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Background: This study aims to determine the association between preoperative cytopathological diagnosis and the histopathological diagnosis of orofacial non-odontogenic tumors. It is also, to determine the sensitivity, specificity and accuracy of fine needle aspiration cytology (FNAC) in the preoperative diagnosis of orofacial malignant non-odontogenic tumors in a Nigerian population., Methods: A 9-month prospective study in which preoperative FNAC followed by open biopsy for confirmatory histopathological evaluation was performed for consenting patients with orofacial swellings. Patients histopathologically diagnosed as non-odontogenic tumors were selected for the study., Results: There were 40 (83.3%) histopathologically diagnosed non-odontogenic tumors. The female to male ratio was 1.7:1 and the patients' mean age was 36 + 21.9 years. The mandible (n = 4, 10.0%) and the preauricular area (n = 4, 10.0%) were the most common sites affected. The cytopathological diagnosis showed 28 (70.0%) of the lesions were malignant, 7 (17.5%) were benign neoplasms and 5 (12.5%) were reactive/inflammatory swellings. The histopathological diagnosis was predominantly malignant (n = 29, 72.5%), consisting mostly of non-Hodgkin's lymphoma (n = 12, 30.0%). There was significant association (P = .000) between cytopathological diagnosis and histopathological diagnosis of the malignant orofacial non-odontogenic tumors. The sensitivity of FNAC to detect malignant orofacial nonodontogenic tumors was 93.1%, the specificity was 90.9%, the positive predictive value was 96.4%, the negative predictive values was 83.3% and the accuracy was 92.5%., Conclusion: The accuracy of FNAC in the diagnosis of orofacial malignant non-odontogenic orofacial tumors is high and hence recommended as a routine preoperative diagnostic tool., (© 2020 Wiley Periodicals LLC.)

Objective: This study aims to determine the clinical features which are helpful as significant indicators in the diagnosis of malignant and nonmalignant nonodontogenic orofacial tumors., Materials and Methods: This was a prospective study performed on patients with swellings in the oral and maxillofacial region clinically suspicious of being tumors of nonodontogenic origin in a Nigerian Tertiary Health Institution. The statistical variables that were analyzed included patients' resume, clinical and radiological features as well as the histopathological diagnosis of the lesions. The level of significance was set at P < 0.05. Inferential analysis was done using Student's t-test, Chi-square, binary logistic regression, and adjusted odds ratio as appropriate., Results: There were forty patients histopathologically diagnosed as nonodontogenic tumors of the orofacial region. Twenty-five (62.5%) were females and 15 (37.5%) were males with mean age of 36 ± 21.9 years. Histopathological features showed three different categories of the lesions: Reactive and benign (nonmalignant) and the malignant lesions. Lymphadenopathy (P = 0.035) and nonmobility of the swellings (P = 0.029) were significant clinical indicators that were strongly associated with histological diagnosis of the malignant nonodontogenic tumors., Conclusion: This study showed that the nonodontogenic tumors occurred mostly in younger patients with a female preponderance. The mandible and the preauricular region were the most common sites. Lymphadenopathy and nonmobility of the swellings were strong clinical indicators for the diagnosis of the malignant nonodontogenic tumors., Competing Interests: None

This article reports 3 cases of melanin pigmented lesions among 75 histologically diagnosed periradicular lesions of extracted teeth. Case 1 was a 25-year old male who presented with one week history of toothache involving a tender carious left mandibular second molar tooth (37), with periapical radiolucency and diagnosed clinically as acute apical periodontitis. The lesion was diagnosed histologically (using Haematoxylin and Eosin) as periapical granuloma, while histochemical examination (using Masson-Fontana technique) showed the presence of round/oval shaped melanin pigmented macrophages (melanophage) in the lesion. Case 2 was a 54-year old male with one week history of toothache associated with tender carious right maxillary first molar tooth (16) with periapical radiolucency. A clinical diagnosis of acute apical periodontitis was made, but histological and histochemical examination showed a melanin pigmented periapical granuloma with spindle shaped melanophage. Case 3 was a 28-year old female who presented with 4 days history of toothache, involving the tender left mandibular first molar tooth (36). The lesion had periapical radiolucency and a clinical diagnosis of acute apical periodontitis. On examination histologically and histochemically, the lesion was diagnosed as an intraosseous melanocytic naevi with dark-brown nests of round naevus cells. In conclusion, this article shows the rarity of melanin pigmented periradicular lesions in the jaws. The cases reported suggest that the trigger for formation of melanin-pigmented cells in the periradicular lesions may be related to the acute phase of the lesions. Further study is recommended to determine if the remnants of the migratory neural crest cells are the precursors of melanin-pigmented cells in the periradicular region.

Background: Mucosal affectation may be a direct cytotoxic or cytostatic effect of methotrexate., Objective: To highlight the diagnostic procedure and treatment intervention erythema multiforme complicating methotrexate-induced allergic stomatitis., Case Report: The patient was a 60-year-old man suffering from stomatitis that rapidly developed into erythema multiforme. The patient had been prescribed methotrexate to treat rheumatoid arthritis. The patient presented with painful ulceration of the vermillion border of the upper and lower lips covered with necrotic tissues. We made a tentative diagnosis of methotrexate induced allergic stomatitis. On the patient's second visit to the clinic, the lesion had developed into crusted and haemorrhagic ulceration with erythematous patches on the lips. The patient was now complaining of weakness, fever and occasional seizure attack. Examination of the upper and lower extremities revealed bilateral bullous eruptions. The definitive diagnosis was that of erythema multiforme complicating methotrexate induced allergic stomatitis. withdrawal of the methotrexate yielded positive result with complete resolution of the lesions after 12 days of drug withdrawal., Conclusion: Early diagnosis of adverse drug reactions is essential for effective treatment, to avoid untoward systemic complications.

This article reports two cases of periradicular Burkitt's lymphoma from Nigeria, to emphasize the difficulties in differentiating the early lesion from other periradicular lesions with similar clinical and radiological findings Case 1, is a 4-year-old boy who presented with a one-month history of a painless, hard, posterior mandibular swelling (right), which was causing loosening and displacement of deciduous teeth (84 and 85). Histopathological examination of periradicular tissues from extracted tooth (85), confirmed the diagnosis of early periradicular B urkitt's lymphoma. Case 2, is a 6-year-old boy who presented with one-week history of a loose, extruded right mandibular first molar tooth (46) and an exfoliated left mandibular first molar tooth (36). After two weeks of follow-up, the patient developed bilateral mandibular swelling at the molar region, as well as peri-orbital and bilateral pedal oedema. Incisional biopsy of the oral lesion at the region of exfoliated left first mandibular molar (36) was useful for histopathological diagnosis of early Burkitt's lymphoma of the jaw. In the face of limited diagnostic tools such as clinico-radiological assessment, cytology or incisional biopsy for incipient periradicular lesions, a high index of suspicion of Burkitt's lymphoma of the jaw may be helpful in early diagnosis and treatment of a lesion, presenting in a child as periradicular radiolucency or mixed radiolucency and radiopacity, with associated loosening and displacement of teeth.