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MYOFIBROBLASTIC LESIONS OF THE ORAL CAVITY: DIAGNOSTIC CRITERIA BASED ON MORPHOLOGIC CHARACTERISTICS
OOOO Volume 129, Number 1 VALENZUELA, CRISTIAN ENRICO ESCOBAR LOPEZ
ABSTRACTS
e177
e PENAFIEL
EKDHAL
and,
Adenomatoid odontogenic tumor (AOT) is a benign (hamartomatous), noninvasive lesion with slow but progressive growth. The 3 variants—follicular, extrafollicular, and peripheral—present identical histologic findings. Objective: To present 27 cases of AOT, highlighting their clinical and histologic characteristics. Study Design: Twenty-seven AOT cases were retrieved from the archives of the Oral Pathology Biopsy Service from University of Chile, between 1976-2013. Clinical and histologic findings are described. Results: Twenty-seven AOT cases were reviewed, of which 25 were intraosseous and 2 were peripheral (gingiva). The cases came from 16 females and 11 males with an age range of 5 to 57 years. Of the 25 intraosseous cases, 17 were follicular (associated with impacted teeth), while 8 were extrafollicular (present between teeth). Thirteen of the 27 cases were in the maxilla, and the other 14 were in the mandible. The 2 peripheral cases were clinically diagnosed as a peripheral giant cell granuloma. Histologically, all specimens were similar in morphology, demonstrating a varied degree of duct-like structures and spindle-shaped epithelial cells. Conclusions: The follicular type was the most frequent variant and initially diagnosed as a dentigerous cyst, emphasizing the importance of the histopathologic study of pericoronary radiolucent lesions.
MYOFIBROBLASTIC LESIONS IN THE ORAL CAVITY: IMMUNOHISTOCHEMICAL ANAL YSIS. DENISE HELEN IMACULADA PEREIRA DE OLIVEIRA, ERICKA JANINE DANTAS DA SILVEIRA, LELIA BATISTA DE SOUZA, CLAUDIA HAYDEE S. CARO-SANCHEZ, HUGO DOMINGUEZ-MALAGON, ADALBERTO MOSQUEDA TAYLOR and, LELIA MARIA GUEDES QUEIROZ Objective: To characterize immunohistochemically a group of oral myofibroblastic lesions (MLs). Study Design: MLs incorporated during the period of 1997-2014 were retrieved from the files and records of the Department of Oral Pathology. Cases of myofibroma (MF), nodular fasciitis (NF), desmoplastic fibroma (DF), and 2 myofibroblastic sarcoma (MS) were stained with antibodies against alpha-smooth muscle actin (a-SMA), H-caldesmon, vimentin, desmin, b-catenin, anaplastic lymphoma protein kinase (ALK-1), and Ki-67. Results: Nineteen of 22 cases of MF, 2/5 NF, 1/10 DF, and 1/2 MS were positive for a-SMA. All cases of MF, NF, DF, and MS were positive for vimentin. One-half of MS cases were positive for desmin. Six out of 10 cases of DF were positives for b-catenin. Two cases of MF were positive for ALK-1. All cases of MF, NF, DF, and MS were negative for H-caldesmon. The Ki-67 labeling index was 10% and 8/22 cases of MF, 3/5 cases of NF, and 2/2 cases of MS exhibited a rate of 10% for this marker. Conclusions: The application of this panel of markers can help the diagnosis of oral MLs, in particular the distinction between fibroblastic, myofibroblastic, and muscle cells proliferation.
MYOFIBROBLASTIC LESIONS OF THE ORAL CAVITY: DIAGNOSTIC CRITERIA BASED
ON MORPHOLOGIC CHARACTERISTICS. DENISE HELEN IMACULADA PEREIRA DE OLIVEIRA, ERICKA JANINE DANTAS DA SILVEIRA, LELIA BATISTA DE SOUZA, CLAUDIA HAYDEE S. CARO-SANCHEZ, HUGO DOMINGUEZ-MALAGON, ADALBERTO MOSQUEDA TAYLOR and, LELIA MARIA GUEDES QUEIROZ Objective: The myofibroblastic lesions (MLs) represent a diagnostic challenge to exhibit similar characteristics and low prevalence in the oral cavity. The objective of this study was to characterize the morphologic particularities of a number of cases of oral MLs. Study Design: All archived cases in an oral pathology service diagnosed as “myofibroma” (MF), “nodular fasciitis” (NF), “desmoplastic fibroma” (DF), and “myofibroblastic sarcoma” (MS) have been revised, totaling 39 cases. A morphologic analysis based on observation of typical and atypical characteristics of each lesion was performed. The diagnosis of these lesions was evaluated and a reclassification of some cases was performed. Results: Thirty sample cases (76.9%) had their diagnosis confirmed and 17 MFs (56.7%), 10 DFs (33.3%), 2 NFs (6.7%), and 1 MS (3; 3%) were identified. Nine cases (23.1%) were reclassified as 5 MFs (55.6%), 3 NFs (33.3%), and 1 MS (11.1%). The final sample included 22 cases of MF, 10 cases of DF, 5 cases of NF, and 2 cases of MS. Conclusions: The MLs of the oral cavity may give rise to diagnostic difficulties because of the diversity of their morphologic characteristics. Thus, the study of these characteristics is essential for the correct diagnosis of these tumors.
TOMOGRAPHIC EVALUATION OF THE PARANASAL SINUSES AFTER THE LE FORT I OSTEOTOMY. NAYANA OLIVEIRA AZEVEDO, LIGIA HELENA ALMEIDA PINHEIRO, RAIMUNDO THOMPSON GON¸CALVES FILHO, MANOEL DE JESUS RODRIGUES MELLO, RAFAEL LIMA e CAVALCANTE GOMES DE VERDE OSTERNE, ABRAHAO SOUZA CARVALHO and, RENATO LUIZ MAIA NOGUEIRA Objective: This study evaluated paranasal sinus abnormalities in patients submitted to orthognathic surgery using the Le Fort I osteotomy by evaluating tomographic features. Study Design: The methodology consisted of the use of cone beam computed tomography (CBCT) for evaluating the maxillary sinus volume, detection, and diagnosis of anatomic defects. In addition, the paranasal sinuses were also classified according to the Lund-Mackay scale. All the aspects evaluated were performed in 3 times: preoperative (T0), postoperative of up to 30 days (T1), and postoperative of at least 5 months to 1 year (T2). Statistical analysis was performed using analysis of variance (ANOVA) and Student t test for non-paired samples. Results: It is noted that the decrease in the air volume of the paranasal sinuses and increase of the values in the scale of Lund-Mackay are present only significantly in T1 in relation to T0 and T2 with P < .001 in both situations. Moreover, despite the induction of considerable morphologic alterations in T2, these can’t be correlated with the results obtained in the other variables. Conclusions: It is concluded that the surgery does not present a risk for increasing tomographic aspects of rhinosinusitis in the paranasal sinuses after the late follow-up.
ABSTRACTS
e177
e PENAFIEL
EKDHAL
and,
Adenomatoid odontogenic tumor (AOT) is a benign (hamartomatous), noninvasive lesion with slow but progressive growth. The 3 variants—follicular, extrafollicular, and peripheral—present identical histologic findings. Objective: To present 27 cases of AOT, highlighting their clinical and histologic characteristics. Study Design: Twenty-seven AOT cases were retrieved from the archives of the Oral Pathology Biopsy Service from University of Chile, between 1976-2013. Clinical and histologic findings are described. Results: Twenty-seven AOT cases were reviewed, of which 25 were intraosseous and 2 were peripheral (gingiva). The cases came from 16 females and 11 males with an age range of 5 to 57 years. Of the 25 intraosseous cases, 17 were follicular (associated with impacted teeth), while 8 were extrafollicular (present between teeth). Thirteen of the 27 cases were in the maxilla, and the other 14 were in the mandible. The 2 peripheral cases were clinically diagnosed as a peripheral giant cell granuloma. Histologically, all specimens were similar in morphology, demonstrating a varied degree of duct-like structures and spindle-shaped epithelial cells. Conclusions: The follicular type was the most frequent variant and initially diagnosed as a dentigerous cyst, emphasizing the importance of the histopathologic study of pericoronary radiolucent lesions.
MYOFIBROBLASTIC LESIONS IN THE ORAL CAVITY: IMMUNOHISTOCHEMICAL ANAL YSIS. DENISE HELEN IMACULADA PEREIRA DE OLIVEIRA, ERICKA JANINE DANTAS DA SILVEIRA, LELIA BATISTA DE SOUZA, CLAUDIA HAYDEE S. CARO-SANCHEZ, HUGO DOMINGUEZ-MALAGON, ADALBERTO MOSQUEDA TAYLOR and, LELIA MARIA GUEDES QUEIROZ Objective: To characterize immunohistochemically a group of oral myofibroblastic lesions (MLs). Study Design: MLs incorporated during the period of 1997-2014 were retrieved from the files and records of the Department of Oral Pathology. Cases of myofibroma (MF), nodular fasciitis (NF), desmoplastic fibroma (DF), and 2 myofibroblastic sarcoma (MS) were stained with antibodies against alpha-smooth muscle actin (a-SMA), H-caldesmon, vimentin, desmin, b-catenin, anaplastic lymphoma protein kinase (ALK-1), and Ki-67. Results: Nineteen of 22 cases of MF, 2/5 NF, 1/10 DF, and 1/2 MS were positive for a-SMA. All cases of MF, NF, DF, and MS were positive for vimentin. One-half of MS cases were positive for desmin. Six out of 10 cases of DF were positives for b-catenin. Two cases of MF were positive for ALK-1. All cases of MF, NF, DF, and MS were negative for H-caldesmon. The Ki-67 labeling index was 10% and 8/22 cases of MF, 3/5 cases of NF, and 2/2 cases of MS exhibited a rate of 10% for this marker. Conclusions: The application of this panel of markers can help the diagnosis of oral MLs, in particular the distinction between fibroblastic, myofibroblastic, and muscle cells proliferation.
MYOFIBROBLASTIC LESIONS OF THE ORAL CAVITY: DIAGNOSTIC CRITERIA BASED
ON MORPHOLOGIC CHARACTERISTICS. DENISE HELEN IMACULADA PEREIRA DE OLIVEIRA, ERICKA JANINE DANTAS DA SILVEIRA, LELIA BATISTA DE SOUZA, CLAUDIA HAYDEE S. CARO-SANCHEZ, HUGO DOMINGUEZ-MALAGON, ADALBERTO MOSQUEDA TAYLOR and, LELIA MARIA GUEDES QUEIROZ Objective: The myofibroblastic lesions (MLs) represent a diagnostic challenge to exhibit similar characteristics and low prevalence in the oral cavity. The objective of this study was to characterize the morphologic particularities of a number of cases of oral MLs. Study Design: All archived cases in an oral pathology service diagnosed as “myofibroma” (MF), “nodular fasciitis” (NF), “desmoplastic fibroma” (DF), and “myofibroblastic sarcoma” (MS) have been revised, totaling 39 cases. A morphologic analysis based on observation of typical and atypical characteristics of each lesion was performed. The diagnosis of these lesions was evaluated and a reclassification of some cases was performed. Results: Thirty sample cases (76.9%) had their diagnosis confirmed and 17 MFs (56.7%), 10 DFs (33.3%), 2 NFs (6.7%), and 1 MS (3; 3%) were identified. Nine cases (23.1%) were reclassified as 5 MFs (55.6%), 3 NFs (33.3%), and 1 MS (11.1%). The final sample included 22 cases of MF, 10 cases of DF, 5 cases of NF, and 2 cases of MS. Conclusions: The MLs of the oral cavity may give rise to diagnostic difficulties because of the diversity of their morphologic characteristics. Thus, the study of these characteristics is essential for the correct diagnosis of these tumors.
TOMOGRAPHIC EVALUATION OF THE PARANASAL SINUSES AFTER THE LE FORT I OSTEOTOMY. NAYANA OLIVEIRA AZEVEDO, LIGIA HELENA ALMEIDA PINHEIRO, RAIMUNDO THOMPSON GON¸CALVES FILHO, MANOEL DE JESUS RODRIGUES MELLO, RAFAEL LIMA e CAVALCANTE GOMES DE VERDE OSTERNE, ABRAHAO SOUZA CARVALHO and, RENATO LUIZ MAIA NOGUEIRA Objective: This study evaluated paranasal sinus abnormalities in patients submitted to orthognathic surgery using the Le Fort I osteotomy by evaluating tomographic features. Study Design: The methodology consisted of the use of cone beam computed tomography (CBCT) for evaluating the maxillary sinus volume, detection, and diagnosis of anatomic defects. In addition, the paranasal sinuses were also classified according to the Lund-Mackay scale. All the aspects evaluated were performed in 3 times: preoperative (T0), postoperative of up to 30 days (T1), and postoperative of at least 5 months to 1 year (T2). Statistical analysis was performed using analysis of variance (ANOVA) and Student t test for non-paired samples. Results: It is noted that the decrease in the air volume of the paranasal sinuses and increase of the values in the scale of Lund-Mackay are present only significantly in T1 in relation to T0 and T2 with P < .001 in both situations. Moreover, despite the induction of considerable morphologic alterations in T2, these can’t be correlated with the results obtained in the other variables. Conclusions: It is concluded that the surgery does not present a risk for increasing tomographic aspects of rhinosinusitis in the paranasal sinuses after the late follow-up.