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Odontogenic and oral soft tissue myxomas: clinicopathologic analysis of 16 cases from Ile-Ife, Nigeria
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e38
Abstracts
AMARO (UNISA), (USP)
October 2012 3
UNIVERSIDADE DE SÃO PAULO
Objective: The purpose of the present research was to analyze the in vivo behavior of conventional versus nanostructured biphasic calcium phosphate bioceramics. Study design: The evaluated biomaterials possessed the same composition: 60% hydroxyapatite (HAp) and 40% b-tricalcium phosphate (b-TCP). An exoskeletal model for guided bone regeneration (GBR) was used. Eight New Zealand rabbits received four hollow titanium cylinders that were fixed to the skull and filled with microstructured particles (MP), nanostructured granules (NG), nanostructured biocement (NB) and blood clot (BC). Results: Specimens were obtained after 12 weeks and analyzed by clinical and histological findings, histomorphometry and scanning electron microscopy. The amount of bone tissue formation was significantly higher to nanostructured granules (NG), followed by NB, BC and MP. Conclusion: Nanostructured biomaterials proved to be biocompatible, did not promote inflammation process, neither foreign body reaction.
ORAL CYTOPATHOLOGY ASSOCIATED DIRECT IMMUNOFLUORESCENCE IN THE DIAGNOSIS OF PEMPHIGUS VULGARIS: AN EFFECTIVE OPTION Cunha KSG1, Picciani BLS2, Silva-Junior A1, Silva-Junior GO3, Cantisano MH4, Oliveira AV5 - 1UNIVERSIDADE FEDERAL FLUMINENSE - PATOLOGIA, 2UNIVERSIDADE FEDERAL FLUMINENSE, 3UNIVERSIDADE FEDERAL FLUMINENSE - CIÊNCIAS BÁSICAS, 4UNIVERSIDADE DO ESTADO DO RIO DE JANEIRO - ESTOMATOLOGIA, 5 UNIVERSIDADE DO ESTADO DO RIO DE JANEIRO PATOLOGIA Pemphigus vulgaris (PV) is an autoimmune disease that often begins in the oral mucosa. Hence, a timely diagnosis is necessary in order to give appropriate therapy. The cytopathology is sensitive and rapid exam to diagnose PV, mainly, when associated with direct immunofluorescence (DIF). The purpose of this study was to evaluate the role of cytopathology associated with DIF in the diagnosis of PV. A 73-year-old man with histopathological diagnosis of PV, presented oral lesions of PV was subjected to collect material for making smears to cytopathological analysis and DIF using anti-IgG. The Pap-stained smears showed findings consistent with PV, as presence of typical acantholytic cells, showing an abundant basophilic cytoplasm, round hypertrophic nucleus with prominent nucleoli. The smears positive by DIF showed deposition of anti-IgG between acantholytic cells. The use of the cytopathology associated with DIF is an alternative more specific, economical, user-friendly to the diagnostic of oral PV.
A LOW GRADE MYOFIBROBLASTIC SARCOMA OF THE ALVEOLAR RIDGE Barrios BCA1, Legorreta B1, Lopez R1 - 1UNAM - ORAL PATHOLOGY The low grade myofibroblastic sarcoma is an heterogeneous neoplasm, with a biological spectrum from a benign to malignant neoplasma. Misdiagnosed as benign lesions can be made. Identifying neoplastic myofibroblasts is important for diagnosis as a myofibroblastic neoplasm. The currently accepted markers for identifying myofibroblasts are muscle-specific actin MSA, smooth muscle actin SMA, desmin, and calponin.
Case presentation: A 74 years old woman with a 1 cm, growth in the right alveolar ridge of the first low molar, with the same color as the normal oral mucosa, asymptomatic, evolution of one year, radiographic findings saucerization. Gross examination: smooth, firm, brown nodule, 1.5 x1.5x1.0 cm, Microscopic examination: with H&E stain shows, spindle myofibroblastic proliferation, with pushing margins and compression of the surrounding tissue, with mitotic activity, with this outcome was necessary to use immunohistochemistry and the result was: Actin (focal ⫹), Ki 67 10%, H-Caldesmon (⫺), S-100(⫺), this result give the diagnosis of low grade myofibroblastic sarcoma. Conclusion: This LGMS is a rare tumor in this localization, and to do a good diagnosis it is important to have the immunohistochemistry markers, and do the ultrastructural (EM) study to support the myofibroblastic differentiation and we are doing this. Differential diagnosis was made with leiomyosarcoma and fibrosarcoma. The cytogenic and molecular genetic studies indicate that sarcomas can be divided in two genetic groups. The focal inflammatory infiltration can help to do the differential diagnosis. The LGMS contain more poorly developed myofibroblast and tends to be more uniform in appearance with a higher cellularity.
ODONTOGENIC AND ORAL SOFT TISSUE MYXOMAS: CLINICOPATHOLOGIC ANALYSIS OF 16 CASES FROM ILE-IFE, NIGERIA Adebiyi KE1, Ndukwe KC1, Aregbesola SB1 - 1OBAFEMI AWOLOWO UNIVERSITY - ORAL/MAXILLOFACIAL SURGERY & ORAL PATHOLOGY Background/objective: Odontogenic myxomas (OMs) are considered slow-growing tumours with potential for extensive bone destruction. We analyzed the cases histologically diagnosed as OM in our centre and compared these to the data found in the current literature. Study design: A record-based study of OMs histologically diagnosed at the Obafemi Awolowo University Teaching Hospital Complex, Ile-Ife, Nigeria between 1990 and 2009 was conducted. Data was analyzed using SPSS version 11. Results: A total of 16 cases were histologically diagnosed, 11(68.8%) in females and 5 (31.2%) in males. Maxilla (7 cases, 43.8%) was the most common site and the mean age at the time of diagnosis was 31.1⫾18.0 years. Myxomas, exhibiting complete myxomatous tissue (8 cases, 50%) with no appreciable fibrous component were the most common histological type. Conclusion: OMs exhibited extensive bone destruction and cortical expansion. The recommended treatment of choice is radical surgery or conservative excision depending on tumour size.
MALIGNANT CEOT, A CASE REPORT IN MEXICO Acosta FO1, JVS2, Espinoza AV3, Legorreta B4, Barrios BCA4 1 UABC - ORAL PATHOLOGY, 2UABC - ORAL SURGERY, 3 HOSPITAL GENERAL TIJUANA BC - PATHOLOGY, 4 UNAM - ORAL PATHOLOGY The malignant variant of the epithelial odontogenic tumor (CEOT) is a rare variant of malignant odontogenic with, only 20 cases reported in the literature, the first benign variant was described by Jens Jorgen Pindborg in 1955. Represent less than 1% of all odontogenic tumors. Case report: In 2010, a 37 year old female went to the diagnostic clinic of the School of Dentistry for presenting a painful swelling on the right body of the mandible with a cortical
e38
Abstracts
AMARO (UNISA), (USP)
October 2012 3
UNIVERSIDADE DE SÃO PAULO
Objective: The purpose of the present research was to analyze the in vivo behavior of conventional versus nanostructured biphasic calcium phosphate bioceramics. Study design: The evaluated biomaterials possessed the same composition: 60% hydroxyapatite (HAp) and 40% b-tricalcium phosphate (b-TCP). An exoskeletal model for guided bone regeneration (GBR) was used. Eight New Zealand rabbits received four hollow titanium cylinders that were fixed to the skull and filled with microstructured particles (MP), nanostructured granules (NG), nanostructured biocement (NB) and blood clot (BC). Results: Specimens were obtained after 12 weeks and analyzed by clinical and histological findings, histomorphometry and scanning electron microscopy. The amount of bone tissue formation was significantly higher to nanostructured granules (NG), followed by NB, BC and MP. Conclusion: Nanostructured biomaterials proved to be biocompatible, did not promote inflammation process, neither foreign body reaction.
ORAL CYTOPATHOLOGY ASSOCIATED DIRECT IMMUNOFLUORESCENCE IN THE DIAGNOSIS OF PEMPHIGUS VULGARIS: AN EFFECTIVE OPTION Cunha KSG1, Picciani BLS2, Silva-Junior A1, Silva-Junior GO3, Cantisano MH4, Oliveira AV5 - 1UNIVERSIDADE FEDERAL FLUMINENSE - PATOLOGIA, 2UNIVERSIDADE FEDERAL FLUMINENSE, 3UNIVERSIDADE FEDERAL FLUMINENSE - CIÊNCIAS BÁSICAS, 4UNIVERSIDADE DO ESTADO DO RIO DE JANEIRO - ESTOMATOLOGIA, 5 UNIVERSIDADE DO ESTADO DO RIO DE JANEIRO PATOLOGIA Pemphigus vulgaris (PV) is an autoimmune disease that often begins in the oral mucosa. Hence, a timely diagnosis is necessary in order to give appropriate therapy. The cytopathology is sensitive and rapid exam to diagnose PV, mainly, when associated with direct immunofluorescence (DIF). The purpose of this study was to evaluate the role of cytopathology associated with DIF in the diagnosis of PV. A 73-year-old man with histopathological diagnosis of PV, presented oral lesions of PV was subjected to collect material for making smears to cytopathological analysis and DIF using anti-IgG. The Pap-stained smears showed findings consistent with PV, as presence of typical acantholytic cells, showing an abundant basophilic cytoplasm, round hypertrophic nucleus with prominent nucleoli. The smears positive by DIF showed deposition of anti-IgG between acantholytic cells. The use of the cytopathology associated with DIF is an alternative more specific, economical, user-friendly to the diagnostic of oral PV.
A LOW GRADE MYOFIBROBLASTIC SARCOMA OF THE ALVEOLAR RIDGE Barrios BCA1, Legorreta B1, Lopez R1 - 1UNAM - ORAL PATHOLOGY The low grade myofibroblastic sarcoma is an heterogeneous neoplasm, with a biological spectrum from a benign to malignant neoplasma. Misdiagnosed as benign lesions can be made. Identifying neoplastic myofibroblasts is important for diagnosis as a myofibroblastic neoplasm. The currently accepted markers for identifying myofibroblasts are muscle-specific actin MSA, smooth muscle actin SMA, desmin, and calponin.
Case presentation: A 74 years old woman with a 1 cm, growth in the right alveolar ridge of the first low molar, with the same color as the normal oral mucosa, asymptomatic, evolution of one year, radiographic findings saucerization. Gross examination: smooth, firm, brown nodule, 1.5 x1.5x1.0 cm, Microscopic examination: with H&E stain shows, spindle myofibroblastic proliferation, with pushing margins and compression of the surrounding tissue, with mitotic activity, with this outcome was necessary to use immunohistochemistry and the result was: Actin (focal ⫹), Ki 67 10%, H-Caldesmon (⫺), S-100(⫺), this result give the diagnosis of low grade myofibroblastic sarcoma. Conclusion: This LGMS is a rare tumor in this localization, and to do a good diagnosis it is important to have the immunohistochemistry markers, and do the ultrastructural (EM) study to support the myofibroblastic differentiation and we are doing this. Differential diagnosis was made with leiomyosarcoma and fibrosarcoma. The cytogenic and molecular genetic studies indicate that sarcomas can be divided in two genetic groups. The focal inflammatory infiltration can help to do the differential diagnosis. The LGMS contain more poorly developed myofibroblast and tends to be more uniform in appearance with a higher cellularity.
ODONTOGENIC AND ORAL SOFT TISSUE MYXOMAS: CLINICOPATHOLOGIC ANALYSIS OF 16 CASES FROM ILE-IFE, NIGERIA Adebiyi KE1, Ndukwe KC1, Aregbesola SB1 - 1OBAFEMI AWOLOWO UNIVERSITY - ORAL/MAXILLOFACIAL SURGERY & ORAL PATHOLOGY Background/objective: Odontogenic myxomas (OMs) are considered slow-growing tumours with potential for extensive bone destruction. We analyzed the cases histologically diagnosed as OM in our centre and compared these to the data found in the current literature. Study design: A record-based study of OMs histologically diagnosed at the Obafemi Awolowo University Teaching Hospital Complex, Ile-Ife, Nigeria between 1990 and 2009 was conducted. Data was analyzed using SPSS version 11. Results: A total of 16 cases were histologically diagnosed, 11(68.8%) in females and 5 (31.2%) in males. Maxilla (7 cases, 43.8%) was the most common site and the mean age at the time of diagnosis was 31.1⫾18.0 years. Myxomas, exhibiting complete myxomatous tissue (8 cases, 50%) with no appreciable fibrous component were the most common histological type. Conclusion: OMs exhibited extensive bone destruction and cortical expansion. The recommended treatment of choice is radical surgery or conservative excision depending on tumour size.
MALIGNANT CEOT, A CASE REPORT IN MEXICO Acosta FO1, JVS2, Espinoza AV3, Legorreta B4, Barrios BCA4 1 UABC - ORAL PATHOLOGY, 2UABC - ORAL SURGERY, 3 HOSPITAL GENERAL TIJUANA BC - PATHOLOGY, 4 UNAM - ORAL PATHOLOGY The malignant variant of the epithelial odontogenic tumor (CEOT) is a rare variant of malignant odontogenic with, only 20 cases reported in the literature, the first benign variant was described by Jens Jorgen Pindborg in 1955. Represent less than 1% of all odontogenic tumors. Case report: In 2010, a 37 year old female went to the diagnostic clinic of the School of Dentistry for presenting a painful swelling on the right body of the mandible with a cortical