch and inferior surface of tongue. Moreover, multiple cervical lymphadenopathy, alopecia, and psoriasic exanthema on the planta were observed. There were no particular lesions of the vulva or inguinal lymphadenopathy. Serological examination showed the RPR test was×128, the TPHA test>2560, and the FTA-ABS test×1280. Since the Jarisch-Herxheimer reaction was induced after treatment with 1000mg/day of amoxicillin for 2 weeks, the patient was treated with 2000mg/day of erythromycin for 6 weeks. Oral lesions improved after 2 weeks of treatment, and the RPR test was×64 after 3 weeks of treatment. After 4 weeks of treatment, the oral lesions almost completely resolved.

We report a rare case of osteosarcoma of upper alveolar bone in which early radiographic changes from could be retrospectively examined.A 37-year-old woman presented with an 18-month history of a persistant unusual sensation in the left upper central incisor despite endodontic treatment. The patient showed extrusion of the left upper central incisor with enlargement of the alveolar bone. Radiologic examination revealed irregular bone formation with bone and root resorption. Since histopathological diagnosis of a biopsy specimen revealed low-grade malignant osteosarcoma, surgical excision was performed. Three years after excision, no evidence of recurrence or metastasis was detected. In our patient, we could examine radiographic changes of the lesion from the early stage of tumor development.