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P22-8 Diagnosis of neoplasm
diameter, of which 26 (90%) and 4 (12%), respectively, were histologically determined to be metastatic.
Conclusion The results of the present study indicate that lymph nodes greater than 10 mm in diameter with no vascular flow are strongly indicative of metastasis, and that lymph nodes with vascular flow are inflammatory, regardless of size. Thus, color Doppler imaging should prove valuable for the differential diagnosis of cervical lymphadenopathy in patients with oral cancer.
8. The Correlation between Ultrasonographic Imaging and Histological Features of Cervical Lymph Node Metastasis in Oral Cancer
Izumisawa, M. l, Yagi, M. 1, Fukuta, Y l, Yokota, M. l, Ohya, T.l, Kudo, K. 1, Shouzushima, M. 2, Satoh, M. 3-
9. Multiple Presentation of Eosinophilic Granuloma (an Interdisciplinary Approach)
Lazareski, S., Vaskov, L, Popovski, V., Zafirovski, Gj. Clinic for Maxillofacial Surgery, Clinic for Orthopedics, University "Ciril and Metodij", Skopje, Macedonia A case is presented of a patient with eosinophilic granuloma occurring in the right ascending ramus of the mandible and in the right acetabulum. The diagnostic work up and the approach to surgery are presented.
10. A Rare Case of Tongue Carcinoma
Ohno, j.1, Nose, M), Fujita, S. 2 1First Department of Oral and Maxillofacial Surgery, 2Department of Oral Radiology, and 3Department of Oral Pathology, School of Dentistry, Iwate Medical University, Iwate, Japan Introduction Cervical lymph node metastasis of oral cancer is an important factor for prognosis. Various diagnostic images have been developed, but it is difficult to diagnose the metastasis. In this study, we compared findings of ultrasonography (US) with the histopathological features of cervical lymph nodes to confirm whether the nodes were false negative (FN) or false positive (FP). Subjects The subjects in this study were twenty patients who underwent neck dissection and could be examined histopathologically between January, 1993, and December, 1996. There were 19 cases of squamous cell carcinoma and one case of adenocarcinoma. The sites of the primary tumors were 8 tongues, 5 lower gums, 3 upper gums, 2 mouth floors and 2 buccal mucosae. Methods Pretherapeutic US findings of of cervical lymph nodes were compared with histopathological findings of resected tumors to evaluate the rate of accurate diagnosis and the incidence of F N and FP. Results The rate of accurate diagnosis was 65% (13/20). The incidence was 5% (1/20) in F N and 30% (6/20) in FR F N cervical lymph nodes were smaller than 10 mm in size, and had no specific findings on US. The 6 FP lymph nodes were larger than 10 mm in size and more than 50 mm in depth/ width ratio. Conclusion It may be difficult to diagnose lymph nodes measuring 10 to 15 mm on US imaging and histopathological positive lymph nodes without extranodal invasion.
1Department of Dentistry, Rakuwakai Otowa Hospital, Kyoto, 2Department of OMS, Kyoto Univ., Kyoto, Japan Is this a rare case that developed a distant metastasis to the mediastinum without cervical lymph node metastases? We encountered a patient with squamous cell carcinoma of the tongue who was found to have squamous cell carcinoma of the mediastinum. A 66-year-old man was seen with a complaint of a painless white lesion arising at the edge of the tongue. The lesion mesured 5 • 8 mm and was located in the right margin of the tongue. It had an irreguler border and elastic hardness. The patient's serum level of SCC-related antigen was 4.5 ng/ml. We suspected tongue carcinoma consisting of a small, superficial lesion with poor invasion. An excisional biopsy was performed, and the histopathological diagnosis was squamous cell carcinoma of the tongue (T1, Grade 2). Surgical margins were evaluated and found to be negative. On the first postoperative day, the patient developed severe hoarseness and a mass lesion, measuring 25• mm, appeared on a computer tomography of the mediastinum region. Under general anethsethia, a biopsy was performed. The histopathological diagnosis was squamous cell carainoma.
11. Verruciform Xanthoma in the Oral Cavity. Clinical analysis of 16 cases
Hashimoto, S. l, Miyakura, T.l, Fujii, E. l, Yoshimasu, H. l, Amagasa, T. l, Okada, N..2 11st Department of Oral and Maxillofacial Surgery, and aDepartment of Clinical Labo., Faculty of'Dentistry, Tokyo Medical and Dental Univ., Tokyo, Japan Verruciform xanthoma (VX) is a verrucous or papillary excrescence that occurs predominantly on the oral mucosa but also on other mucosal sites and on the skin.