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DIAGNOSTIC CHALLENGE OF AN ORAL ULCER IN A PATIENT WITH SYSTEMIC ERYTHEMATOSUS LUPUS
OOOO Volume 129, Number 1 Therefore, pluripotential embryonic epithelial cells can develop into glandular tissue. Collaboration: Pathology Institute Mejia Jimenez (Cali, Colombia).
ORAL MANIFESTATION OF DIFFUSE LARGE B-CELL LYMPHOMA. MICHELLE ROXOGONCALVES, ¸ LUAN SANTANA KOVALSKI, MARINA GIRARDI SCHUEIGART, LUIS FERNANDO DA ROSA RIVERO, VINICIUS COELHO CARRARD, MANOELA DOMINGUES MARTINS and, JULIANA ROMANINI A 45-year-old man presented with an extensive gingival growing disseminated in the jaws, leading to limitations with eating, talking, and mouth closure. The diagnostic hypothesis was lymphoma. A test for human immunodeficiency virus (HIV) was positive. An incisional biopsy was performed and histopathologic analysis was compatible with lymphocytic malignant neoplasm (unspecified). At subsequent immunohistochemical analysis, a diagnosis of diffuse large B-cell lymphoma was rendered. The patient was referred to a hematologist and started on chemotherapy. Initially, a significant clinical improvement was seen and the patient remains under treatment. The patient is in clinical and radiographic control, without mouth lesions. The World Health Organization classifies lymphomas into Hodgkin lymphoma (HL) and non-Hodgkin lymphoma (NHL). Based on morphologic aspects and immunohistochemistry, these tumors may be classified as B-cell, T-cell, and natural killer cell type. The B-cell origin comprises about of 85% of lymphomas and presents immunoreactivity for markers like CD20 and CD79a.
DIAGNOSTIC CHALLENGE OF AN ORAL ULCER IN A PATIENT WITH SYSTEMIC ERYTHEMATOSUS LUPUS. ADEMAR TAKAHAMA JUNIOR, FABIO AUGUSTO ITO, HELITON GUSTAVO DE LIMA and, JORGE ESQUICHE LEON
ABSTRACTS
e35
MARTINS, LUIS FERNANDO RIVERO, KONRADO MASSING DEUTSCH, MANOELA DOMINGUES MARTINS and, VINICIUS COELHO CARRARD A 32-year-old white woman was referred for evaluation of palate lesion with 3 months’ duration. Medical history included recent investigation for tuberculosis due to the presence of nodules detected on chest radiograph and previous treatment for syphilis. The patient exam revealed nasal obstruction, cough, secretion drainage, and weight loss. Extraoral examination showed erythema and edema in the face. Moreover, erosive lesions, crusts and purulent drainage were observed in the nasal area. Intraorally, an extensive necrotic lesion with bone destruction and exposure, midline palatal perforation was detected. Differential diagnosis included tertiary syphilis, leishmaniosis, tuberculosis, deep mycosis, Wegener granulomatosis, maxillary sinus carcinoma, and T-cell/natural killer (T/NK) lymphoma. Hematologic tests were negative for infectious diseases. Incisional biopsy followed by histopathologic examination revealed an unspecified malignant neoplasm. Epstein-Barr virus (EBV) was positive in the sample. T/NK lymphoma diagnosis was supported by morphologic aspects and immunohistochemical profile. Treatment comprised radiotherapy, and a partial remission was observed. The patient remains under follow-up care.
OSTEOLIPOMA IN BUCCAL MUCOSA: A RARE VARIANT OF LIPOMA. DANIELLE RESENDE CAMISASCA, GIULIA SOUZA COSTA, ANA CAROLINA DE MOURA DA SILVA, ISABEL BRAGA TORQUATO, SERGIO LINS DE AZEVEDO VAZ, ^ LILIANA APARECIDA PIMENTA DE BARROS and, TANIA e VELLOSO REGINA GRAO Osteolipoma is an extremely rare histologic variant of lipoma that contains mature lamellar bone. We report a case of a 27-year-old man with history of a small, rounded lesion in the right cheek that started in childhood, without symptomatology, but with continuous growing. On the examination, facial asymmetry was observed, without lymph node enlargement. A firm nodule of about 2.5 cm was seen involving his right buccal mucosa. A panoramic radiograph showed radiopaque irregular shapes in the region of the first upper and lower right molars. The lesion was excised, and pathologic examination of the specimen showed fragments of trabecular bone between adipocytes. Definitive pathologic diagnosis was osteolipoma. There was no recurrence at 7 months’ follow-up. Although osteolipoma is very rare, it is important to keep it in the differential diagnosis of nodules with a firm consistency in the oral mucosa and when noting a radiopaque image on panoramic exam.
A white 47-year-old woman complained about a lesion in gingiva present for 2 months. Her medical history included systemic erythematosus lupus with previous use of corticosteroids. The intraoral examination revealed an irregularly shaped gingival ulcer in the upper posterior region. Radiographic examination showed no significant abnormalities. According to clinical and radiographic features, malignant or infectious lesions were hypothesized. After an incisional biopsy, microscopic evaluation revealed an intense mixed inflammatory infiltrate with the presence of Reed-Sternberg like cells of Hodgkin lymphoma. Immunohistochemistry was positive for CD20, CD30, CD15, PAX-5, and LMP-1. Based on the clinical, microscopic, and immunophenotypic appearance, a diagnosis of Epstein-Barr virus (EBV)-positive mucocutaneous ulcer (EBVMCU) was established. After 2 months, total regression of the lesion was noted without any intervention. EBVMCU is a lymphoproliferative disorder presenting as isolated cutaneous or mucosal ulcers during treatment with immunosuppressive drugs or in elderly patients and frequently mimics a malignant neoplasm on the microscopic evaluation.
JUVENILE SPONGIOTIC GINGIVITIS ASSOCIATED WITH IDIOPATHIC GINGIVAL PAPILLOKERATOSIS WITH CRYPT FORMATION. LAIS DE BARROS PINTO GRIFONI, AUDREY FOSTER LEFORT ROCHA, ANDREIA and, CLAUDIA BUFALINO, JORGE ESQUICHE LEON MARIA NAVARRO
ORAL MANIFESTATION OF T-CELL/NATURAL KILLER LYMPHOMA: A CASE REPORT. FERNANDA BROCHIER CARDOSO, LUAN ^ SANTANA KOVASLKI, MARCO ANTONIO TREVIZANI
Juvenile spongiotic gingivitis (JSG) is an uncommon entity with a predominance for girls, with the majority of patients in the second decade of life. The idiopathic gingival papillokeratosis with crypt formation (IGPC), described in March of 2017, affects the maxillary attached gingiva of both genders in the
ORAL MANIFESTATION OF DIFFUSE LARGE B-CELL LYMPHOMA. MICHELLE ROXOGONCALVES, ¸ LUAN SANTANA KOVALSKI, MARINA GIRARDI SCHUEIGART, LUIS FERNANDO DA ROSA RIVERO, VINICIUS COELHO CARRARD, MANOELA DOMINGUES MARTINS and, JULIANA ROMANINI A 45-year-old man presented with an extensive gingival growing disseminated in the jaws, leading to limitations with eating, talking, and mouth closure. The diagnostic hypothesis was lymphoma. A test for human immunodeficiency virus (HIV) was positive. An incisional biopsy was performed and histopathologic analysis was compatible with lymphocytic malignant neoplasm (unspecified). At subsequent immunohistochemical analysis, a diagnosis of diffuse large B-cell lymphoma was rendered. The patient was referred to a hematologist and started on chemotherapy. Initially, a significant clinical improvement was seen and the patient remains under treatment. The patient is in clinical and radiographic control, without mouth lesions. The World Health Organization classifies lymphomas into Hodgkin lymphoma (HL) and non-Hodgkin lymphoma (NHL). Based on morphologic aspects and immunohistochemistry, these tumors may be classified as B-cell, T-cell, and natural killer cell type. The B-cell origin comprises about of 85% of lymphomas and presents immunoreactivity for markers like CD20 and CD79a.
DIAGNOSTIC CHALLENGE OF AN ORAL ULCER IN A PATIENT WITH SYSTEMIC ERYTHEMATOSUS LUPUS. ADEMAR TAKAHAMA JUNIOR, FABIO AUGUSTO ITO, HELITON GUSTAVO DE LIMA and, JORGE ESQUICHE LEON
ABSTRACTS
e35
MARTINS, LUIS FERNANDO RIVERO, KONRADO MASSING DEUTSCH, MANOELA DOMINGUES MARTINS and, VINICIUS COELHO CARRARD A 32-year-old white woman was referred for evaluation of palate lesion with 3 months’ duration. Medical history included recent investigation for tuberculosis due to the presence of nodules detected on chest radiograph and previous treatment for syphilis. The patient exam revealed nasal obstruction, cough, secretion drainage, and weight loss. Extraoral examination showed erythema and edema in the face. Moreover, erosive lesions, crusts and purulent drainage were observed in the nasal area. Intraorally, an extensive necrotic lesion with bone destruction and exposure, midline palatal perforation was detected. Differential diagnosis included tertiary syphilis, leishmaniosis, tuberculosis, deep mycosis, Wegener granulomatosis, maxillary sinus carcinoma, and T-cell/natural killer (T/NK) lymphoma. Hematologic tests were negative for infectious diseases. Incisional biopsy followed by histopathologic examination revealed an unspecified malignant neoplasm. Epstein-Barr virus (EBV) was positive in the sample. T/NK lymphoma diagnosis was supported by morphologic aspects and immunohistochemical profile. Treatment comprised radiotherapy, and a partial remission was observed. The patient remains under follow-up care.
OSTEOLIPOMA IN BUCCAL MUCOSA: A RARE VARIANT OF LIPOMA. DANIELLE RESENDE CAMISASCA, GIULIA SOUZA COSTA, ANA CAROLINA DE MOURA DA SILVA, ISABEL BRAGA TORQUATO, SERGIO LINS DE AZEVEDO VAZ, ^ LILIANA APARECIDA PIMENTA DE BARROS and, TANIA e VELLOSO REGINA GRAO Osteolipoma is an extremely rare histologic variant of lipoma that contains mature lamellar bone. We report a case of a 27-year-old man with history of a small, rounded lesion in the right cheek that started in childhood, without symptomatology, but with continuous growing. On the examination, facial asymmetry was observed, without lymph node enlargement. A firm nodule of about 2.5 cm was seen involving his right buccal mucosa. A panoramic radiograph showed radiopaque irregular shapes in the region of the first upper and lower right molars. The lesion was excised, and pathologic examination of the specimen showed fragments of trabecular bone between adipocytes. Definitive pathologic diagnosis was osteolipoma. There was no recurrence at 7 months’ follow-up. Although osteolipoma is very rare, it is important to keep it in the differential diagnosis of nodules with a firm consistency in the oral mucosa and when noting a radiopaque image on panoramic exam.
A white 47-year-old woman complained about a lesion in gingiva present for 2 months. Her medical history included systemic erythematosus lupus with previous use of corticosteroids. The intraoral examination revealed an irregularly shaped gingival ulcer in the upper posterior region. Radiographic examination showed no significant abnormalities. According to clinical and radiographic features, malignant or infectious lesions were hypothesized. After an incisional biopsy, microscopic evaluation revealed an intense mixed inflammatory infiltrate with the presence of Reed-Sternberg like cells of Hodgkin lymphoma. Immunohistochemistry was positive for CD20, CD30, CD15, PAX-5, and LMP-1. Based on the clinical, microscopic, and immunophenotypic appearance, a diagnosis of Epstein-Barr virus (EBV)-positive mucocutaneous ulcer (EBVMCU) was established. After 2 months, total regression of the lesion was noted without any intervention. EBVMCU is a lymphoproliferative disorder presenting as isolated cutaneous or mucosal ulcers during treatment with immunosuppressive drugs or in elderly patients and frequently mimics a malignant neoplasm on the microscopic evaluation.
JUVENILE SPONGIOTIC GINGIVITIS ASSOCIATED WITH IDIOPATHIC GINGIVAL PAPILLOKERATOSIS WITH CRYPT FORMATION. LAIS DE BARROS PINTO GRIFONI, AUDREY FOSTER LEFORT ROCHA, ANDREIA and, CLAUDIA BUFALINO, JORGE ESQUICHE LEON MARIA NAVARRO
ORAL MANIFESTATION OF T-CELL/NATURAL KILLER LYMPHOMA: A CASE REPORT. FERNANDA BROCHIER CARDOSO, LUAN ^ SANTANA KOVASLKI, MARCO ANTONIO TREVIZANI
Juvenile spongiotic gingivitis (JSG) is an uncommon entity with a predominance for girls, with the majority of patients in the second decade of life. The idiopathic gingival papillokeratosis with crypt formation (IGPC), described in March of 2017, affects the maxillary attached gingiva of both genders in the