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Clinicopathological studies and flow cytometric analyses were performed for 62 cases of odontogenic keratocyst obtained from the file of the Department of Oral and Maxillofacial Surgery, Nihon University School of Dentistry between 1984 and 1998. The Patients ranged in age from 12 to 74 years, and the peak incidence was in the third decade. The male: female ratio was 1.5: 1. Cysts were most frequently found in the third molar region, including the ramus. Most cysts were found incidentally on radiographic examination and appeared as unilocular, smooth bordered, radiolucent lesions. Most lesions were less than 4cm in diameter. Impacted teeth were found in 24 of 70 cysts, and 18.6% of the cysts were associated with root resorption of neighboring teeth. When classified according to the keratin type of the cyst-wall epithelium, most cysts were type II (58.5%).Flow cytometric analysis was performed for lining epithelial cells isolated from paraffin embedded specimens. Nuclear staining was done with Ki-67 antibody. The Ki-67 antigen labeling rate of odontogenic keratocysts was significantly higher (7.9±5.7%) than that of radicular cysts (2.9±1.3%). The number of cysts with a high Ki-67 antigen labeling rate was higher in type III than in the other three groups. We found a significant correlation between the Ki-67 antigen labeling rate on flow cytometry and the Ki-67 antigen positive cell rate on immunohistochemical examination. An advantage of flow cytometric analysis is that it can precisely enumerate proliferating cells of odontogenic keratocysts.

We reported here a case of Lymphoepithelial cyst arising at the ventral surface of the tongue in a 34 year old male.Histopathological examination revealed that the cyst was composed of fibrous tissue, thin squamous epithelium and lymphoid tissue with a prominent germinal center. This case was considered to be a typical, oral lymphoepithelial cyst.We also examined the distribution of immunoglobulins, T and B cells and lysozyme.Immunohistological examination revealed that immunoglobulin-positive cells (IgG, IgA and IgM) were distributed between the lining epithelium and lymphoid tissue with a variation in number. Localization of lysozyme-positive cells was similar to that of immunoglobulin-positive cells. Similar to tonsil and lymph node, B cells were observed in the cap area and medulla of lymphoid tissue while decreased numbers of T cells were found in fibrous connective tissue beneath the lining epithelium.

Spindle cell carcinoma is considered a subtype of squamous cell carcinoma that has a sarcomatoid appearance. In the head and neck region, cases of spindle cell carcinoma of the larynx have occasionally been reported. However, spindle cell cacrcinoma of the maxillary sinus is extremely rare. We describe a case of spindle cell carcinoma of the maxillary sinus in a 53-year-old woman. Surgical treatment was performed under the clinical diagnosis of a maxillary neoplasm. During the operation, a biopsy specimen was taken, and the histopathological diagnosis was a spindle cell carcinoma. The lesion was removed under general anesthesia. Radiotherapy and chemotherapy were additionally given to prevent recurrence and metastasis of the tumor.There has been no evidence of recurrence as of 5 years 6 months after surgrey.

Suppurative arthritis usually occurs by hematogeneous dissemination of an infection localized in some other organ of the body. Much less frequently, bacteria may invade the joint either by direct spread of a neighboring infection or through a perforating injury. We reported an unusual case of suppurative arthritis in the left temporomandibular joint of a 53-year-old woman. The arthritis presented after a certain period after tooth extraction of the left lower 2nd molar tooth, and detachment of the cartilage cap. The joint was surgically removed because of resistance to long-term antibiotic therapy.

We have described two cases of ossifying fibroma in this paper.The first one was a recurrent case which occurred in a 52 year-old male patient. Tumor masses were found in the lower rim of mandible and in scar tissue close to previously operated areas. Histopthological examination revealed that tumor masses were composed of a proliferation of spherical and trabecular bones and dense fibrous tissue with a high cellularity.The second one was a case observed in a 26 year-old female patient. Histopathological examination revealed that the majority of tumors consisted of a proliferated fibrous tissue and a few immature fibrous bony tissues that were scattered at the peripheral region of this fibrous tissue.Although the enucleation of tumor or marginal resection of mandible were recommended for the treatment of ossifying fibroma, more extensive continuous resection of mandible should be applied to the cases which small tumor nests were scattered throughout the mandible such as case 1.

We recently experienced two cases of relatively rare bilateral submandibular sialolithiasis, which are describe in ditail in this paper.Case No.1 was a 26-year-old male having a swollen submandibular region of the left only X-ray films showed a presence of salivary stone not only in the left but also in the submandibular. Both stones could be surgically removed from the oral cavity.Case No.2, a 20-year-old female, attended our department with a chief complant of diffuse swelling of the left submandibular. Symptoms appeared only in the left side but subsequent X-ray films showed a presence of salivary stone in both sides. However, neither of stones could be removed surgically.The structures of both right and left salivary stones were observed in the former case using a scanning electron microscopy.Both right and left stones were consisted of three layers (center core, laminated structure outer layer), showing a remarkable difference in the center core and outer layer between two stones.

A case was reported of squamous cell carcinoma arising in left upper neck of 61-for 1 year old male.The patient complained that had been suffered painful swelling in left upper neck region for 1 month since he had his left upper teeth extracted.An elastic hard tumor the size of a baby's fist with adhesion underneath was found in the first visit examination.An en-block resection of tumor with adhesive surroundings was performed, though preoperative biopsy showed no evidence of malignancy.Histopathological examination of the specimen revealed that the tumor was squamous cell carcinoma. Even though we had not found tumor cell remained on surgical margin area, 60Co (5, 000 rad) irradiation and Peplomycin (50mg) chemotherapy was performed after the resection. The patient was followed up for 2 years administering Picibanil (5KE/week) and had no local reccurance or metastasis.We concluded that this case was Branchiogenic carcinoma because of the below characteristics;1.Tumor was located between M. sternocleidmastoideus and V.juglaris internal of upper neck region.2.Tumor had cystic cavity with keratinized substance inside.3.Histopathological examination revealed that the cystic structure was not formed by necrosis caused by carcinoma.4.Numbers of lymphoid tissues with germinal center were found in the specimen.5.Even though we tried Otorhinolaryngologic, internal examinations and further research of maxillofacial region, we could not find any primary lesion so that the tumor of the upper neck was deened not metastatic.