Biomedical subjects
Publications and source records attributed to D R Weathers.
A case of chondromyxoid fibroma in the mandible of a 12-year-old boy is reported. A review of the literature is presented with emphasis on flow and image cytometric analysis and evaluation of the radiologic and histologic differences between chondromyxoid fibroma and chondrosarcoma.
Merkel cell carcinoma is a rare cutaneous neuroendocrine tumor that occurs predominantly in the head and neck region of older patients. An 88-year-old white man had an erythematous, umbilicated tumor on his lower lip, which on histopathologic examination showed solid sheets of infiltrating basaloid round cells with a high mitotic index. Globular, paranuclear immunostaining for low-molecular-weight cytokeratins (Nos. 8, 18, and 19) and neurofilament was observed. On ultrastructural examination, the tumor cells demonstrated paranuclear whorls of intermediate filament aggregates and occasional electron-dense granules. This unique cytokeratin- and neurofilament-staining pattern with coexpression enabled the Merkel cell carcinoma to be differentiated from other small cell malignant tumors that included metastatic neuroendocrine carcinomas from other regions. The follow-up 1 year after surgery and radiation showed that the patient remained disease free. Review of the literature revealed 11 cases of oral Merkel cell carcinomas with a predilection for the labial mucosa of older men. The mode of treatment and the clinical course of these cases are also presented, with an update on therapeutic management of Merkel cell carcinomas.
Crystalloids have been previously described in salivary gland tumors. In order to ascertain the incidence of these structures, the authors reviewed a series of 294 minor salivary gland tumors. One hundred thirty pleomorphic adenomas were identified, and 6 of these contained crystalloids. No crystalloids were found in other benign or malignant salivary gland tumors. These six file cases and a recent seventh case containing crystalloids were studied by light and electron microscopy and with histochemistry. Two types of crystalloids were found. One case contained previously described tyrosine-rich crystalloids, and the other six contained crystalloids composed of radially arranged collagen fibers. Both types of crystalloids are further characterized and discussed.
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A clinical and histologic study of eighty oral melanotic lesions which do not readily fit into recognized categories of melanotic lesions was conducted. These lesions tend to occur in the fifth decade of life and are most frequently seen on the gingiva, with the buccal mucosa and palate the next most frequent sites. The lesions are usually single, smaller than 1 cm., but they may also occur as multiple lesions. There is no sex bias, and there seems to be a number of etiologic factors. In a few cases long-term follow-up was possible. There is no indication of a tendency toward recurrence or development of malignant lesions. Histologically, none of the lesions shows atypia. Melanin pigmentation tends to be present in significant amounts in the basal-cell layer and less often in the lamina propria. There are no outstanding histologic differences among the eighty specimens. It is suggested that the term oral melanotic macule be used for these lesions, unless a specific cause can be confirmed by clinical data. Although these lesions should not be considered premalignant, it would be prudent to remove them for histologic confirmation of clinical impressions.
This case documents the course and treatment of a severe reaction to an unusual foreign body. A tooth brush bristle was lodged in the lower anterior areas between the cuspid and lateral incisor teeth. Although the patient noted some original discomfort, severe pain and bone destruction did not occur until 6 weeks after the original symptoms began. Treatment involved full thickness flap reflection of the involved area. The histologic examination showed a typical foreign body reaction to the bristle. All teeth remained vital throughout the disease process and healing phase. Healing was uneventful and the lost bone completely regenerated.
Fifty-five cases of a melanotic lesion of the lips which is well known, but not well described, are reported. The lesions characteristically occur on the lower lips of young adults. Males and females are equally affected. These lesions may be ephelides, postinflammatory melanoses, or unique lesions for which there is no exact cutaneous counterpart. We suggest the term labial melanotic macule as a descriptive one which would encompass the three different constituent entities. On the basis of follow-up information obtained and the histopathologic character of the lesions, this entity is benign and does not, in our opinion, have any malignant potential.
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The authors present three cases which created diagnostic problems. The etiology of these is, in the authors' experience, unique and not generally known. It is suggested that this etiology be considered whenever palatal erythema, ecchymoses, or petechiae are seen.