- Email: [email protected]
Sublingual Lipoma: Case Report
OOOO Volume 119, Number 3 Izmir, Turkey; 2Department of Internal Medicine, Clinic of Rheumatology, Izmir Katip Çelebi University Ataturk Training and Research Hospital, Izmir, Turkey Objective: Sjögren’s Syndrome (SS) is a systemic, multi-organ, autoimmune disease with an incidence of 4/ 100.000, predominantly affecting women. Minor salivary gland biopsy has been long considered as the gold standard of diagnosis. More than one focus (a cluster of >¼50 lymphocytes) within a 4mm2 area of glandular tissue is supportive for SS. Our study aims to demonstrate whether there is a significant difference between histologic focus score (FS)¼1 and FS>1. Study Design: Biopsies of 99 patients who were evaluated according to the American-European Consensus Group 2002 criteria (AECGC) at our instution’s Rheumatology clinic between 2010 and 2012 were reviewed retrospectively. Results: 91.9% of our patients were women. Two patients had inadequate samples for focus scoring. Out of 97 patients, 5 (5,15%) had FS¼1 and 32 (32.98%) FS>1. Chi-Square analyses showed a significant correlation between FS>¼1 and clinical presence of SS (p<0.004). Conclusions: FS¼1 was accepted, followed and treated as SS depending on AECGC. Keywords: Sjögren’s Syndrome, focus score
AN UNSUAL LOCATION OF INTRAORAL HEMANGIOMA: A CASE REPORT Esma Cos¸kun1, Selen Adilo glu1, 1 1 2 Alper Aktas¸ , Göknur Topaloglu , Ömer Günhan , Ayça Dere1, 1Department of Oral and Maxillofacial Surgery, Hacettepe University, Ankara, Turkey; 2Department of Pathology, Gata University, Ankara, Turkey Hemangioma can be defined as a benign tumor characterized microscopically by proliferation of blood vessels. It is mostly seen in the head and neck region and rarely in the oral cavity. Hemangiomas are histologically classified into capillary and cavernous forms. There was no relevant medical history and no predisposing factors of hemangioma like hormonal changes, infection or trauma.So Masson’s hemangioma was also considered in differantial diagnosis. In this case, we present a 50 years old male patient had an asypmtomatic red-purple lobulated lesion with well defined margins, localized on the right side of buccal mucosa, on the superior of the occlusal plane and the posterior of parotid duct, at the level of edentuolus area (no sign of trauma). The lesion is finally confirmed as cavernous hemangioma histopathologically. Keywords: nontraumatic region, lobular, cavernous, hemangioma
ABSTRACTS Abstracts e153 The aim of this study is to conduct systematic review on the role of causative drugs in oral lichenoid lesions (OLLD) and the clinic-pathological features which still has uncertainty in diagnosis. Study Design: Bibliographic searches were performed to identify articles in PubMedÒ electronic databases from 1993 to 2013. Results: OLLD’s were detected frequently in patients with a history of zidovudine and imatinib mesylate medication. OLLD mostly occurred on buccal mucosa (42.37%). The most preferable treatment modality is withdrawal of the drugs and topical steroid regimen. Thirty OLLD cases were confirmed by biopsies which were characterized diffuse inflammatory infiltrate through the deep side the lamina propria. Conclusions: Medical history and histological features are the two basic criteria for the differential diagnosis of OLLD. Keywords: Oral Lichenoid Lesions, Lichenoid Drug Allergy, Oral Lichenoid Drug Reaction, Treatment
MINOR SALIVARY GLAND NEOPLASMS OF THE ORAL CAVITY: OUR HOSPITAL EXPERIENCE OF 17 CASES Emel Civas¸1, Fulya Çakala gao glu1, Demet Etit1, 1 1 Nes¸e Ekinci , Leyla Hayrullah , Seçil Arslano glu2, 1 Department of Pathology, Izmir Katip Çelebi University Ataturk Training and Research Hospital, Izmir, Turkey; 2 Department of Otorhinolaryngology, Izmir Katip Çelebi University Ataturk Training and Research Hospital, Izmir, Turkey Introduction: Minor salivary gland neoplasms (MSGNs) are unusual, accounting for only 15-20% of all salivary gland tumors. The commonest site of MSGNs of the head and neck is the oral cavity. Pleomorphic adenoma is the most common benign neoplasm and mucoepidermoid carcinoma is the most common malignancy. The aims of this study is to describe our experience of MSGNs in the oral cavity seen over last 5years. Study Design: Seventeen salivary gland tumors located in the oral cavity have been diagnosed at our institution between 2007-13. Results: 64% of the cases (11/17) were females and 35,3% (6/17) were males. Mean age of the patients were 40. 52,9% of the cases were malignant while 47,1% were benign. Conclusions: 47% of the cases were pleomorphic adenoma, 29,5% were mucoepidermoid carcinoma, 23,5% were adenoid cystic carcinoma. Palate was the most common site. Keywords: salivary gland tumors, oral cavity
ORAL LICHENOID LESIONS RELATED TO DRUGS: REVIEW OF CLINICOPATHOLOGICAL FEATURES AND DIFFERANTIONAL DIAGNOSIS Emre Barıs¸1, Burcu Sengüven1, Tamer Tüzüner2, Sibel Elif Gültekin1, 1Department of Oral Pathology, Gazi University Faculty of Dentistry, Ankara, Turkey; 2Department of Pedodontics, Karadeniz Technical University Faculty of Dentistry, Trabzon, Turkey
SUBLINGUAL LIPOMA: CASE REPORT Fulya Çakala gao glu1 , Leyla Hayrullah 1, Demet Etit 1, Seyran Yi git 1, Emel Civas¸1 , Seçil Arslano glu 2, 1Department of Pathology, Izmir Katip Çelebi University Ataturk Training and Research Hospital, Izmir, Turkey; 2 Department of Otorhinolaryngology, Izmir Katip Çelebi University Ataturk Training and Research Hospital, Izmir, Turkey
Objective: Oral lichenoid lesion is termed as a condition of the oral cavity having an identifiable etiology. A number of drugs have been described as a causative factor of those reactive lesions.
Introduction: Lipomas, despite being the most common mesenchymal tumors of the trunk and extremities, are rarely encountered in the oral cavity. They comprise 1% to 4% of
ORAL AND MAXILLOFACIAL PATHOLOGY e154 Abstracts all the benign oral lesions. They are common in the buccal mucosa, tongue, and palate, but only 6% to 10% are sublingual. Case Presentation: A 59-year-old female patient was referred to our institution for a sublingual swelling with a duration of 8 years and an accelerated growth during the last year. Complete excision was performed with a prediagnosis of ranula. Macroscopically the 3.8 2.5 1-cm tumor was well circumscribed, encapsulated with a homogeneous, yellow cut surface. Microscopy spported the diagnosis of a classic lipoma consisting of uniform mature lipocytes with eccentric nuclei. Discussion: Histologically oral lipomas may be classified as classic/atypical/pleomorphic/spindle cell/salivary gland lipoma, angiolipoma, intramuscular lipoma or fibrolipoma. Secondary changes, atrophy or intramuscular location should be assessed meticulously in order not to be confused with liposarcoma. Keywords: Sublingual lipoma, classic lipoma
INVESTIGATION OF EPSTEIN-BARR VIRUS AND HUMAN PAPILLOMA VIRUS IN TURKISH PATIENTS WITH NASOPHARYNGEAL CARCINOMA USING IN-SITU HYBRIDISATION Hayriye Tatlı Dogan1, Aydan 1 1 Kılıçarslan , Nuran Sungu , Mehmet Dogan3, Gaye Güler Tezel2, Gülnur Güler2, 1Department of Pathology, Atatürk Education and Research Hospital, Ankara, Turkey; 2Department of Pathology, Hacettepe University, Ankara, Turkey; 3Department of Pathology, Dr. A.Yurtaslan Ankara Oncology Education and Research Hospital, Ankara, Turkey Objective: Nasopharyngeal carcinoma(NPC) is associated with Ebstein-Barr virus. Human papilloma virus(HPV) was also detected in a proportion of NPC cases. In this retrospective study we analyze the frequency of EBV and HPV infection family16 in 82 patients with NPC. Study Design: A total of 82 from two medical center were evaluated for EBV and HPV. We used in situ hybridization to show EBV and HPV status on automatic platform. Results: 74 of 82 NPC (90,2%) were EBV positive and 8 were negative. The highest rate of EBV positivity was shown in WHO type 3 (undifferentiated) NPC which were 65 of 68 (95,6%) cases. 4 of 82 NPC contained HPV and three of them have also positive for EBV. One of the type 2 (nonkeratinizing) was HPV positive and EBV negative. Conclusions: Our data revealed that EBV is closely associated with NPC in Turkey. Unlike the frequent HPV positivity in NPC in USA literature, we found lower rates. Keywords: nasopharyngeal carcinoma, EBV, HPV
CLEAR CELL ODONTOGENIC CARCINOMA, THREE CASES: CLINICAL, RADIOGRAPHIC AND MOLECULAR FEATURES OF THIS RARE ODONTOGENIC TUMOR Aaron E. Yancoskie1, Gianfranco Favia2, John E. Fantasia1, 1 Hofstra North Shore-LIJ School of Medicine, New Hyde Park, NY, USA; 2University of Bari, Bari, Italy Background: Clear cell odontogenic carcinoma (CCOC) is a rare odontogenic tumor that has a female predilection, most commonly occurring in the mandible, with a peak incidence in the sixth decade. It is characterized by locally aggressive behavior and has the potential to metastasize. Approximately 84 cases have been reported in the English literature. Methods: We present three cases demonstrating the classic microscopic features of clear cell odontogenic carcinoma. All three cases presented as a large radiolucency in the mandible.
OOOO March 2015 Treatment consisted of segmental resection with continuity defect and varied reconstructions. Molecular evaluation of one case by FISH demonstrated rearrangement of the Ewing sarcoma breakpoint region one gene (EWSR1) and the activating transcription factor one gene (ATF1). Conclusıon: This finding is similar to that reported by Bilodeau and colleagues who first reported the identification of the EWSR1-ATF1 in CCOC. Keywords: Clear Cell Odontogenic Carcinoma, EWSR1, ATF1, FISH
SHEDDING OF POLYOMAVIRUS BK AND JC IN SALIVA OF KIDNEY TRANSPLANT PATIENTS Cynthia Motta Canto, Laura Masami Sumita, Fabiana Agena, Tânia Tozetto Mendoza, Paulo Henrique, Braz Silva, Maria Cristina Domingues Fink, Department of Virology, Tropical Medicine Institute, University of São Paulo, Brasil Objective: The aim of this study was to investigate the excretion and viral load of JC virus and BK in saliva of patients receiving renal transplants. Study Design: Were evaluated saliva samples from 127 patients (58 women and 69 men) for the presence of JC and BK virus by real-time PCR. Results: Fifty-eight samples (45.6%) were positive for BKV, 37.9% in females and 36.2% in the male group. The excretion of JC virus was identified in only one male subject (0.79%). The median viral load in women BKV was 1180 copies/ ml, and among men was 849 copies/ml. There was no association between excretion and post-transplant time. Conclusions: Our results showed a high shedding of BK virus in the saliva of renal transplant patients. On the other hand, JC virus was rarely found in the fluid. These data suggest different routes of transmission and reservoirs for these viruses. Keywords: polyomavirus, shedding, saliva, renal transplantation
HUMAN HERPESVIRUS-8 ORAL SHEDDING IN AMERINDIAN POPULATIONS IN THE BRAZILIAN AMAZON REGION Laura Masami Sumita1, Wilton Santos Freire1, Mariana Quiroga3, Maria Cristina D.S. Fink1, Cynthia L.M. Canto1, Tania Regina Tozetto Mendoza1, Paulo Henrique Braz Silva2, Cláudio Sérgio Pannuti3, 1Laboratório de Virologia-LIM 52- Instituto de Medicina Tropical de São Paulo -Universidade de Sâo Paulo; 2Faculdade de Odontologia - Universidade de São Paulo; 3Departamento de Moléstias Infecciosas e Parasitárias - HCFMUSP Objective: The oral cavity plays a vital role in the transmission of a large range of viroses including most human herpes viroses. EBV and CMV are common in the oral mucosa with periodontis lesions, but also HSV, HHV-6 and HHV-7 can be shed from a health oral mucosa. HHV-8 is associated with Kaposi’s sarcoma, a form of cancer that became known through its diagnosis in patients with AIDS. The vírus is hyperendemic in Amerindian populations, but its modes of transmission are unknow. Study Design: Salivary HHV-8 DNA was detected by use of a nested polymerase chain reaction assay and was sequenced. Results: HHV-8 DNA in saliva was detected in 23% of HHV-8 seropositive Amerindians. Detection of HHV-8 decreased with age and was more common in mem. HHV-8 DNA samples were sequenced, and all clustered as subtype E. Conclusions: The data support the hypothesis of early acquisition and horizontal transmission, via saliva.
AN UNSUAL LOCATION OF INTRAORAL HEMANGIOMA: A CASE REPORT Esma Cos¸kun1, Selen Adilo glu1, 1 1 2 Alper Aktas¸ , Göknur Topaloglu , Ömer Günhan , Ayça Dere1, 1Department of Oral and Maxillofacial Surgery, Hacettepe University, Ankara, Turkey; 2Department of Pathology, Gata University, Ankara, Turkey Hemangioma can be defined as a benign tumor characterized microscopically by proliferation of blood vessels. It is mostly seen in the head and neck region and rarely in the oral cavity. Hemangiomas are histologically classified into capillary and cavernous forms. There was no relevant medical history and no predisposing factors of hemangioma like hormonal changes, infection or trauma.So Masson’s hemangioma was also considered in differantial diagnosis. In this case, we present a 50 years old male patient had an asypmtomatic red-purple lobulated lesion with well defined margins, localized on the right side of buccal mucosa, on the superior of the occlusal plane and the posterior of parotid duct, at the level of edentuolus area (no sign of trauma). The lesion is finally confirmed as cavernous hemangioma histopathologically. Keywords: nontraumatic region, lobular, cavernous, hemangioma
ABSTRACTS Abstracts e153 The aim of this study is to conduct systematic review on the role of causative drugs in oral lichenoid lesions (OLLD) and the clinic-pathological features which still has uncertainty in diagnosis. Study Design: Bibliographic searches were performed to identify articles in PubMedÒ electronic databases from 1993 to 2013. Results: OLLD’s were detected frequently in patients with a history of zidovudine and imatinib mesylate medication. OLLD mostly occurred on buccal mucosa (42.37%). The most preferable treatment modality is withdrawal of the drugs and topical steroid regimen. Thirty OLLD cases were confirmed by biopsies which were characterized diffuse inflammatory infiltrate through the deep side the lamina propria. Conclusions: Medical history and histological features are the two basic criteria for the differential diagnosis of OLLD. Keywords: Oral Lichenoid Lesions, Lichenoid Drug Allergy, Oral Lichenoid Drug Reaction, Treatment
MINOR SALIVARY GLAND NEOPLASMS OF THE ORAL CAVITY: OUR HOSPITAL EXPERIENCE OF 17 CASES Emel Civas¸1, Fulya Çakala gao glu1, Demet Etit1, 1 1 Nes¸e Ekinci , Leyla Hayrullah , Seçil Arslano glu2, 1 Department of Pathology, Izmir Katip Çelebi University Ataturk Training and Research Hospital, Izmir, Turkey; 2 Department of Otorhinolaryngology, Izmir Katip Çelebi University Ataturk Training and Research Hospital, Izmir, Turkey Introduction: Minor salivary gland neoplasms (MSGNs) are unusual, accounting for only 15-20% of all salivary gland tumors. The commonest site of MSGNs of the head and neck is the oral cavity. Pleomorphic adenoma is the most common benign neoplasm and mucoepidermoid carcinoma is the most common malignancy. The aims of this study is to describe our experience of MSGNs in the oral cavity seen over last 5years. Study Design: Seventeen salivary gland tumors located in the oral cavity have been diagnosed at our institution between 2007-13. Results: 64% of the cases (11/17) were females and 35,3% (6/17) were males. Mean age of the patients were 40. 52,9% of the cases were malignant while 47,1% were benign. Conclusions: 47% of the cases were pleomorphic adenoma, 29,5% were mucoepidermoid carcinoma, 23,5% were adenoid cystic carcinoma. Palate was the most common site. Keywords: salivary gland tumors, oral cavity
ORAL LICHENOID LESIONS RELATED TO DRUGS: REVIEW OF CLINICOPATHOLOGICAL FEATURES AND DIFFERANTIONAL DIAGNOSIS Emre Barıs¸1, Burcu Sengüven1, Tamer Tüzüner2, Sibel Elif Gültekin1, 1Department of Oral Pathology, Gazi University Faculty of Dentistry, Ankara, Turkey; 2Department of Pedodontics, Karadeniz Technical University Faculty of Dentistry, Trabzon, Turkey
SUBLINGUAL LIPOMA: CASE REPORT Fulya Çakala gao glu1 , Leyla Hayrullah 1, Demet Etit 1, Seyran Yi git 1, Emel Civas¸1 , Seçil Arslano glu 2, 1Department of Pathology, Izmir Katip Çelebi University Ataturk Training and Research Hospital, Izmir, Turkey; 2 Department of Otorhinolaryngology, Izmir Katip Çelebi University Ataturk Training and Research Hospital, Izmir, Turkey
Objective: Oral lichenoid lesion is termed as a condition of the oral cavity having an identifiable etiology. A number of drugs have been described as a causative factor of those reactive lesions.
Introduction: Lipomas, despite being the most common mesenchymal tumors of the trunk and extremities, are rarely encountered in the oral cavity. They comprise 1% to 4% of
ORAL AND MAXILLOFACIAL PATHOLOGY e154 Abstracts all the benign oral lesions. They are common in the buccal mucosa, tongue, and palate, but only 6% to 10% are sublingual. Case Presentation: A 59-year-old female patient was referred to our institution for a sublingual swelling with a duration of 8 years and an accelerated growth during the last year. Complete excision was performed with a prediagnosis of ranula. Macroscopically the 3.8 2.5 1-cm tumor was well circumscribed, encapsulated with a homogeneous, yellow cut surface. Microscopy spported the diagnosis of a classic lipoma consisting of uniform mature lipocytes with eccentric nuclei. Discussion: Histologically oral lipomas may be classified as classic/atypical/pleomorphic/spindle cell/salivary gland lipoma, angiolipoma, intramuscular lipoma or fibrolipoma. Secondary changes, atrophy or intramuscular location should be assessed meticulously in order not to be confused with liposarcoma. Keywords: Sublingual lipoma, classic lipoma
INVESTIGATION OF EPSTEIN-BARR VIRUS AND HUMAN PAPILLOMA VIRUS IN TURKISH PATIENTS WITH NASOPHARYNGEAL CARCINOMA USING IN-SITU HYBRIDISATION Hayriye Tatlı Dogan1, Aydan 1 1 Kılıçarslan , Nuran Sungu , Mehmet Dogan3, Gaye Güler Tezel2, Gülnur Güler2, 1Department of Pathology, Atatürk Education and Research Hospital, Ankara, Turkey; 2Department of Pathology, Hacettepe University, Ankara, Turkey; 3Department of Pathology, Dr. A.Yurtaslan Ankara Oncology Education and Research Hospital, Ankara, Turkey Objective: Nasopharyngeal carcinoma(NPC) is associated with Ebstein-Barr virus. Human papilloma virus(HPV) was also detected in a proportion of NPC cases. In this retrospective study we analyze the frequency of EBV and HPV infection family16 in 82 patients with NPC. Study Design: A total of 82 from two medical center were evaluated for EBV and HPV. We used in situ hybridization to show EBV and HPV status on automatic platform. Results: 74 of 82 NPC (90,2%) were EBV positive and 8 were negative. The highest rate of EBV positivity was shown in WHO type 3 (undifferentiated) NPC which were 65 of 68 (95,6%) cases. 4 of 82 NPC contained HPV and three of them have also positive for EBV. One of the type 2 (nonkeratinizing) was HPV positive and EBV negative. Conclusions: Our data revealed that EBV is closely associated with NPC in Turkey. Unlike the frequent HPV positivity in NPC in USA literature, we found lower rates. Keywords: nasopharyngeal carcinoma, EBV, HPV
CLEAR CELL ODONTOGENIC CARCINOMA, THREE CASES: CLINICAL, RADIOGRAPHIC AND MOLECULAR FEATURES OF THIS RARE ODONTOGENIC TUMOR Aaron E. Yancoskie1, Gianfranco Favia2, John E. Fantasia1, 1 Hofstra North Shore-LIJ School of Medicine, New Hyde Park, NY, USA; 2University of Bari, Bari, Italy Background: Clear cell odontogenic carcinoma (CCOC) is a rare odontogenic tumor that has a female predilection, most commonly occurring in the mandible, with a peak incidence in the sixth decade. It is characterized by locally aggressive behavior and has the potential to metastasize. Approximately 84 cases have been reported in the English literature. Methods: We present three cases demonstrating the classic microscopic features of clear cell odontogenic carcinoma. All three cases presented as a large radiolucency in the mandible.
OOOO March 2015 Treatment consisted of segmental resection with continuity defect and varied reconstructions. Molecular evaluation of one case by FISH demonstrated rearrangement of the Ewing sarcoma breakpoint region one gene (EWSR1) and the activating transcription factor one gene (ATF1). Conclusıon: This finding is similar to that reported by Bilodeau and colleagues who first reported the identification of the EWSR1-ATF1 in CCOC. Keywords: Clear Cell Odontogenic Carcinoma, EWSR1, ATF1, FISH
SHEDDING OF POLYOMAVIRUS BK AND JC IN SALIVA OF KIDNEY TRANSPLANT PATIENTS Cynthia Motta Canto, Laura Masami Sumita, Fabiana Agena, Tânia Tozetto Mendoza, Paulo Henrique, Braz Silva, Maria Cristina Domingues Fink, Department of Virology, Tropical Medicine Institute, University of São Paulo, Brasil Objective: The aim of this study was to investigate the excretion and viral load of JC virus and BK in saliva of patients receiving renal transplants. Study Design: Were evaluated saliva samples from 127 patients (58 women and 69 men) for the presence of JC and BK virus by real-time PCR. Results: Fifty-eight samples (45.6%) were positive for BKV, 37.9% in females and 36.2% in the male group. The excretion of JC virus was identified in only one male subject (0.79%). The median viral load in women BKV was 1180 copies/ ml, and among men was 849 copies/ml. There was no association between excretion and post-transplant time. Conclusions: Our results showed a high shedding of BK virus in the saliva of renal transplant patients. On the other hand, JC virus was rarely found in the fluid. These data suggest different routes of transmission and reservoirs for these viruses. Keywords: polyomavirus, shedding, saliva, renal transplantation
HUMAN HERPESVIRUS-8 ORAL SHEDDING IN AMERINDIAN POPULATIONS IN THE BRAZILIAN AMAZON REGION Laura Masami Sumita1, Wilton Santos Freire1, Mariana Quiroga3, Maria Cristina D.S. Fink1, Cynthia L.M. Canto1, Tania Regina Tozetto Mendoza1, Paulo Henrique Braz Silva2, Cláudio Sérgio Pannuti3, 1Laboratório de Virologia-LIM 52- Instituto de Medicina Tropical de São Paulo -Universidade de Sâo Paulo; 2Faculdade de Odontologia - Universidade de São Paulo; 3Departamento de Moléstias Infecciosas e Parasitárias - HCFMUSP Objective: The oral cavity plays a vital role in the transmission of a large range of viroses including most human herpes viroses. EBV and CMV are common in the oral mucosa with periodontis lesions, but also HSV, HHV-6 and HHV-7 can be shed from a health oral mucosa. HHV-8 is associated with Kaposi’s sarcoma, a form of cancer that became known through its diagnosis in patients with AIDS. The vírus is hyperendemic in Amerindian populations, but its modes of transmission are unknow. Study Design: Salivary HHV-8 DNA was detected by use of a nested polymerase chain reaction assay and was sequenced. Results: HHV-8 DNA in saliva was detected in 23% of HHV-8 seropositive Amerindians. Detection of HHV-8 decreased with age and was more common in mem. HHV-8 DNA samples were sequenced, and all clustered as subtype E. Conclusions: The data support the hypothesis of early acquisition and horizontal transmission, via saliva.