International diagnostic criteria and delay of diagnosis in Behçet's disease.
Explore the source record for details and available documents.
Adolescent↗
Biomedical subjects
M D Mignogna
Publications and source records attributed to M D Mignogna.
Oral manifestations of idiopathic lenticular mucocutaneous pigmentation (Laugier-Hunziker syndrome): a clinical, histopathological and ultrastructural review of 12 cases.
OBJECTIVE: To present a clinical, histopathological and ultrastructural study on a group of patients affected by idiopathic mucocutaneous pigmentation (Laugier-Hunziker syndrome: LHS). MATERIALS AND METHODS: Twelve patients were investigated: clinical examination, laboratory tests, and X-ray studies together with light microscopy and electron microscopy were performed in order to diagnose LHS. RESULTS: All cases showed acquired, benign, macular hyperpigmentation of buccal mucosa lips and nails. Histologically, pigmentations are due to an accumulation of melanin in the basal layer keratinocytes and an increase in the number of melanophages in the submucosa and/or papillary dermis. Ultrastructurally there were increased numbers of normal-appearing melanosomes in keratinocytes of the lower epithelium. No evidence of malignant changes were detected. CONCLUSIONS: The importance of this condition relates to it being included in the differential diagnoses of pigmentary disorders of the oral mucosa with associated nail involvement. It is important to recognize this acquired benign disorder to avoid unnecessary investigations and treatments.
Adult↗
Overexpression of cyclin-D1, bcl-2, and bax proteins, proliferating cell nuclear antigen (PCNA), and DNA-ploidy in squamous cell carcinoma of the oral cavity.
The prognostic role of the expression of bcl-1, bcl-2, bax, PCNA, and DNA-ploidy in a series of 25 oral squamous cell carcinoma (SCC) was investigated. The average age of the patients was 62.04 years (range, 27 to 81 years), with a sex ratio (M/F) of 23:2. The follow-up mean time was 2.24 years (range, 8 months to 8 years from surgery). Immunohistochemistry for PCNA, bcl-2, bcl-1, and bax proteins was carried out on 5-microm serial sections from formalin-fixed, paraffin-embedded tissue. The findings were compared with clinicopathologic data and with follow-up. The statistical evaluation of the results of the current study suggests that the low positivity for PCNA with a high positivity for bcl-2 protein are related to a better clinical behavior of the tumors. By converse, a high expression of PCNA, bax, and bcl-1 appears to correlate with a worse prognosis. All of our cases of SCC showed the presence of aneuploid populations, which was not correlated with the clinicopathologic parameters or with the overexpression of bcl-1, bcl-2, bax, and PCNA. Therefore, the aneuploidy per se did not predict the clinical evolution for the single cases of cancers. Nevertheless, once the parameters considered for the evaluation of DNA were examined in detail, it appeared that some of them, individually or combined with each other or with the expression of bcl-1, bcl-2, and bax, gained statistical significance in predicting the clinical evolution of SCC of our series. Particularly, high values of 2cDI and DNA-MG and the absence or reduction of the euploid population were associated with a short interval between surgery and recurrence or death, and this significance persisted when the simultaneous presence of overexpression of bcl-1 was considered.
Adult↗
The possible association between oral lichen planus and oral squamous cell carcinoma: a clinical evaluation on 14 cases and a review of the literature.
Between 1986 and 1996, 263 patients, 156 females and 107 males, affected by oral lichen planus (OLP), were followed at the Division of Oral Medicine and Pathology, University of Naples 'Federico II', Italy, and at the Institute of Dentistry and Maxillofacial Surgery, University of Bari, Italy. During this follow-up, the possible association of OLP with oral squamous cell carcinoma (SCC), together with the possible association of OLP, oral SCC and chronic HCV-hepatitis, were investigated. 14 cases (5.32%) were known to have developed oral SCC: 10 (3.8%) in an area of pre-existing OLP, 3 (1.14%) in other sites, in 1 case the diagnosis of OLP and SCC was synchronous (0.38%). 3 patients were positive for anti-HCV antibody. Many carcinomas were in areas of reticular/plaque OLP. 3 patients had multiple simultaneous sites of oral involvement (21.42%); 5 patients developed oral SCC in different sites during the follow-up period (35.71%). These data, together with a clear histological evidence of progression to carcinoma within OLP lesions, suggest the probability of some cases of at least OLP having an intrinsic property predisposing to neoplastic transformation, confirming previous studies. For these reasons, the authors think that it is necessary to follow-up the patients regularly at least annually and possibly for life for the early diagnosis of a possible neoplastic degeneration. These consideration are particularly important in the case of atrophic or erosive OLP, and plaque OLP, especially when involving the dorsum of tongue.
Adult↗
A rare case of fibrosarcoma of the jaws in a 4-year-old male.
A case of fibrosarcoma in a 4-year-old male child is reported. Primary fibrosarcomas of bone in the head and neck region are rare. The histological appearance of the tumour is related to its grade of differentiation. It could present a high level of cellularity and the amount of collagen is variable. The accepted treatment is radical surgery; however, metastases could occur in the lungs. This article is presented to highlight the rarity of fibrosarcomas in the jaws of children.
Biopsy↗
Oral lichen planus and HCV infection: a clinical evaluation of 263 cases.
BACKGROUND: Hepatitis C virus (HCV) infection induces variable dermatologic manifestations. Our purpose was to determine whether there is an association between HCV infection and oral lichen planus (OLP). METHODS: Antibodies to HCV were determined in patients with OLP (263 patients; 156 women and 107 men, with a mean age of 55.5 years) and in a control population. RESULTS: Seventy six cases (28.8%) were positive for HCV antibodies with the second-generation enzyme-linked immunosorbent assay (ELISA II) test. All of these cases were confirmed with the second-generation recombinant immunoblot assay (RIBA II) test. In 61 cases (23.1%), high levels of serum transaminase were found. Positivity for hepatitis B virus (HBV) markers was found in 31 patients (11.7%) and for hepatitis A virus (HAV) markers in 43 patients (16.3%). None had positivity for hepatitis D virus (HDV) markers. As a control group, we used 100 patients (58 women and 42 men, with a mean age of 55.3 years) referred to the School of Dentistry of the University of Naples "Federico II," and treated for general dental caries. In the control group, HCV antibody positivity was found in three cases. CONCLUSIONS: The high prevalence of HCV antibody in this group of patients with OLP, higher than in the healthy population, suggests a link (p = 1.423 x 10(-7), chi-squared test) between these two diseases. These findings stress the importance of liver examination in OLP patients, and the need for other studies on the high susceptibility to hepatitis viruses in the population in the southern part of Europe.
Adult↗
Morphometric study of nucleolar organiser regions (AgNOR) in HPV-associated precancerous lesions and microinvasive carcinoma of the oral cavity.
A morphometric study of silver-stained nucleolar organiser regions (NOR) was performed on histological sections from routinely paraffin-embedded blocks of 26 oral biopsy specimens (21 cases of leukoplakia consisting of 13 low, 4 moderate, 4 severe degree of dysplasia, and 5 cases of microinvasive carcinomas). In situ hybridisation (ISH) for HPV-DNA was performed on serial sections of the same samples. The following parameters were studied: V NOR (single AgNOR volume per nucleus), TV NOR (total AgNOR volume per nucleus), and R.I. (AgNOR's roundness index). The results highlight that not all the morphometric features of AgNORs allow the discrimination between lesions with dysplasia of low, moderate and severe degree and microinvasive carcinoma. TV NOR appeared useful, while the other morphometric parameters appeared statistically not significant i differentiating between the different lesions. These findings suggest that high values of TV NOR in oral dysplasia could represent a risk marker, identifying a subgroup of lesions with a worse prognosis, constituting then a possible indication for rigorous clinical management and/or for complex treatment of these HPV-associated preneoplastic lesions.
Adult↗
Oral pemphigus: clinical significance of esophageal involvement: report of eight cases.
The extension of the blisters of pemphigus to the esophagus is relatively uncommon, especially in patients treated with corticosteroids who appear to be in clinical remission. The aim of this study was to evaluate the esophagus in eight patients affected by oral pemphigus in various stages of the disease. Upper gastrointestinal endoscopy revealed esophageal involvement in five patients (two men and three women); three had blisters or erosions in the upper esophagus, whereas two showed red longitudinal lines along the entire organ. Direct immunofluorescence was positive in all eight patients. It is suggested that endoscopic examination of esophageal mucosa is an objective criterion by which to judge the success of therapy of pemphigus vulgaris.
Adrenal Cortex Hormones↗
Immunocytochemical detection of autoantibody deposits in Tzanck smears from patients with oral pemphigus.
Eighteen patients, ten affected by pemphigus vulgaris and four affected by herpes simplex of the oral mucosa, together with four healthy patients as controls, were investigated by cytologic examination of Papanicolaou stained smears obtained by scraping the oral mucosa. In all cases additional smears were immunostained with the alkaline phosphatase-anti-alkaline phosphatase (APAAP) technique using monoclonal antibodies against human heavy IgG chains and lambda light chains. The results have shown that, for a cytological diagnosis of pemphigus, this technique can be used as an easy substitute for the immunofluorescence test and does not require any specialized training or equipment. The findings are clearly detectable by light microscopy and allow, together with the immunostaining, an adequate visualization of cell morphology.
Adult↗
[The presence of Human Papillomavirus (HPV) in microinvasive in situ spinocellular carcinoma of the oral cavity. Preliminary report].
BACKGROUND: The authors examined 15 cases of in situ and early oral SCC to detect the presence of HPV genoma. METHODS: They proceeded to in situ hybridization on paraffined specimens utilizing DNA-biotinylated fragments in commercial kit (Vyra Type in situ, Life Technologies, Gaithersburg, MD, USA). RESULTS: HPV-DNA was detected in 9 cases: 6/11, 16/18, 31/33/35 serotypes were detected. The distribution of viral serotypes by sites showed a prevalence of 16/18 serotype in tongue and floor of the mouth carcinoma, a prevalence of 6/11 serotype in gingiva, hard palate and buccal mucosa carcinoma, and 31/33/35 in commissura. CONCLUSIONS: The results suggest an important role of HPV in oral carcinogenesis, but further investigations are necessary to confirm these data on larger groups of patients to obtain a higher significance of the results.
Adult↗
[Non-Hodgkin lymphoma with primary location in the oral cavity, extranodal variety. Report of a case].
Non-Hodgkin lymphomas with primary localization in the oral cavity are a relatively rare nosological entity which is difficult to diagnose and is generally accompanied by a fatal prognosis. The authors describe a case referred to their attention that presented symptoms such as paresthesia to the lower half lip, local tumefaction, etc, easily attributed to the recent extraction of 3.7. The fact that prompted them to investigate further was precisely the clinical and radiological characteristics which, even if vague, are indicative of non-Hodgkin lymphoma with an oral localization. The authors also examine and discuss the staging techniques and type of polychemotherapy used in this case.
Antineoplastic Combined Chemotherapy Protocols↗
Granular cell ameloblastoma: a case report with histochemical findings.
A case of granular cell ameloblastoma (GCA) was studied by light microscopy and histochemistry. Microscopically, the lesion showed small groups or large clusters of granular neoplastic cells, with pyknotic and hyperchromatic nuclei, oriented away from the basement membrane, in a back-to-back arrangement. The "granular change" is thought to be due to a dysfunctional status of neoplastic cells, and the pathogenesis of this tumour seems to be age-related. The prognosis of GCA is good, generally corresponding to that of the classical ameloblastoma; as yet, only one case has been described with a more aggressive biological behaviour (high recurrence rate).
Adult↗
Odontogenic myxoma of the jaws: a clinical, radiologic, immunohistochemical, and ultrastructural study.
Ten cases of odontogenic myxoma were evaluated radiologically, histologically, and histochemically. Ultrastructural examination was performed in five cases. Stellate cells with branching processes were seen in an abundant acid mucopolysaccharide background. Occasionally macrophages were found in the tumors. In two cases islands of inactive odontogenic epithelium were identified. The ultrastructural features suggest that many lesional cells are very similar to a myofibroblast. With the avidin-biotin complex immunohistochemical technique, the lesions were tested with antibodies to S- 100 protein, neuron-specific enolase, neurofilaments, glial fibrillary acid protein, keratin, desmin, muscle-specific actin, and vimentin. All the lesions were found to be positive for vimentin and muscle-specific actin, and negative for the rest. The results of our study seem to confirm the muscle-specific actin-positivity of odontogenic myxomas as previously reported.
Actins↗
Prognostic evaluation of HPV-associated precancerous and microinvasive carcinoma of the oral cavity: combined use of nucleolar organiser regions (AgNOR) and proliferating cell nuclear antigen (PCNA).
Nucleolar Organiser Regions (NORs) and Proliferating Cell Nuclear Antigen (PCNA) were investigated on routine paraffin embedded histologic sections of 30 oral biopsy specimens (six cases of leukoplakia with low-degree of dysplasia, nine cases of leukoplakia with moderate-degree of dysplasia, nine cases of leukoplakia with severe-degree of dysplasia, six cases of squamous microinvasive carcinomas), tested for HPV-DNA by in situ hybridisation (ISH). The absolute number of NORs per nucleus and the percentage of nuclear positivity for PCNA were found to be different in each group of pathology, with further diversity due to the presence or absence of HPV-DNA. In the major part of HPV-positive lesions, the AgNOR number and percentage of cells positive for PCNA were found to be generally lower than in corresponding negative forms. Conversely, a few cases of HPV+ lesions showed significantly higher values both of AgNOR and PCNA, if compared to the other cases of HPV+ and HPV- lesions. These data suggested that high values of AgNOR and PCNA, in moderate and high grade oral dysplasia, could represent an "alarm signal" of a worse prognosis, and then a possible indication for a strict clinical management and/or a stronger treatment of some HPV-associated preneoplastic lesions.
Adult↗
Early diagnosis of multiple hamartoma and neoplasia syndrome (Cowden disease). The role of the dentist.
A typical case of Cowden disease is presented. This is rare mucocutaneous disease, genetically determined, with multiple organ system involvement in which a malignancy, particularly of breast and thyroid gland, may develop. The disease can be diagnosed in its early stages by gingival and cutaneous manifestations. We emphasize that the dentist may be the first health care professional who recognizes the syndrome, which is a crucial step to prevent and cure the predictable malignancy.
Adult↗
Myxoma of the jaws with an unusual intracellular banded structure.
Myxoma of the jaw is a rare odontogenic tumor, probably derived from the dental apparatus. The case described here was studied by both light and electron microscopic methods. Stellate cells with branching processes were reported in an abundant acid mucopolysaccharide stroma, and ultrastructurally these cells were seen to be fibroblast. Occasionally myxoblasts and macrophages were reported in the tumor. No odontogenic epithelium was identified, while an intracellular synthesis of cross-striated fibrils was observed. The ultrastructural features suggest that the connective tissue cell is the proliferating component of the tumor and is very similar to a fibroblast.
Adult↗
Peripheral ameloblastoma: case report.
A case of peripheral ameloblastoma, a rare odontogenic tumour, is presented. This tumour appears to differ from endo-osseous ameloblastoma by the absence of local malignancy. It exhibits a less aggressive and destructive behavior and does not invade the underlying bone. Conservative treatment of the tumour is the treatment of choice.
Aged↗
Gingival localization of fibrosarcoma of soft oral tissues: case report.
A gingival localization of fibrosarcoma of soft oral tissues was described in a 58-year-old female. Primary fibrosarcoma of the head and neck region is rare. The histological appearance of the tumour is related to its grade of differentiation. The amount of collagen is variable. The accepted treatment is radical surgery; but metastases occur frequently in the lungs.
Female↗