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Although odontogenic lesions have been extensively described and studied, anomalous, challenging cases occasionally come to the attention of the pathologist. Here, we report the clinical and microscopic characteristics of an unusual cystic lesion of odontogenic origin. A 16-year-old male presented with swelling and pain to palpation of the right mandible as well as numbness of the right lower lip. Radiographically, the corresponding lesion was well-defined and radiolucent with internal radiopaque foci. It extended from the right first premolar posteriorly, approaching the angle of the mandible, and involved the mandibular first molar which was impacted and displaced. The second and third right mandibular molars were also impacted and displaced. The patient was treated by excisional biopsy under general anesthesia. The histopathologic examination revealed the presence of multicystic areas lined by a thin, non-keratinizing squamous epithelium that resembled the epithelial lining of a dentigerous cyst. In continuity with the cystic lining, areas of myxoid tissue reminiscent of dental papilla were observed. The myxoid tissue formed structures that were surfaced by an epithelium comprising a basal layer of ameloblast-like cells with reverse polarity of the nuclei. Above the basilar cells, additional layers of epithelial cells composed a structure resembling the enamel organ. Subjacent to the basilar ameloblast-like cells, a condensation of mesenchymal cells with polarized nuclei opposite to the ameloblast-like cells was present. These mesenchymal cells resembled odontoblasts. In addition, numerous mineralized structures amongst the odontogenic epithelial tissue were present. To date, the patient remains well and without evidence of recurrence after 36 months of follow-up.

Secreted osteoclastogenic factor of activated T cells (SOFAT) is a novel activated human T-cell-secreted cytokine that induce osteoclastogenesis in a RANKL-independent manner. The aim of this study was to evaluate the immunohistochemical expression of SOFAT in intraosseous and extraosseous lesions. Thirty-two oral biopsies were divided into 2 groups: (1) intraosseous lesions-4 cases of cherubism, 5 central giant cell lesions, 3 osteoblastomas, 3 cementoblastomas, 2 periapical lesions and (2) extraosseous lesions-5 peripheral giant cell lesions, 5 cases of oral paracoccidioidomycosis, and 5 foreign body reactions. Immunohistochemistry was performed for SOFAT and tartrate-resistant acid phosphatase. Image analysis consisted of a descriptive evaluation of the immunohistochemical staining pattern observed. Tartrate-resistant acid phosphatase-positive lesions included those containing multinucleated giant cells (MGC) from both groups. SOFAT was positive in MGC of the intraosseous lesions group, except in periapical foreign body reactions as well as extraosseous lesions. SOFAT was shown to be a putative marker of osteoclasts, which proved useful to differentiate them from multinucleated macrophages. Osteoclast induction may be both dependent and independent from the RANK/RANKL/OPG pathway and independent from the bone microenvironment.

Pigmented lesions of the oral mucosa encompass several benign and malignant conditions that may be a matter of concern under both clinical and histopathological views. We reported a case of a 62-year-old woman, presenting with an asymptomatic, deeply pigmented lesion on the soft palate. On examination, it appeared asymmetrical, with irregular borders and an area of ulceration. A biopsy, taken to rule out melanoma, revealed a pigmented carcinoma in situ. Throughout the tumor thickness, numerous interspersed melanocytes were found that did not extend to neighboring epithelium. These were large, richly dendritic, and presented abundance of melanin granules and small nuclei. Mild melanin incontinence was found. Scanty transfer of pigment to dysplastic epithelial cells was found through Fontana Masson staining. On immunohistochemical analyses, there were pancytokeratin-stained tumor epithelial cells; increased cell proliferation throughout the entire thickness of the tumor was emphasized by Ki-67 immunomarking. P16 was negative. The dendritic cells were selectively stained for S-100, HMB45 and Melan A. Wide spectrum in situ hybridization for human papillomavirus (HPV) was negative. Unfortunately, following diagnosis, the patient refused any treatment option. Pigmented squamous cell carcinoma with melanocyte colonization must be taken into account in the differential diagnosis of pigmented lesions of the oral cavity.

Synovial sarcoma (SS) is a rare malignant mesenchymal tumor that mainly occurs in body extremities, being uncommon in the head and neck region. In the present study, we described a case of primary intraosseous SS arising in the mandible of a 22-year-old young male. The patient reported a painful swelling on the left side of the mandible for the last 7 months. Imaging exams showed the presence of an expansive and multilocular radiolucent lesion, extending from the left condyle to the mandibular body. The clinic diagnostic hypotheses were ameloblastoma or malignant neoplasm. Histologically, the lesion was characterized by a proliferation of spindle cells exhibiting vesicular nuclei and evident nucleolus. Neoplastic cells were positive for AE1/AE3, cytokeratin 7, vimentin, CD-99, and TLE-1 and negative for CD-34, S-100, SMA, and HHF-35. A combination of clinical, histologic, and immunohistochemical characteristics supported the diagnosis of SS. The patient was referred for treatment, and preoperative exams did not reveal any other tumor foci in the body of the patient. The final diagnosis was of a primary intraosseous SS of the mandible.

Background Adenoid cystic carcinoma (ACC) is a salivary gland malignancy with poor long-term survival, which warrants studies aimed at clarifying the pathogenesis of this disease in order to widen the scope of therapeutic options currently available. Alterations in regulatory mechanisms relating to vascular support, cell death and autophagy are important pathways for tumor growth in cancer. Thus, the present study aimed to access vascular supply, apoptosis, autophagy and cell senescence in ACC of minor salivary glands. Methods We analyzed 25 cases of minor salivary gland ACC by immunohistochemistry using anti-CD34, anti-CD105, anti-D2–40, anti-Bax, anti-Bcl-2, anti-Beclin-1, anti-LC3B, anti-p21 and anti-p16. Results Microvessel density was low and based on anti-CD34, anti-CD105 and anti-D2–40 immunostaining. There was positivity for anti-CD34, anti-Bcl-2, anti-Beclin, anti-LC3B and anti-p21 and a positive correlation between Bcl-2 and Beclin (p = 0.014). Conclusions Our results showed that ACC does not depend on neo-angiogenesis and is probably associated to anti-apoptotic, autophagic and anti-senescence events.

This report describes the diagnostic process of a rare disorder in a Brazilian female child. The patient presented initially as a 7-year-old with multiple whitish submucosal nodules of a fibrous consistency in the lower lip, but with an inconclusive pathology report. When she turned 9 years of age, she presented with exacerbation of the original clinical findings, which then involved the upper lip, buccal mucosa, tongue and lingual frenulum. In addition, dermatological lesions were noted on the child’s limbs and face, as well as a hoarse voice. Histopathological examination of the buccal mucosa revealed dense connective tissue with hyaline foci, which were positive with periodic acid-Schiff (PAS) staining and resistant to diastase digestion. Clinical and histopathological findings led to the diagnosis of a rare genetic disease with fewer than 300 reported cases - lipoid proteinosis. Magnetic resonance imaging revealed calcium deposits in her amygdaloid region of the brain, and nasopharyngolaryngoscopy revealed lesions in her vocal cords. The patient currently is stable and under multidisciplinary follow-up, but no treatment has been recommended to date. Resumo Este relato descreve o processo diagnóstico de uma doença rara em uma criança brasileira do sexo feminino. A paciente, inicialmente com 7 anos de idade, apresentava múltiplos nódulos submucosos esbranquiçados, de consistência fibrosa, no lábio inferior, mas com um laudo patológico inconclusivo. Quando completou 9 anos de idade, ela apresentou exacerbação dos achados clínicos originais, que envolveram o lábio superior, mucosa bucal, língua e frênulo lingual. Além disso, lesões dermatológicas foram observadas nos membros e no rosto da criança, assim como rouquidão. O exame histopatológico da mucosa bucal revelou tecido conjuntivo denso com focos hialinos, que foram positivos com coloração periódica com ácido-Schiff (PAS) e resistente à digestão da diástase. Os achados clínicos e histopatológicos levaram ao diagnóstico de uma doença genética rara com menos de 300 casos relatados - proteinose lipoide. A ressonância magnética revelou depósitos de cálcio em amígdala cerebral e a nasofaringolaringoscopia revelou lesões em cordas vocais. Atualmente, a paciente está estável e em acompanhamento multidisciplinar, mas nenhum tratamento foi recomendado até o momento.

The present study aimed to compare the expression of p63/p40 with smooth muscle actin (SMA) and vimentin (VIM) by myoepithelial cells in minor salivary gland tumors. Fifty-two formalin-fixed paraffin-embedded samples of minor salivary gland tumors derived from intercalated duct (pleomorphic adenoma [PA], adenoid cystic carcinoma [ACC], epithelial-myoepithelial carcinoma [EMC], polymorphous adenocarcinoma [PAC], and secretory carcinoma [SC]) and 3 samples of minor salivary gland tumors derived from excretory duct (mucoepidermoid carcinoma [MEC]) were evaluated by means of immunohistochemistry. The data were analyzed qualitatively. The results indicated that p63 and p40 expression were detected in myoepithelial cells present in PA, ACC, and EMC. However, both proteins were also observed in squamous areas of PA and all cases of MEC. SMA were noticed in some myoepithelial cells of PA, ACC, and EMC. Expression of SMA was negative in the other salivary gland tumors evaluated. VIM was constantly expressed by myoepithelial cells in PA, ACC, and EMC. VIM was also observed in cells of PAC and SC, but not in squamous areas of PA and MEC. In conclusion, p63 expression is almost comparable with VIM in detecting myoepithelial cells, an immunolabeling pattern not followed by p40, and consequently, caution has to be taken during the interpretation of salivary gland tumor exhibiting an p63/p40 phenotype in order to avoid a misdiagnosis.

Background DNA ploidy analysis is arguably the most sensitive and reproducible approach to assess risk in oral potentially malignant disorders. Although aneuploidy has been associated with a high risk of malignant transformation (MT), the current diagnostic criteria of aneuploidy are not specific to oral mucosal tissues and thus yield positive predictive values (PPVs) ranging from 30% to 40%. Objective The aims of this study were to analyze the ploidy status of archived material diagnosed as oral leukoplakia (OL) with follow-up data on MT and to review the risk classification criteria. Methods Nuclei suspensions were enzymatically prepared from formalin-fixed, paraffin-embedded tissue from 121 patients with OL and stained with propidium iodide for flow cytometry. Twenty-three patients had MT. Histograms were initially analyzed for the proportion of nuclei in G1 phase (2c), S phase, G2 phase (4c), and 5c-exceeding rate (5cER). Histograms diagnosed as aneuploid were further investigated qualitatively on the basis of nuclei distribution pattern. Log-rank test on Kaplan-Meier curves (LRKM; P Results Seven aneuploid histogram types were detected, of which only 3 proved truly high risk. EAR was then stratified as low risk (diploid), medium risk (low-risk aneuploid), and high risk, whereas TAR remained as diploid (low risk) and aneuploid (high risk). Aneuploidy in TAR had PPV of 55%, SS of 88%, and SP of 81% (LRKM P Conclusions Enhancement of TAR based on qualitative histogram classification significantly improves predictive values. Flow cytometry is an accessible approach to assess MT risk in OL.

Made available in DSpace on 2018-11-26T15:45:48Z (GMT). No. of bitstreams: 0 Previous issue date: 2017-12-01 Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP) Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq) Polymorphous adenocarcinoma (PAC) is a malignant epithelial neoplasm that affects almost exclusively the minor salivary glands, generally described as having a relatively good prognosis. Aberrant nuclear factor erythroid 2 (NF-E2)-related factor (Nrf2) activation in tumor cells has been associated with induction of antioxidant enzymes, such as peroxiredoxin I (Prx I) and increased matrix metalloproteinase (MMP) expression. In this context, the aim of the present study was to evaluate the expression of Nrf2 and correlate it with Prx I and MMP-2 secretion in PAC. Thirty-one cases of PAC from oral biopsies were selected and immunohistochemically analyzed for Nrf2 and Prx I. MMP-2 quantification was performed on primary cell cultures derived from PAC. Oral squamous cell carcinoma (OSCC) cell cultures were used as control. A high immunoexpression of Nrf2 was observed in both the cytoplasm and the nucleus of neoplastic cells from PAC. Nuclear staining for Nrf2 suggested its activation in the majority of the PAC cells, which was confirmed by the high expression of its target gene, Prx I. Quantification of MMP-2 secretion showed lower levels in PAC cell cultures when compared to OSCC cell cultures (p < 0.05). In conclusion, although Nrf2 overexpression has been frequently associated with high-grade malignancies, such relationship is not infallible and, in fact, the opposite may occur in low-grade tumors, such as PAC of minor salivary glands. Sao Leopoldo Mandic Inst & Res Ctr, Dept Oral Pathol, Rua Jose Rocha Junqueira 13, BR-13045755 Campinas, SP, Brazil State Univ Sao Paulo, Aracatuba, SP, Brazil Univ Fed Minas Gerais, Belo Horizonte, MG, Brazil State Univ Sao Paulo, Aracatuba, SP, Brazil FAPESP: 2015/12418-5 CNPq: 304031/2014-3

Made available in DSpace on 2020-12-10T19:43:26Z (GMT). No. of bitstreams: 0 Previous issue date: 2019-12-01 Objectives This study aimed to revisit benign odontogenic ghost cell lesions (BOGCL) by hematoxylin and eosin staining and immunohistochemistry. Materials and methods Thirty cases of calcifying odontogenic cyst (COC) and 6 cases of dentinogenic ghost cell tumor (DGCT) were selected for histopathological and immunohistochemical analysis. Sections stained for cytokeratin (K) 14, K-19, amelogenin, collagen type 1 (COL-1), and dentin matrix acidic phosphoprotein 1 (DMP-1) were evaluated using qualitative analysis. Sections stained for Ki-67 and minichromosome maintenance protein-2 (MCM-2) were evaluated using semi-quantitative analysis. Results A morphologic overlap was noticed in all BOGCL. Moreover, no differences were detected in the expression of K-14 and K-19. The expression of proliferative markers Ki-67 and MCM-2 was similar between cystic and tumor lesions (p > .05). The presence of COL-1 and absence of amelogenin in the so-called dysplastic dentin, associated with its histologic pattern, suggest that this is in fact an enameloid-like tissue. Conclusions The dysplastic dentin should be considered an enameloid-like tissue in these lesions. Fed Univ Tocantins, Sch Med, Quadra 109 Norte,Ave NS-15,ALCNO 14, BR-77001090 Palmas, Tocantins, Brazil Sch Med & Dent, Fac Human & Econ & Hlth Sci ITPAC, Palmas, TO, Brazil Sao Leopoldo Mand Inst & Res Ctr, Oral Pathol, Campinas, SP, Brazil Sao Paulo State Univ, Pathol & Clin Propaedeut, Aracatuba, SP, Brazil Sao Paulo State Univ, Pathol & Clin Propaedeut, Aracatuba, SP, Brazil

Background Polymorphous low-grade adenocarcinoma (PLGA) remains a diagnostic challenge for most pathologists due to its large spectrum of histological patterns. In this study, the expression of two new markers recently described for salivary gland tumors was studied in PLGA. Methods The morphology of 33 cases of PLGA was carefully evaluated using hematoxylin-and-eosin-stained sections and confirmed by immunohistochemistry for cytokeratin 7, vimentin, and S-100. Periodic acid–Schiff with diastase digestion was also used. The expression of mammaglobin and DOG-1 was carried out using the EnVision System. Mammaglobin was assessed according to the percentage of positively stained tumor cells, while DOG-1 was evaluated according to its presence and site. For MCM-2 and Ki-67, markers of proliferation, the labeling index of cell nuclei positivity was evaluated using total cell number. The ETV6-NTRK3 fusion was examined by fluorescence in situ hybridization analysis. Results The histological patterns of the tumor were classified as lobular or non-lobular. For the non-lobular pattern, tubular, cribriform, glomeruliform, trabecular, and papillary patterns were observed. Mammaglobin was present in all PLGA cases, and its expression was stronger (P = 0.01) in the lobular than in the non-lobular pattern. The expression of DOG-1 was present in the apical portion and cytoplasm of the cells. Proliferation markers were low for all cases independent of histological pattern. Conclusions Polymorphous low-grade adenocarcinoma has been confirmed to originate from the intercalated duct and to feature high expression of mammaglobin in its lobular pattern resembling that of mammary secretory analogue carcinoma, except for the ETV6 gene rearrangement.

Desquamative gingivitis is a generic condition with gingival scaling that can be a manifestation of autoimmune diseases such as lichen planus, pemphigus, and pemphigoid, etc. Diagnosis is based on biopsy of the lesions, hematoxylin and eosin staining (HE), and direct immunofluorescence, and the treatment of choice is the use of corticosteroids. A 59-year-old white female presented with areas of intense erythema and extensive ulcerations spread throughout the gingivae on both arches and on the hard palate, which stopped her from adequately feeding due to pain and bleeding. An incisional biopsy was taken and direct IFD confirmed the diagnosis of lichen planus. The treatment was based on corticosteroids and colchicine, without success. Vitamin D dosage was requested, which was low, and after increasing levels of vitamin D, the lesions began to decrease, resulting in total remission of the disease.

Some studies have shown that ameloblastoma may show mutation in the BRAF-V600 E gene. Objective: The objective of this study was to evaluate the expression of the mutated BRAF-V600 E protein in cases of unicystic ameloblastoma (UA; n = 22) and multicystic ameloblastoma (MA; n = 18). Study Design: Clinical-pathologic parameters such as age, sex, and tumor location were correlated with positive and negative BRAF expression. Results: All cases of UA were identified in the mandible and only 1 case of MA was located in the maxilla. From the 40 cases, 33 (82.5%) were positive for the anti–BRAF-V600 E antibody, 18 of AU (82%), and 15 of AM (83%). The correlation between the BRAF expression and the variables did not show statistical significance (P> .05). Conclusion: The BRAF-V600 E mutation was frequent in the studied ameloblastomas and it occurs independently of age, sex, and subtype (UA and MA).

An 85-year-old Caucasian female presented with a 3-year history of tongue enlargement associated with serious difficulties with swallowing and speech. Her medical history of relevance was hypertension and anxiety. Physical examination revealed multiple asymptomatic multisized nodules of fibrous consistency spread throughout the skin and oral mucosa. A truly remarkable sign observed was the prompt development of ecchymosis during manipulation of oral tissues. Histopathologic examination of her tongue biopsy revealed the presence of homogeneous, eosinophilic material within connective tissue and around capillaries. This amorphous extra-cellular material stained positively with Congo red and appeared apple-green when viewed under polarized light, confirming the amyloid nature of the deposits. The patient was referred for medical evaluation. A bone marrow biopsy revealed multiple myeloma as the primary cause of amyloidosis. A combination of melphalan, thalidomide, and prednisone was the treatment of choice. The patient passed away after 2 weeks of treatment.

Tumor metastasis to the oral cavity is rare and can occur in both soft and hard tissue. Diagnosis is a challenge because it can mimic reactional lesions such as pyogenic granuloma and giant cell peripheral lesion. When they occur, the gingiva is the site of higher frequency followed by maxillary bones and, more rarely, soft tissues. Edema, bulging, and paresthesia that appear abruptly should be suspected for metastasis. In this study we present a serial of 2 cases of metastasis to the soft tissues of the mandible, one of colorectal tumor and 1 of lung cancer, with clinical and histopathologic images. In 1 case (colorectal metastasis), despite the extensive expansion in the alveolar ridge, no bone reabsorption was observed on radiographic examination. Paresthesia and asymmetry of the soft tissues of the face were observed as a common clinical feature of both cases.

Oral epidermoid carcinoma (OEC) is malignant neoplasia arising from the oral epithelium, comprising most of 90% of cancers in the oral cavity. Lip carcinoma is related to ultraviolet radiation exposure, and intra-oral carcinomas are related to tobacco smoking and alcohol consumption. About 15% of oropharyngeal lesions are related to HPV. OEC can affect any area of the oral mucosa. We report a series of 11 cases of OEC, with distinct appearance and localization, affecting males and females aged 34 to 90 years, with or without a history of exposure to risk factors. Lesions varied from small leukoplastic plaques to endophytic tumors with significant bone invasion. When indicated, radiographs and CT scans showed hypodense lesions with extensive bone destruction. OECs were diagnosed by incisional biopsy, and the treatments included surgery resection, radiotherapy, and/or chemotherapy, depending on the TNM stages. The prognosis varied according to tumor size, lymph node invasion, and/or distant metastasis.

Primary Squamous Cell Carcinoma (SCC) of the salivary glands is a very rare disease and establishing the true origin of an SCC manifesting in a salivary gland is always a daunting task, due to the natural proximity of salivary glands to surface epithelia. The aim of this report is to describe and discuss an SCC originating from the excretory duct of the submandibular gland with an unusual histological papillary appearance. A 39-year-old male presented with a slow growing mass in the floor of the mouth, which was clinically nodular, exophytic and ulcerated. Histological examination revealed a predominantly papillary architecture surrounding an intact salivary duct, which showed mucicarmine-positive material and no cell atypia. The duct was in a continuum with the neoplastic tissue, disposed as sheets of basaloid cells with foci of dysplastic squamous epithelium with minimal keratinization. The lesion was positive to CK14 throughout the parenchyma, CK7 in the luminal cells of ductal structures, CK13 in rare epidermoid areas and generally to AE1/AE3, highlighting foci of keratinization. The case reported herein is a very rare neoplasm in an unprecedented intraoral site, which emphasises the importance of histochemistry and immunohistochemistry in the diagnosis of rare lesions.

Considered as an aggressive counterpart of central ossifying fibroma (OF), juvenile ossifying fibroma (JOF) is a benign fibro-osseous neoplasm characterized by an unpredictable destructive behavior, elevated morbidity, mutilating treatment and high potential for local recurrences. The aim of this study is to compare the analysis for cell proliferation and vascular markers between JOF and OF. Cell proliferation index was measured by Ki-67 and Mcm-2 expression and microvessel density (MVD) was obtained by the immunoexpression of CD34/CD105. We observed a reduced expression of vascular markers, where MVD for CD34 was significantly higher in JOF than in OF (p = 0.009), but no statistical difference was found for CD105. JOF and OF showed low expression for Ki-67 and Mcm-2 and no difference was noted between both, suggesting that other mechanisms such as anti-apoptotic and/or pro-autophagic pathways or even increased expression of matrix metalloproteinases may be responsible for the aggressiveness of JOF.

Endoglin, known to be expressed in proliferating vessels, is of worth when evaluating microvessel density as a prognostic factor in many types of malignancies, including some subtypes of leukemia cells. In childhood acute lymphoblastic leukemia, endoglin is associated with adverse outcome. In bone marrow, endoglin identifies the repopulating hematopoietic stem cells. Mast cells are a component of normal tissue and play an important role in the regulation of several processes, including inflammation and neoplasia. The aim of this study was to evaluate the use of endoglin as a biological marker of mast cells compared with the gold standard stains. We studied 15 specimens of neurofibroma, 9 of mastocytosis, and 6 of fibrous scar tissue through immunohistochemistry (for endoglin and mast cell tryptase) and histochemical staining using toluidine blue. Quantitative analysis of the cells was performed by counting 5 hotspots. The validity of endoglin as a mast cell marker was assessed by intraclass correlation coefficient. The Kruskal-Wallis test was used to compare mast cell count for each marker. A strong endoglin expression was found in the cytoplasmic granules of mast cells within the 3 groups. Similar results were observed with mast cell tryptase as well as toluidine blue. The intraclass correlation coefficient revealed that endoglin is a highly reliable biomarker of mast cells when compared with mast cell tryptase and toluidine blue. In conclusion, endoglin may assist in the diagnosis and pathogenesis study of various processes associated with mast cells. An endoglin-neutralizing treatment for solid cancers and leukemia could also affect mastocytes and the immunologic system.

A case of solitary fibrous tumor is reported. Solitary fibrous tumor is a rare neoplasia characterized by the proliferation of fusiform cells of mesenchymal origin accounting for at least 2% of all soft tissue tumors. In this present case, the initial diagnosis was salivary gland tumor because of the location in the hard palate. Histologically, the tumor was composed by conjunctive tissue with proliferation of oval and fusiform cells. The immunohistochemical analysis was positive for CD34 and CD99. The lesion was treated by surgical resection. The clinical, imaging, histological and immunohistochemical data are discussed in this study. Keywords Solitary fibrous tumor; Oral cavity; Hard palate; Differential diagnosis.

A novel T cell-secreted cytokine, termed secreted osteoclastogenic factor of activated T cells (SOFAT) that induces osteoclastic bone resorption in a RANKL-indepen- dent manner, has been described. Our group have previously reported that SOFAT is highly expressed in gingival tissues of patients with chronic periodontitis suggesting a putative role in the bone loss associated with periodontal disease. The aim of the present study was to identify other potential cellular sources of SOFAT in the bone resorptive lesions of patients with periodontal disease. Gingival tissues were biopsied from systemically healthy subjects without periodontal disease (n=5) and patients with chronic periodontitis (n=5), and the presence of SOFAT was analyzed by immunohistochemistry and immunofluorescence staining. The present data demon - strated marked SOFAT staining in diseased periodontal tissues that was predominantly associated with the lymphocytic infiltration of gingival tissues. Notably, in addition to CD3 + T cells, B-lineage cells including plasma cells also exhibited strong staining for SOFAT. As SOFAT has not previously been reported in B-lineage cells, splenic T cells and B cells were further purified from BALB/c mice and activated using CD3/CD28 and lipopolysaccharide, respectively. SOFAT was quantified by reverse transcription‑quantitative polymerase chain reaction and was shown to be significantly expressed (P

Made available in DSpace on 2018-11-12T17:27:41Z (GMT). No. of bitstreams: 0 Previous issue date: 2016-03-01. Added 1 bitstream(s) on 2018-11-12T17:35:43Z : No. of bitstreams: 1 S1981-86372016000100079.pdf: 206986 bytes, checksum: c5a659eafa4ffd2826bdf0d14ace52dc (MD5) RESUMO O xantoma verruciforme é uma lesão muito rara, benigna, com aspecto papilar, indolor, séssil, localizada, principalmente, na gengiva e mucosa alveolar, podendo ocorrer na pele e genitália. O grau de queratinização da superfície influencia na cor, variando de branca a vermelha. Histopatologicamente é caracterizado pela presença de macrófagos com citoplasma espumoso (células de xantoma) acumulados e confinados ao tecido conjuntivo papilar. Criptas invaginadas alternam-se com extensões papilares. As cristas epiteliais alongadas estendem-se para a lâmina própria em profundidade uniforme. Sua etiologia e patogênese são desconhecidas, apesar de várias hipóteses terem sido sugeridas, como trauma local ou viral. O diagnóstico diferencial pode incluir o papiloma escamoso, o carcinoma escamoso papilar e o condiloma acuminado. O tratamento é a excisão conservadora e o prognóstico é excelente. O objetivo deste trabalho foi relatar um caso clínico de xantoma verruciforme localizado na gengiva inserida mostrando seu aspecto clínico e histopatológico. ABSTRACTVerruciform xanthoma is a rare, benign lesion, with a papillary aspect, asymptomatic, sessile, white colored, and well-demarcated, that occurs in the gingiva and alveolar mucosa. The histopathological aspect is characterized by the presence of macrophages with foam cytoplasm (xanthoma cells) confined to the soft papillary tissue. The etiology and pathogenic mechanisms are unknown, although some hypothesis, such as local trauma or viral origin have been suggested. The aim of this article was report a clinical case of verruciform xanthoma located in the gingiva showing the clinical and histopathological aspects. Faculdade São Leopoldo Mandic Curso de Odontologia Programa de Pós-Graduação em Patologia Bucal Universidade Estadual Paulista Júlio de Mesquita Filho Faculdade de Odontologia Departamento de Patologia e Propedêutica Clínica Universidade Estadual Paulista Júlio de Mesquita Filho Faculdade de Odontologia Departamento de Patologia e Propedêutica Clínica

This report describes a rare case of nodular fasciitis (NF) of the oral cavity, discussing the clinical, histological, and immunohistochemical characteristics. Histopathologic diagnosis of this type of lesion can be challenging due to its differential diagnosis, which principally includes sarcoma. The patient presented with a painless, well-defined nodule, reported as increasing in size, located at the apical aspect of the upper left buccal sulcus. Histologically, the lesion revealed spindle cell proliferation arranged in fascicles, while immunohistochemistry demonstrated positivity for smooth muscle actin. Eight months after complete surgical excision, no signs of local recurrence have been observed.

Background Polymorphous low-grade adenocarcinoma (PLGA) is a rare malignant tumor that usually arises in the minor salivary glands. Growth factors are cell-secreted peptides that regulate biological processes such as growth, proliferation, and differentiation. In salivary gland tumors, immunoexpression of growth factors and their receptors is associated with cell proliferation, malignant transformation, and tumor invasion. This study analyzed the expression of growth factors and receptors in PLGA, in other to better understand the mechanisms involved in the process of neoplastic cell proliferation and tumor progression. Methods The expression of growth factors FGF-2, PDGF-A, PDGF-B and receptors FGFR-1, FGFR-2, PDGFR-α, and EGFR was analyzed in 24 PLGA samples in comparison with normal salivary glands, by immunohistochemistry. A semi-quantitative analysis determined cell positivity in all stained sections. Scores were assigned according to percentage of reactive cells: score 0 50%. The level of significance was set at 5%. Results Most of the growth factors and receptors, apart from FGFR-2, were significantly reactive in PLGA. Comparing to salivary acini, all of the reactive growth factors and receptors were significantly stronger in PLGA. Comparing to salivary ducts, the expression of FGF-2, PDGF-B, FGFR-1, and EGFR was significantly stronger in the nuclei and/or cytoplasm of the neoplastic cells. Conclusions The increased expression of the growth factors and receptors in the PLGA, compared to normal salivary glands, may be related to cell proliferation, somehow participating in the oncogenic process.

Sialolithiasis, or salivary calculus, is a disease of the salivary glands, characterized by the formation of mineralized structures within the excretory salivary ducts or the glandular parenchyma. Approximately 80% occur in the submandibular gland, followed by the parotid and sublingual glands. Although rare, sialolithiasis can also occur in the minor salivary glands. Although the oral cavity and upper lip are the most common sites, they can develop in any region of the oral cavity that contains minor salivary glands. Treatment is based on surgical excision of the lesion, with a favorable prognosis. This study presents three cases of sialolithiasis of minor salivary glands of the upper and lower lip, addresses their clinical characteristics and correlation with microscopic findings, diagnosis and treatment plans. Etiology and factors that should be considered during diagnosis, appropriate treatment and improved prognosis are discussed in this study.

Mucoepidermoid carcinoma (MEC) is the most common primary salivary gland malignancy in both adults and children. It has a slight female predilection and usually presents as a painless, rubber-like or soft mass, which may be fixed or mobile. Histologically, MEC is comprised of a mixture of cell types including mucous, epidermoid, and intermediate cells that can be arranged in solid nests or cystic structures. In the oral cavity, it most frequently occurs at the palate or buccal mucosa. The present paper aimed to describe an unusual case of MEC arising in the palatine tonsil.

The peripheral giant cell granuloma (PGCG) is a nonneoplastic lesion commonly caused by local irritation. This report describes a 46-year-old Caucasian male who presented with a PGCG associated with a dental implant. The dental implant was originally placed in August 2012. Ten months later, the patient presented with a well-circumscribed lesion associated with and covering the implant, at which time the lesion was excised. Four months later, due to recurrence of the lesion, a deeper and wider excisional biopsy with curettage of the adjacent bone was performed. No evidence of recurrence has been reported after 12 months of follow-up. Immunohistochemistry, using the antibody CD68, was performed to investigate the origin of the multinucleated giant cells, with their immunophenotype being similar to those of other giant cell lesions, including central giant cell granuloma, foreign-body reactions, and granulomatous reactions to infectious agents.

Made available in DSpace on 2018-11-26T20:08:57Z (GMT). No. of bitstreams: 0 Previous issue date: 2017-12-01 Adenomatoid odontogenic tumor (AOT) is a benign epithelial odontogenic tumor characterized by slow and progressive growth. When central lesions are associated with an unerupted permanent tooth, they are also known as the follicular type. Histological variants of AOT may complicate diagnosis with possible adverse effects on treatment and prognosis. The aim of this study is to report a case of a follicular AOT with extensive calcifying epithelial odontogenic tumor (CEOT)-like histopathological areas in the anterior region of the mandible that was treated by enucleation. The teeth displaced by the tumor were repositioned with orthodontic treatment, and after 7 years of follow-up, the bone trabeculae were normal with no evidence of recurrence. The clinical, radiographic and histopathologic aspects of these tumors are discussed and the debate surrounding whether these cases are true combined lesions or histologic variants of the primary tumor is raised. Lutheran Univ Palmas, Dept Oral Pathol, Palmas, Tocantins, Brazil Fed Univ Tocantins, Dept Hlth Sci, Palmas, Tocantins, Brazil Sa Leopoldo Mand Inst & Res Ctr, Dept Oral Pathol, Campinas, SP, Brazil Sa Paulo State Univ, Dept Oral Pathol, Aracatuba, SP, Brazil Gen Publ Hosp Palmas, Palmas, Tocantins, Brazil ULBRA, CEULP, Fac Odontol, Av Teotonio Segurado,1501 Sul,POB 85, BR-77019900 Palmas, Tocantins, Brazil

Made available in DSpace on 2018-11-26T17:24:28Z (GMT). No. of bitstreams: 0 Previous issue date: 2017-04-01 Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP) Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq) There is mounting evidence on the importance of some biological processes in tumor growth, such as vascular supply, apoptosis, autophagy, and senescence. We have investigated these processes in polymorphous low-grade adenocarcinoma (PLGA), in an attempt to identify those that are relevant for this particular lesion. We analyzed 31 cases of PLGA using immunohistochemistry to antibodies against CD34 and CD105 to detect blood vessels; against D2-40 to detect lymphatic vessels; against Bax, Bcl-2, and survivin to explore cell apoptosis; and against Beclin and LCB3 to investigate autophagy and against p21 and p16 to assess senescence. Our results showed that PLGA growth does not depend on newly formed vessels but only on preexisting vasculature. Furthermore, PLGA is promoted by autophagy, sustained by both anti-apoptotic and anti-senescence signals, and stimulated by Bcl-2 and survivin. Sao Leopoldo Mandic Inst & Res Ctr, Dept Oral Pathol, Rua Jose Rocha Junqueira,13 Ponte Preta, BR-13045755 Campinas, SP, Brazil Univ Fed Minas Gerais, Dept Oral Pathol, Belo Horizonte, MG, Brazil State Univ Sao Paulo, Dept Oral Pathol, Aracatuba, SP, Brazil State Univ Sao Paulo, Dept Oral Pathol, Aracatuba, SP, Brazil FAPESP: 2015/12418-5 CNPq: 304031/2014-3

Syphilis is a sexually transmitted disease with increased number of cases in Brazil. Case 1 involved a 19-year-old woman referred for painless ulcer evaluation in the lower lip. It was also observed erythematous papules on the palms. Case 2 involved a female patient referred for evaluation of nodules and painless fissures in the back of the tongue with no other visible lesions. In both cases, Venereal Disease Research Laboratory and anti-HIV tests were requested, and incisional biopsy was performed, whose histopathologic diagnosis in both cases was suggestive of syphilis. Subsequently an antitreponema immunohistochemical reaction was performed, with a positive result for both cases. In case 1, Venereal Disease Research Laboratory was reagent and anti-HIV negative; in case 2, the patient did not return with the requested tests. Considering the increase in the number of cases of syphilis in the country, the knowledge of syphilis oral manifestations in all its stages is of fundamental importance.

Objectives The aim of this study was to evaluate and compare cases of multicystic (MA) and unicystic ameloblastomas (UA). Methods The classification was based on the radiographic aspects. In addition, characteristics such as symptomatology, age, sex, and anatomic region were also compared. Fisher exact test was performed, with significance level of .05. Results The radiographic analyses were performed and the posterior region was the most prevalent one (77.6%), 15.3% cases were located in the anterior region, and 7.1% were observed in both regions. Moreover, 55 cases were classified as MA and 43 as UA. The cortical expansion was observed in 90 cases; from this amount, 54 cases of ameloblastoma were MA (98.2%) and 36 cases of UA (80%) (P = .01). The predominant histologic patterns in MA were the plexiform pattern (36%) and the follicular type (29%) and for UA were cystic (51%) and plexiform pattern (31%). Conclusions Radiographs and histopathologic exams are essential for the diagnosis of ameloblastoma. Unicystic ameloblastomas cannot be considered a less aggressive entity compared with the multicistic ameloblastoma in the studied cases. Institutional grant from Sao Leopoldo Mandic Dental School (PIC 021/2017).

The 8 cases selected for this presentation include medication-related osteonecrosis of the jaw (MRONJ) treated conservatively: 2 cases of breast cancer metastasis, 3 cases of multiple myeloma, and 3 cases of osteoporosis. Two of them occurred in the implant area and in 1 case, the treatment was concluded with hyperbaric oxygen therapy. In 5 cases, a bisphosphonate was given via intravenous route and 3 cases by oral administration. Only 1 case had a combination of bisphosphonates and monoclonal antibody (denosumab). The time to bone sequestration, formation, and expulsion (varied from 3 mo to 4 y) will be discussed. In all cases, the treatment was performed with topical antiseptics and radiographic and clinical monitoring. In some cases, conservative surgery was needed, whereas in others, the necrotic bone was expelled spontaneously. Institutional grant from Sao Leopoldo Mandic Dental School.

A 2-year-old male patient came to our service with the complaint of swelling located in the left side of the lower jaw. There was a history of trauma 3 months prior to the lesion formation. The swelling was initially noticed as a small nodule, which increased in size gradually. On palpation, the swelling was well localized, firm, nonmobile, 3 × 3 cm in diameter, nontender, fixed to the underlying bone, and nonadherent to the superficial skin. No submandibular lymphadenopathy was noted. Computed tomography scan of the jaws with a 3-dimensional reconstruction image showed the presence of a soft tissue lesion with bone erosion of the inferior aspect of the left side of the body of the mandible. Histologically, a typical biphasic cellular arrangement was noted. Immunohistochemical markers have been useful for the definitive diagnosis of this uncommon neoplasm. The clinical, radiologic, histologic and immunohistochemical aspects corroborate the diagnosis of infantile myofibroma.

Heterotopic gastrointestinal cyst (HGC) is a rare, benign lesion that can be found in any part of the gastrointestinal tract. The present study aimed to report a case of HGC occurring in the oral cavity. A 1-year-old male child was noted to have a fistula in the submental region. Intraoral examination did not reveal any sign of changes in the oral cavity structures. Computed tomography showed isodense masses localized in the sublingual and submental spaces. An excisional biopsy was carried out and the specimen was fixed in 10% buffered formalin. Microscopic examination revealed a fragment of cystic capsule covered with nonkeratinized stratified squamous epithelium, which in some areas was replaced by gastric mucosa. These microscopic findings rendered the diagnosis of HGC. The patient's postoperative course was uneventful and the follow-up to date shows no recurrence.

Myoepithelial cells have been implicated in the regulation of the transition from in situ to invasive neoplasia in salivary gland tumors. Considering the importance of the microenvironment of the tumor, the present in vitro study therefore analyzed the morphological and phenotypic changes undergone by benign myoepithelial cells from pleomorphic adenoma (PA) stimulated by tumor-conditioned medium. The benign myoepithelial cells were obtained from PA and were cultured with fibronectin extracellular matrix protein, supplemented with tumor-conditioned medium, which was harvested from breast ductal adenocarcinoma AU-565 and melanoma Hs 852.T cells. The morphological alterations were assessed by immunofluorescence analysis using vimentin antibody. The α-smooth muscle actin (α-SMA) and fibroblast growth factor (FGF)-2 proteins were analyzed by indirect immunofluorescence and quantitative polymerase chain reaction (qPCR). No morphological changes were observed in the myoepithelial cells cultured in fibronectin protein under stimulation from either tumor-conditioned medium. The immunofluorescence results, which were supported by qPCR analysis, revealed that only α-SMA was upregulated in the fibronectin substratum, with or without tumor-conditioned medium obtained from breast ductal adenocarcinoma and melanoma cells. No significant difference in FGF-2 mRNA expression was detected when the cells were cultured either in the tumor-conditioned medium or in the fibronectin substratum. The tumor-conditioned medium harvested from breast ductal adenocarcinoma and melanoma did not affect myoepithelial cell differentiation and function, which was reflected by the fact that there was no observed increase in α-SMA and FGF-2 expression, respectively.

Epithelial membrane antigen (EMA) and DOG1 are used as marker of epithelial cells, particularly the luminal cells, of salivary gland tumours. The aim of this study was to compare the EMA and DOG1 expression in tumours of minor salivary glands. Cases of pleomorphic adenoma (PA), basal cell adenoma (BCA), canalicular adenoma (CA), adenoid cystic carcinoma (ACC), polymorphous adenocarcinoma (PAC), mucoepidermoid carcinoma (MEC) and epithelial-myoepithelial carcinoma (EMC) were submitted to immunohistochemistry for EMA and DOG1. In PA and BCA, EMA and DOG1 were observed in luminal cells, while in CA the tumour cells were negative for both proteins. The EMA and DOG1 pattern expression detected in EMC was similar to that one observed in benign tumours. In ACC, both myoepithelial e epithelial expressed EMA and DOG-1. PAC tumour cells were only positive for DOG1, whereas MEC were only positive for EMA. In conclusion, EMA and DOG1 expression in benign salivary gland tumours was similar to normal salivary gland tissue and can be used as good marker of tumoral cells derived from intercalated ducts or its progenitor cells, while in malignant salivary gland tumours EMA expression is, however, better used as an indicator of aggressive behavior than a marker of luminal cells.

Epidemiological research on maxillofacial lesions establishes and helps in the determination of demographic characteristics of oral pathology. It cooperates in planning the population needs and guiding dental surgeons in determining preventive actions and appropriate treatment. Objectives To perform a retrospective analysis of the biopsies done at the Stomatologic clinic of Sao Leopoldo Mandic Institute and Research Center (Brazil). Methods The study of all the biopsies done in the Stomatologic clinic that were performed between January 2012 and December 2017 is the aim of this research. Results It was observed that during the evaluated period, 2,892 appointments and 341 biopsies were performed. These biopsies were classified according to the order of higher prevalence of the diagnosed oral pathologies: 1) Reactional lesions (n = 82), 2) Cysts (n = 39), 3) “others” (n = 36), 4) Malignant neoplasms (n = 31), 5) Bone lesions (n = 26), 6) Non-neoplastic epithelial lesions (n = 24), 7) Infectious lesions (n = 20), 8) Inflammatory lesions of the salivary gland (n = 19), 9) Autoimmune conditions (n = 14), 10) Benign neoplasms (n = 10). Conclusion The study provided the possibility to observe the profile and prevalence of the pathologies that affected the patients attended in the Stomatologic clinic, in addition to assisting the professionals in future planning of this important service of diagnosis and treatment of oral diseases.

Aims The morphological criteria for identification of intercalated duct lesions (IDLs) of salivary glands have been defined recently. It has been hypothesised that IDL could be a precursor of basal cell adenoma (BCA). BCAs show a variety of histological patterns, and the tubular variant is the one that presents the strongest resemblance with IDLs. The aim of this study was to analyse the morphological and immunohistochemical profiles of IDLs and BCAs classified into tubular and non-tubular subtypes, to determine whether or not IDL and tubular BCA represent distinct entities. Methods and results Eight IDLs, nine tubular BCAs and 19 non-tubular BCAs were studied. All tubular BCAs contained IDL-like areas, which represented 20–70% of the tumour. In non-tubular BCA, IDL-like areas were occasional and small (

A novel activated human T cell-secreted cytokine, referred as secreted osteoclastogenic factor of activated T cells (SOFAT), that induce osteoclastogenesis in a RANKL-independent manner was recently described. This study evaluated the role of SOFAT in periodontal tissues and periodontitis. Gingival biopsies were harvested from systemically healthy non-periodontitis (n = 15) and chronic periodontitis patients (n = 15). The mRNA and protein levels of SOFAT were measured by qPCR and by enzyme-linked immunosorbent assay, respectively. Moreover, RAW 264.7 cells were cultured with SOFAT or Receptor activator of nuclear factor-kB ligand (RANKL) and stained for tartrate-resistant acid phosphatase (TRAP). Also, mice received a palatal injection between the first and second upper molar of SOFAT (100 ng/ml) or saline solution (0.9%). The upper jaw was removed, histologically processed and stained with hematoxilin and eosin to observe the presence of osteoclast-like cells. The mRNA and protein levels of SOFAT were significantly higher in the gingival tissue of the periodontitis group when compared to non-periodontitis one (p < 0.05). In addition, SOFAT potently induced TRAP-positive multinucleated cell formation by RAW 264.7 cells as well as induced the formation of osteoclast-like cells in the periodontal ligament in mice. The present study demonstrated that SOFAT may play an important role in periodontitis.

Peroxisome proliferator-activated receptor-gamma (PPARγ) regulates both glucose metabolism and bone mass. Evidence suggests that the therapeutic modulation of PPARγ with synthetic agonists activity may elicit undesirable effects on bone. However, there is no information regarding its natural agonist 15d-PGJ2, besides its excellent anti-inflammatory action. In the present study the effects of 15d-PGJ2 on osteoblastic cells were determined. Osteoblastic cells (MC3T3) were cultured in an osteogenic medium in the presence of 1, 3 or 10 μM of 15d-PGJ2 during 21 days and alizarin and Von Kossa staining were employed. The protein expression (type-I collagen, osteonectin, osteopontin, RANKL, osteoprotegerin, HDAC-9c and PPAR-γ) was evaluated after 3 days in the presence of 15d-PGJ2 by western blotting and indirect immunofluorescence methods. The production of mineralized extracellular matrix was observed by transmission electron microscopy. After 72 h of culture, the mRNA was extracted for RT-qPCR analysis of RUNX expression. In the presence of all 3 tested 15d-PGJ2 doses, alizarin red and Von kossa staining were positive demonstrating the ability to the osteoblast differentiation. Type-I collagen and osteonectin proteins expression were up-regulated (p < 0.05) after 72 h in the presence of the smaller doses of 15d-PGJ2. In contrast, osteopontin, RANKL and OPG expression did not significantly alter. In the presence of 15d-PGJ2 it was possible to visualize mineralized nodules in the extracellular matrix confirmed with the increased RUNX mRNA expression. 15d-PGJ2 at small doses increased the osteoblast activity and the bone-related proteins expression.

Peripheral odontogenic fibroma is considered a gingival tumor characterized by a proliferation of relatively cellular fibrous or fibromyxomatous connective tissue which exhibits variable amounts of odontogenic epithelium and sometimes foci of calcification in the form of dentinoid, cementicles, or bone. It is considered the extraosseous counterpart of central odontogenic fibroma. This lesion usually is presented as a focal swelling in the gingiva, occurring in a wide age range, and the anterior region of the gingiva is the most frequent anatomic site. Conservative local excision is the treatment frequently adopted and its recurrence rate varies widely, and its biologic behavior is still unknown. In this study, the authors discuss 3 cases of peripheral odontogenic fibroma, and present their clinical and histopathological features and management.

Aim The aim of this study was to evaluate the inflammatory response to MTA Fillapex, AH Plus, and Pulp Canal Sealer Extensive Work Time (EWT), in a murine bone defect grafting model. Materials and methods Bilateral mandibular critical defects were produced in 45 Wistar rats with a trephine bur#2 and filled with the endodontic sealers. After 7, 14, and 28 days, the rats were euthanized and their jaws were histologically prepared. Results For the 7-day group, no statistical significance was observed among all studied groups (p > 0.05), and high levels of inflammatory infiltrate were detected. After 14 and 28 days, Pulp Canal Sealer EWT showed statistically lower inflammatory response in comparison to other sealers (p < 0.05) except for the control group (no sealers). Conclusion Pulp Canal Sealer EWT presented the lowest levels of inflammatory response. The critical defect grafting model was an effective method to detect differences among differences on the biological response to endodontic sealers. Clinical significance Knowing the biocompatibility of endodontics sealers that will be used in filling the root canal. How to cite this article Scelza MZ, Campos CAM, Scelza P, Adeodato CSR, Barbosa IB, de Noronha F, Montalli V, Napimoga M, de Araújo VC, Alves GG. Evaluation of Inflammatory Response to Endodontic Sealers in a Bone Defect Animal Model. J Contemp Dent Pract 2016;17(7):536-541.

Objective The aim of the present study was to establish a primary cell culture derived from polymorphous low grade adenocarcinoma (PLGA). Design The neoplastic cells were derived from a 57-year-old female patient diagnosed with PLGA. A fragment of the tumor was collected and submitted to enzymatic digestion followed by centrifugation on a Percoll gradient. The cell population was characterized by means of immunofluorescence and detection of PRKD1 gene mutations. Results Epifluorescence analysis of the primary culture revealed that the malignant epithelial cells were predominantly polygonal in shape and positive for cytokeratin 7, vimentin, and S100. The doubling time of the cell culture was 86.73 h. The restriction digestion assay showed that the neoplastic cells possess PRKD1 gene mutations. Conclusion The establishment of primary cell culture derived from PLGA should be considered a useful tool for molecular analysis of this salivary gland tumor.

Bone replacement materials have been widely used to reconstruct atrophic jawbones. Based on previous reports demonstrating the presence of viable cells in bone blocks even after processing by musculoskeletal tissue banks for orthopedic use, the aim of this study was to evaluate the presence of cells in bone blocks from three Brazilian tissue banks for maxillary reconstructions. All samples were processed by the respective tissue banks, according to the guidelines of the Brazilian National Sanitary Surveillance Agency. Three samples were removed from each block for subsequent histological processing and stained using hematoxylin & eosin. Further evaluation included section staining by the Feulgen method and ultrastructural analysis using scanning electron microscopy (SEM). Light microscopy images from all bone samples showed presence of osteocyte-like cells in all groups and intense Feulgen staining, demonstrating presence of DNA in bone even after tissue processing. The ultrastructural analysis showed red blood cells in lacunae within the bone tissue. In conclusion, despite bone tissue processing by the musculoskeletal tissue banks, cells may be found within the bone used for allogeneic grafts. Resumo Substitutos ósseos têm sido amplamente utilizados para reconstrução de ossos maxilares atróficos. Uma vez que relatos anteriores demonstram a existência de células viáveis em blocos ósseos após processamento pelos bancos de tecidos músculo-esqueléticos para uso ortopédico, o objetivo deste trabalho foi avaliar a presença de células provenientes de três bancos de tecidos músculo-esqueléticos do Brasil. Todas as amostras foram processadas pelos respectivos bancos seguindo as normas da Agência Nacional de Vigilância Sanitária brasileira. Foi realizada a retirada de 3 amostras de cada bloco, que foram destinadas para processamento histológico e subsequente coloração por hematoxilina e eosina e Feugen e análise ultra-estrutural através de microscopia eletrônica de varredura (MEV). As imagens de microscopia de luz de todos os fragmentos de enxertos ósseos mostraram presença de células do tipo osteócito em todos os grupos avaliados, bem como intensa coloração por Feulgen, demonstrando a presença de DNA nos ossos mesmo após o processamento realizado. As análises ultraestruturais evidenciaram a presença de hemácias nas lacunas do tecido ósseo. Conclui-se que mesmo após os processamentos realizados pelos bancos de tecidos músculo-esqueléticos é possível encontrar células nos ossos utilizados para enxertia alógena.

Tumoral invasion process is the result of a complex interaction between the tumor cells and microenvironment which plays an important role in modulating the growth and invasion of the cancer. The myoepithelial cells, present in glandular organs such as the breast and salivary glands, seem to exert paracrine effects on the glandular epithelium, acting as natural tumor suppressors. To verify the influence of the benign myoepithelial cells in the invasion of malignant cells, simulating an in situ carcinoma ex pleomorphic adenoma, we have cultured three different high-potential invasive malignant tumors (breast ductal adenocarcinoma, melanoma and oral squamous cell carcinoma) in conditioned medium of myoepithelial cells from salivary gland pleomorphic adenomas using transwell chambers with 8-μm pores membrane coated with matrigel. After 96 h, quantitative analyses of the results were performed by calculating the invasion index (number of cells that invaded in relation to the total number of cells). The results showed that there was a reduction of the invasion index mean for the three different malignant tumors. This study supports a tumoral suppressor function of the myoepithelial cells from pleomorphic adenoma in in vitro invasion process.

Costa A F, Tasso M G, Mariano F V, Soares A B, Chone C T, Crespo A N, Fresno M F, Llorente J L, Suarez C, de Araujo V C, Hermsen M & Altemani A (2012) Histopathology 60, 816–837 Levels and patterns of expression of hypoxia-inducible factor-1α, vascular endothelial growth factor, glucose transporter-1 and CD105 in adenoid cystic carcinomas with high-grade transformation Aims: To compare the expression of proteins regulated by hypoxia between adenoid cystic carcinoma (ACC) with and without high-grade transformation (HGT). Methods and results: In eight ACC–HGT and 18 ACC without HGT, expression of hypoxia-inducible factor-1 (HIF-1α), vascular endothelial growth factor (VEGF), glucose transporter-1 (GLUT-1) and microvascular density (MVD) by CD105 (a hypoxia-inducible protein expressed in angiogenic endothelial cells) was determined. Expression levels of HIF-1α and VEGF as well as CD105-MVD did not differ significantly between: (i) transformed and conventional areas (TA and CA, respectively) of ACC–HGT, (ii) CA and ordinary ACC. HIF-1α was detected in 100% of cases and presented a diffuse expression pattern. No significant association was found between levels of HIF-1α expression and tumour size, metastasis and recurrence. GLUT-1 showed a prostromal expression pattern and was observed exclusively in TA (three of six cases) and in only three of 14 ACC. Conclusions: Both the absence of significant alterations in levels of expression of HIF-1α, VEGF and CD105 and the patterns of expression of HIF-1α and GLUT-1 suggest that hypoxia may not play a key role in the process of high-grade transformation of ACC. Although HIF-1α expression is a common finding in ACC, it cannot be used as a marker of tumour aggressiveness.

There is controversial evidence regarding the levels of antioxidant molecules in type 2 diabetes periodontitis patients. Thus, the aim of the present study was to evaluate the gene expression of antioxidant enzymes in the gingival tissue of poorly and well-controlled type 2 diabetic subjects with chronic periodontitis (CP).Gingival biopsies were harvested from systemically and periodontally healthy subjects (n=12), systemically healthy subjects with CP (n=15), well-controlled (n=8) and poorly controlled (n=14) diabetic subjects with CP. The messenger RNA (mRNA) levels of peroxiredoxin (PRDX) 1 and 2, catalase (CAT), glutathione peroxidase (GPX1) and superoxide dismutase (SOD) 1 and 2 were measured by quantitative polymerase chain reaction (qPCR).The results showed that PRDX1 and GPX1 were up-regulated by periodontitis (p0.05), independently of the glycaemic status, whilst PRDX2 and SOD2 genes were slightly influenced by periodontitis, but significantly induced when periodontitis was associated with DM, especially under a poor glycaemic control (p0.05). Moreover, CAT and SOD1 expressions were not significantly influenced by any of these inflammatory disorders (p0.05).In conclusion, both PRDX1 and GPX1 were overexpressed in CP whilst PRDX2 and SOD2 were up-regulated especially in the poorly controlled diabetic group with CP.

Nodal metastasis is an important prognostic indicator in head and neck cancers, including salivary carcinomas. In these, the risk for lymph node metastasis is variable and strongly associated with the tumor histologic type. The aim of the current study was to evaluate the lymphatic vessel density (LVD) and expressions of lymphangiogenic growth factors by tumor cells in different histologic types of salivary carcinomas subdivided according to the risk for nodal metastasis. In 15 high-risk (undifferentiated, high-grade mucoepidermoid and salivary duct carcinomas) and 60 low/moderate-risk tumors (adenoid cystic, low/intermediate-grade mucoepidermoid, acinic cell, myoepithelial, epithelial-myoepithelial and polymorphic low-grade carcinomas) the expressions of vascular endothelial growth factor-C (VEGF-C), hepatocyte growth factor (HGF) and D2-40 (for assessing LVD) were examined. No significant differences were encountered between high- and low/moderate/-risk carcinomas regarding LVD and VEGF-C or HGF expressions. Furthermore, the expression of these proteins did not correlate with LVD. Lymphatic vascular invasion was found mainly in high-risk carcinomas. Intratumoral LVD was significantly lower than peritumoral, regardless of the risk for metastasis and primary site of the lesion. The histologic types of salivary carcinomas which are associated with high-risk for nodal metastasis do not present increased LVD or VEGF-C and HGF expressions. The greater tendency for metastasis in these carcinomas seems to be related to their capacity to invade lymph vessels. Further studies on tumor cell interactions with lymphatic endothelial cells are needed to improve our understanding of the metastatic potential of salivary carcinomas.