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Background Monoclonal gammopathy is a biological reality encountered in approximately 1% of the general population. In the absence of clinical and biological signs, it is considered of undetermined significance; however, it can be a biological signature of a monoclonal lymphocytic or plasma-cell proliferation. Their localisation to the oral mucosa remains rare and difficult to diagnose, particularly in indolent forms that escape imaging techniques. Case presentation Here, we report the case of a 73-year-old woman with a history of IgM kappa gammopathy followed for 13 years. The patient did not have a chronic infection or an autoimmune disease, and all the biological investigations and radiological explorations were unremarkable during this period. The discovery of a submucosal nodule in the cheek led to the diagnosis of MALT lymphoma and regression of half of the IgM kappa level after resection. The review of the literature shows the dominance of clinical signs (i.e., a mass or swelling) in the diagnosis of primary MALT lymphomas of the oral cavity after surgical resection. Conclusions Our case illustrates the role of examination of the oral cavity in the context of a monoclonal gammopathy. The absence of clinical and radiological evidence in favor of lymphoplasmacytic proliferation, does not exclude a primary indolent MALT lymphoma of the oral mucosa.

We report on a case of carcinoma cuniculatum (CC) of the maxillary gingival mucosa. A 60-year-old woman presented with an exophytic gingivo-palatal mass with slow growth and osteolytic evolution. A first performed biopsy was negative for malignancy. The diagnosis of CC was established on the surgical representative biopsy. CC is a rare low-grade variant of squamous cell carcinoma that is usually found in the foot or in oral cavity. The pathognomonic microscopic feature of CC is an endo- and/or exophytic lesion composed by a well differentiated squamous epithelium infiltrating into underlying stroma forming a complex pattern of keratin cores and keratin filled "rabbit warren" crypts. CC is a locally evolutive carcinoma with a usually good prognosis usually without lymph node or distant metastatic evolution.

We report on a case of carcinoma cuniculatum (CC) of the maxillary gingival mucosa. A 60-year-old woman presented with an exophytic gingivo-palatal mass with slow growth and osteolytic evolution. A first performed biopsy was negative for malignancy. The diagnosis of CC was established on the surgical representative biopsy. CC is a rare low-grade variant of squamous cell carcinoma that is usually found in the foot or in oral cavity. The pathognomonic microscopic feature of CC is an endo- and/or exophytic lesion composed by a well differentiated squamous epithelium infiltrating into underlying stroma forming a complex pattern of keratin cores and keratin filled "rabbit warren" crypts. CC is a locally evolutive carcinoma with a usually good prognosis usually without lymph node or distant metastatic evolution.

PURPOSE: The present study addressed the prevalence of functional somatic syndromes (FSS) in temporomandibular disorders (TMD) patients and in control patients. We also investigated the overlap between history of FSS and psychometric data. PATIENTS AND METHODS: We evaluated sociodemographic characteristics, reports of previous FSS, and measures of depression and somatization as determined by the psychometric scales of the Symptom Checklist-90-Revised (SCL-90-R). Samples comprised 56 TMD patients and 103 controls who were routine dental patients. RESULTS: The reports of at least one FSS were significantly more prevalent in TMD patients than in control patients. The former group also reported significantly more frequent occurrences of multiple FSS. The median depression and somatization scores on the SCL-90-R were higher in TMD patients. TMD patients were significantly more frequently classified in the moderate and severe classes of the SCL-90-R somatization scale. The depression and somatization scores were significantly correlated. A significant and positive relationship between the number of reports of FSS and the somatization score was found in both TMD patients and in control patients. The depression score was significantly and positively linked with the incidence of FSS in the control group. CONCLUSION: TMD patients more frequently report FSS and multiple FSS than routine dental patients. Somatization of TMD patients can be assessed by inquiring as to their history of FSS.

International audience; The use of photoluminescence (PL) probes in immunodiagnostic procedures requires highly specific and precise labeling of biomarkers and he tags whose PL is easily differentiable from that of the autofluorescence of cells in clinical specimens. Nanoprobes consisting of core/shell quantum dots (QDs), notably CdSe/ZnS ones, and single-domain antibodies (sdAbs) with PL excited in the multiphoton mode meet both requirements. These diagnostic nanoprobes are

International audience; High-quality imaging for immunofluorescence diagnosis in medical practice requires a high sensitivity of labeling and discrimination between the fluorescence of immunostaining probes and tissue autofluorescence. Multiphoton microscopy with excitation in the near-infrared spectral region, far from the region of excitation of tissue autofluorescence, enables deep imaging of biological tissues. CdSe/ZnS quantum dots (QDs) conjugated to single-domain antibodies (sdAbs) are efficient diagnostic nanoprobes with diameters 40 times higher than that for one-photon excitation.

International audience; Human DNA topoisomerase I (topo I) is the molecular target ofthe camptothecin group of anticancer drugs. Laboratory studies haveshown that the cellular response to topo I–targeted drugs depends onthe topo I expression and DNA replication rate and the apoptoticpathway activity. In this study, we tested potential indicators of thesensitivity of topo I–targeted drugs in 36 cases of oral squamous cellcarcinoma (OSCC). Formalin-fixed, paraffin-embedded tissue sec-tions were immunostained with monoclonal antibodies against Ki-67,p53, and topo I, and with polyclonal antibodies against DNA topo-isomerase II-alpha (topo II-alpha). These markers were also tested in 18epithelial hyperplastic lesions and 18 mild dysplasias. Immunostain-ing was quantified by the percentage of stained nuclei in each sample (the labeling index); 200 immunoreactive epithelial nuclei werecounted per case for each antibody. The results support the possi-bility of using topo II-alpha staining for assessing the proliferative activ-ity. High expression of topo II-and topo I in OSCCs suggests thatthey may serve as potential indicators of sensitivity to topo I inhibitors. However, the apoptotic pathway assessed by p53 immunostain-ing was found to be uninformative. Analysis of the relationshipbetween immunohistochemical results and clinical and pathologicparameters (the T and N stages and differentiation) showed that onlythe differentiation parameter correlated with the topo I expressionrate. Thus, significant increase in the topo I expression in the poorlydifferentiated OSCCs suggests their higher sensitivity to drugtreatment.

Le cas d’un lymphome non hodgkinien chez un homme de 65 ans est rapporte. Ce cas illustre les difficultes rencontrees pour le diagnostic de cette entite anatomo-clinique en raison de son aspect clinique et radiologique et, plus particulierement, de son mode d’evolution. En effet, l’importante reaction inflammatoire reactionnelle peritumorale accentue le caractere difficilement accessible de la lesion tumorale et rend la biopsie par voie endo-buccale non significative. Le profil immunohistochimique diffus a grandes cellules B et le caractere primitif localise au sinus maxillaire sont des facteurs de bon pronostic. Dans le cas presente, le traitement par chimiotherapie et radiotherapie externe a permis d'obtenir une remission complete a trois ans. (Med Buccale Chir Buccale 2004; 10: 31-36)

et l’INR (international normalized ratio) sont indiques : (1) soit pour le depistage des anomalies congenitales ou acquises de l’hemostase ; (2) soit pour l’evaluation d’un risque hemorragique connu et/ou la surveillance d’un traitement anti-thrombotique. Dans le cadre du depistage des anomalies de l’hemostase, le recours a ces examens n’est en aucun cas systematique. En effet, en l’absence d’elements evocateurs, la decouverte fortuite d’une anomalie de l’hemostase est rare et souvent de faible valeur predictive positive quant a ses manifestations operatoires potentielles. Le depistage d’anomalies de l’hemostase repose d’abord sur une recherche prealable d’argument(s) pertinent(s) en faveur d’un trouble de l’hemostase, par un interrogatoire (tableau 1) et par l’observation d’eventuels signes cliniques evocateurs. Ce sont les reponses aux questions et l’examen clinique qui orienteront l’indication et le choix des eventuels examens demandes. medecine buccale chirurgie buccale

International audience

Le rhabdomyosarcome est une tumeur maligne rare qui s'observe surtout chez l'enfant et l'adolescent. Pres de la moitie des RMS surviennent au niveau de la tete et du cou. Le pronostic de ce type de tumeur est particulierement sombre. Un cas de rhabdomyosarcome a localisation palatine chez une femme de 27 ans est rapporte ainsi que son evolution sur une periode de trois ans et demi. Il s'agit d'une lesion dont l'aspect radiologique initial simulait une image de granulome peri-apical. Cet aspect a retarde la mise en route d'une prise en charge therapeutique adequate. Malgre un traitement agressif associant chimiotherapie, chirurgie et radiotherapie, le processus tumoral a continue a progresser ineluctablement, aboutissant a une issue fatale. Cette observation illustre la necessite de proceder systematiquement a un examen anatomopathologique de tout tissu pathologique preleve lors d'une intervention de chirurgie apicale. (Med Buccale Chir Buccale 2002; 8: 81-8).

An ideal multiphoton fluorescent nanoprobe should combine a nanocrystal with the largest possible two-photon absorption cross section (TPACS) and the smallest highly specific recognition molecules bound in an oriented manner. CdSe/ZnS quantum dots (QDs) conjugated to 13-kDa single-domain antibodies (sdAbs) derived from camelid IgG or streptavidin have been used as efficient two-photon excitation (TPE) probes for carcinoembryonic antigen (CEA) imaging on normal human appendix and colon carcinoma tissue. The TPACS for some conjugates was higher than 49,000 GM (Goeppert-Mayer units), considerably exceeding that of organic dyes being close to the theoretical value of 50,000 GM calculated for CdSe QDs. The ratio of sdAb-QD emission to the autofluorescence for 800 nm TPE was 40 times higher than that for 457.9 nm one-photon excitation. TPE ensures a clear discrimination of CEA-overexpressing tumor areas from normal tissue. Oriented sdAb-QD conjugates are bright specific labels for detecting low concentrations of antigens using multiphoton microscopy. From the Clinical Editor This study demonstrates carcinoembryonic antigen imaging on normal human appendix and colon carcinoma tissue utilizing CdSe/ZnS quantum dots conjugated to streptavidin or to 13-kDa single-domain antibodies as efficient two-photon excitation probes.

This paper reports the case of a 39-year-old woman who presented with symptoms of Eagle's Syndrome and an ossified stylohyoid ligament (SHL). Symptoms had developed immediately after trauma to the neck. No injury to the SHL was radiologically observable, but the causal relationship between the trauma and the occurrence of symptoms was evident. A new symptom of Eagle's Syndrome mimicking osteoathrosis of the temporomandibular joint was observed. The risk of misdiagnosis of temporomandibular disorders and the etiological role of neck trauma in Eagle's Syndrome are discussed.

International audience; Semiconductor fluorescent quantum dots (QDs) have just demonstrated their numerous advantages over organic dyes in bioimaging and diagnostics. One of characteristics of QDs is a very large cross section of their two-photon absorption. A common approach to biodetection by means of QDs is to use monoclonal antibodies (mAbs) for targeting. Recently, we have engineered ultrasmall diagnostic nanoprobes (sdAb–QD) based on highly oriented conjugates of QDs with the single-domain antibodies (sdAbs) against cancer biomarkers. With a molecular weight of only 13 kDa (12-fold smaller than full-size mAbs) and extreme stability and capacity to refolding, sdAbs are the smallest functional Ab fragments capable of binding antigens with affinities comparable to those of conventional Abs. Ultrasmall diagnostic sdAb–QD nanoprobes were engineered through oriented conjugation of QDs with sdAbs. This study is the first to demonstrate the possibility of immunohistochemical imaging of colon carcinoma biomarkers with sdAb–QD conjugates by means of two-photon excitation. The optimal excitation conditions for imaging of the markers in clinical samples with sdAb–QD nanoprobes have been determined. The absence of sample autofluorescence significantly improves the sensitivity of biomarker detection with the use of the two-photon excitation diagnostic setup.

Le cystadenome est une tumeur epitheliale rare des glandes salivaires (OMS 2005). Elle represente 4,2 a 4,7% de l'ensemble des tumeurs benignes (Lim et al. 2008). Histologiquement, l’aspect polykystique presente le plus souvent un epithelium d’aspect papillaire et, plus rarement, d’aspect muqueux. Il atteint preferentiellement les glandes salivaires accessoires du palais, des levres et des joues (Guccion et al. 1997). La parotide reste cependant une localisation frequente (45 %). On retrouve une legere predominance feminine (Buchner et al. 2007) et l’âge moyen de decouverte est de 57 ans. Le cas rapporte est celui d’un homme de 58 ans, adresse par son medecin traitant pour une tumefaction jugale droite evoluant depuis 48 heures. L’interrogatoire revele l'existence d'une masse intra-jugale asymptomatique depuis de nombreuses annees. Il declare avoir eu un traumatisme quelques heures avant l'apparition de la tumefaction. L'examen clinique montre, une peau tendue et rouge et une muqueuse jugale normale. La palpation bidigitale est indolore. Elle met en evidence une masse intra-jugale circonscrite, mobile et de consistance molle, au contenu fluctuant. L’examen endo-buccal est sans particularite hormis la presence de debris radiculaires dans le secteur maxillaire droit. L'orthopantomogramme conforte l’examen clinique. Il n'y a pas d'adenopathies palpables. L'echographie montre une image hypoechogene, polylobulee, bien limitee, qui mesure 30mm x 25mm ; les echos traduisent la presence d'un contenu liquidien epais. Devant l’ensemble des elements recueillis, l’hypothese d’une poussee inflammatoire sur une lesion benigne intra-jugale est retenue, probablement d’origine salivaire. La prise en charge a consiste dans un premier temps en une antibiotherapie associant amoxicilline et acide clavulanique. Apres resolution de l'episode aigu, l'exerese chirurgicale est realisee sous anesthesie locale potentialisee par voie d’abord endo-buccale. L’incision de la muqueuse permet de mettre en evidence une lesion kystique bilobee, de couleur jaune. Le contenu evacue lors du geste est opalin et visqueux. La lesion est adherente au muscle buccinateur. L'examen anatomopathologique montre une formation en majeure partie constituee par des cavites kystiques juxtaposees, de formes arrondies ou ovalaires, festonnees, contenant un abondant materiel eosinophile; certaines cavites comportent un epithelium avec des cellules internes contenant quelques vacuoles de mucus, et des cellules externes myoepitheliales. Il existe egalement des structures canalaires associees, festonnees, bordees par un double revetement. Le tissu interstitiel est constitue des elements conjonctifs physiologiques, parsemes de cellules inflammatoires mononuclees et de macrophages. L'anatomo-pathologiste conclut a un cystandenome developpe sur une glande salivaire accessoire. L’observation rapportee illustre une tumefaction faciale aigue secondaire a une poussee inflammatoire survenant sur un processus tumoral benin non odontogene. En raison de sa rarete et de l'absence de caracteres cliniques specifiques, l’orientation diagnostique devant une masse intrajugale reste difficile. Les tumeurs des glandes salivaires representent moins de 3% des tumeurs de l’extremite cephalique et seulement 25% d'entre elles se developpent sur des glandes salivaires accessoires (Dhanuthai et al. 2009). 56eme Congres de la SFMBCB, 02015 (2011) DOI: 10.1051/sfmbcb/20115602015 © Owned by the authors, published by EDP Sciences, 2011