Search

Made available in DSpace on 2021-06-25T10:48:58Z (GMT). No. of bitstreams: 0 Previous issue date: 2021-05-01 Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP) Aim: To characterize plasma cell subsets in chronic periapical lesions affecting permanent and primary teeth. Methodology: Only chronic periapical lesions without root canal treatment were selected. Twenty-one radicular cysts and 7 periapical granulomas affecting permanent teeth and 19 radicular cysts and 4 periapical granulomas affecting primary teeth were assessed for immunoglobulin (Ig) light chain (kappa and lambda), Ig heavy chain (IgG, IgG4, IgA, IgM and IgD) and plasma cell immunohistochemical markers (MUM1/IRF4, EMA and CD138). The data acquired were analysed by Student’s t test, Mann–Whitney U, Friedman test followed by Dunn's multiple comparison test and Spearman’s rank correlation. Results: All cases were polyclonal (having similar kappa/lambda light chain ratios). IgG was most abundant compared to other Ig heavy chains (all, P

Made available in DSpace on 2022-04-29T08:30:47Z (GMT). No. of bitstreams: 0 Previous issue date: 2022-04-01 Objectives: While unknown for oropharyngeal squamous cell carcinoma (OPSCC) and oral squamous cell carcinoma (OSCC), some studies assessing cervical carcinoma have shown that human papillomavirus (HPV) co-infection can be associated with its prognosis. Methods: Through in situ hybridization (HPV and Epstein-Barr virus [EBV] probes) and immunohistochemistry (p16INK4a, cyclin D1, p53, and Ki-67 antibodies), 126 OPSCC and 109 OSCC samples were assessed. Results: All patients were EBV-negative. OPSCC (25%) showed a significant association with HPV compared to OSCC (11%). Almost all HPV-associated cases were p16INK4a-positive. Regarding OPSCC and OSCC, 23 and 7 cases were positive for high-risk HPV (HRHPV) only, 6 and 3 cases for low-risk HPV (LRHPV) only, and 3 and 2 cases for HRHPV/LRHPV, respectively. HPV-associated carcinomas showed a significantly higher proliferative index than HPV-unassociated carcinomas. Both carcinomas showed a similar overall survival rate, which was not affected by the HPV status. However, when comparing HPV-associated subgroups, patients with HRHPV/LRHPV-associated carcinomas showed worse survival. Conclusion: LRHPV-associated and HRHPV/LRHPV-associated cases can also be detected when assessing OSCC and OPSCC. Further studies, especially in populations with a high prevalence of HPV-associated OPSCC, are necessary to understand the clinicopathological behavior of these neoplasm subgroups. Oral Pathology Department of Stomatology Public Oral Health and Forensic Dentistry Ribeirão Preto Dental School (FORP/USP) University of São Paulo, São Paulo Oral Medicine Department of Diagnosis and Surgery Araraquara Dental School São Paulo State University (UNESP), São Paulo Centro Clínico de Cabeza y Cuello Department of Pathology and Forensic Medicine Ribeirão Preto Medical School (FMRP/USP) University of São Paulo, São Paulo Oral Medicine Department of Diagnosis and Surgery Araraquara Dental School São Paulo State University (UNESP), São Paulo

Langerhans cell histiocytosis (LCH) is an inflammatory myeloid neoplasia commonly affecting children with frequent somatic mutations in MAPK pathway genes including BRAFV600E and MAP2K1. Some studies suggest that LCH cells can recruit and modulate inflammatory cells, which could provide reciprocal survival signals. To characterize the immune profile of infiltrating inflammatory cells, and to clarify their participation in LCH pathogenesis, a detailed immunohistochemical analysis was performed. Fifteen (10 children, 5 adults) LCH cases were assessed through macrophage (CD68 and CD163), mature dendritic cell (mDC; CD83 and CD208), regulatory T cell (Treg; CD4, CD25 and FOXP3) and cytotoxic lymphocyte (CL; CD56, CD57, perforin and granzyme B) immunomarkers. Moreover, lymphocytic and LCH markers were also analysed. All cases were S100, CD1a, CD207 and CD4-positive. Bcl-2 and cyclin D1 expression was observed in 13 of 15 cases. In the immune microenvironment, M2-polarized macrophages and Tregs were the predominant cell populations, followed by significantly (P < .005) smaller levels of mDCs and CLs. Additionally, the number of CD3 + cells was significantly higher than that of CD20 + cells. In the CD3 + cell population, there were a significantly higher number of CD4 + cells than CD8 + cells. While there were no differences when comparing the paediatric and adult populations, FOXP3 + cells were significantly higher in patients with multisystem involvement and treated with chemotherapy, than single-site cases and those without chemotherapy. Our results suggest that M2-polarized macrophages and Treg infiltration can promote LCH development and survival, probably through pro-tumoral, immunosuppressive and/or cytokine-mediated mechanisms. This work highlights the need for further exploration of immune-targeted therapy for LCH.

Made available in DSpace on 2021-06-25T10:48:29Z (GMT). No. of bitstreams: 0 Previous issue date: 2020-11-01 Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP) We report a 7-year-old boy who presented with a nodule on the upper lip. A previous clinical history of mechanical trauma in the lesional area had been noted. After surgical excision, microscopy revealed fibrocollagenous fascicles associated with neurovascular bundles and skeletal striated muscle fibers in diffuse subepithelial distribution, suggesting rhabdomyomatous mesenchymal hamartoma. However, strict clinicopathological correlation favored a healing process with trapped striated skeletal muscle tissue. After three years of follow-up, an improvement in the aesthetic appearance of the upper lip was observed. To the best of our knowledge, a case of pseudo-rhabdomyomatous mesenchymal hamartoma has not been reported to date. Department of Pediatric Dentistry School of Dentistry of Ribeirão Preto FORP/USP University of Sao Paulo Oral Medicine Department of Diagnosis and Surgery Araraquara Dental School Universidade Estadual Paulista (UNESP) Oral Pathology Department of Stomatology Public Oral Health and Forensic Dentistry School of Dentistry of Ribeirão Preto FORP/USP University of São Paulo Oral Medicine Department of Diagnosis and Surgery Araraquara Dental School Universidade Estadual Paulista (UNESP) FAPESP: 2016/02713-2

Squamous cell carcinoma (SCC) with a rhabdoid phenotype (SCCRP) is an extremely rare entity in the maxillofacial region. To date, only 2 oral SCCRP cases have been reported. The presence of this phenotype is associated with a worse prognosis than conventional SCC. A 44-year-old man was referred presenting painful facial asymmetry evidenced by increase of volume in the left maxilla with several months of evolution. Computerized tomography examination showed extensive osteolytic lesion on the left maxilla and maxillary sinus. The histopathologic analysis showed typical morphologic features of SCCRP constituted by polygonal and discohesive cells with large hyaline cytoplasmic inclusions and eccentric nuclei with single prominent nucleoli. Immunohistochemistry revealed positivity for CK AE1/AE3, epithelial membrane antigen (EMA), vimentin, CD138, INI-1, focally for α–smooth muscle actin, and CD68. Ki-67 was > 40%. Although rare, SCCRP should be considered in the differential diagnosis when assessing malignant neoplasms affecting the maxilla. FAPESP (2016/11419-0 and 2017/02502-4).

Methotrexate (MTX) is an antimetabolic drug used for treating rheumatoid arthritis (RA), psoriasis, and Crohn’s disease, including also lymphoproliferative diseases, among others. At low doses, MTX is beneficial in the management of patients with RA and psoriasis. Here, we report a case of MTX-induced oropharyngeal mucositis. A 75-year-old woman presented in our service complaining of a mouth sore 6 days ago. Her medical history revealed hypothyroidism and RA, the latter in treatment with MTX, 7.5 mg/week. Intra-oral examination revealed an ulceration covered by a fibrinopurulent membrane and erythematous borders, measuring 2 cm in diameter and located in the right side of the soft palate. An incisional biopsy evidenced a nonspecific superficial ulceration. After excluding other possible causes, the final diagnosis was MTX-induced oropharyngeal mucositis, which should be considered in the differential diagnosis of oropharyngeal ulcerative lesions.

Myopericytoma is a rare mesenchymal tumor characterized by a hemangiopericytoma-like vascular pattern with perivascular myoid differentiation. To date, only 11 cases of oral myopericytoma have been reported. To the best of our knowledge, myopericytoma with gingival involvement and associated with calcifications has not been reported, expanding their clinicopathological spectrum. Herein, we report a 12-year-old girl female patient who presented a gingival nodule diagnosed as ossifying myopericytoma, which should be considered in the differential diagnosis when assessing oral soft tissue lesions, especially in pediatric patients.

Nasopharyngeal angiofibroma is a benign but locally aggressive tumor of unknown etiology, typically occurring in the nasopharynx of male adolescents. A 21-year-old male patient was referred presenting left facial swelling and a nodular lesion arising from the upper vestibule. The imaginologic analysis showed a large mass occupying the left maxillary sinus. After incisional biopsy, microscopy exhibited a prominent vascular component constituted by vessels of variable size and shape, supported by cellular stroma, as well as collagenized and fibromyxoid areas. Immunohistochemistry showed positivity for vimentin, α–smooth muscle actin, and CD34 and focally for D2-40, desmin, and CD10. Moreover, CD68, CD163, FXIIIA, and CD209 highlighted numerous tumor-infiltrating immune cells, either macrophages or dendritic cells. The Ki-67 was 3%. The Weber Ferguson approach was used to remove the whole lesion. Besides growth factors and androgen receptors, the role of tumor-infiltrating immune cells in nasopharyngeal angiofibroma tumorigenesis should be clarified.

Objective Current evidences support that squamous cell carcinomas (SCCs) of the oral cavity (OSCC) and oropharynx (OPSCC) are distinct and unique, with differences on its pathogenesis, treatment, and prognosis. SMARCB1/INI1 is a potent tumor suppressor, whereas nuclear protein in testis (NUT) antibody identifies midline carcinoma (NMC), a rare aggressive carcinoma typically located on the midline of the head and neck. Although with different clinicopathological features, OPSCC and NMC share anatomic location. Interestingly, the SMARCB1/INI1 and NUT expression profile in OSCC and OPSCC is unknown. Study Design The immunohistochemical analysis of SMARCB1/INI1 and NUT antibodies were performed on tissue microarrays containing 108 OSCC and 52 OPSCC formalin-fixed paraffin-embedded samples. Results Only 3 cases (2 OSCC and 1 OPSCC) were SMARCB1/INI1 negative, whereas 3 cases (2 OPSCC and 1 OSCC) were NUT positive. Moreover, SMARCB1/INI positivity was observed in surface epithelium, endothelial cells, mononuclear inflammatory cells, salivary gland ducts and sebaceous gland acini, whereas 7 cases with only intense cytoplasmic staining for NUT were considered nonspecific. Conclusions Our results show that SMARCB1/INI1+/NUT- immunoexpression profile is prevalent when assessing OSCC and OPSCC. However, it is recommended to analyze these antibodies, because of the prognostic effect of identifying SMARCB1/INI1-deficient SCC and NMC cases. FAPESP (2016/11419-0).