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Objective: To report the first examples of ectopic salivary glands of TMJ ligaments & capsules., Methods and Materials: Nine subjects with chronic TMJ disorders were found incidentally to have ectopic salivary glands (choristomas) within or near damaged TMJ ligaments and capsules. Clinicopathologic characteristics of 12 TMJs are summarized., Results: The 9 subjects were ages 22-64 years (average = 43.0); 6 were female. Microscopic examination revealed major, almost complete ligament replacement by dense, avascular fibrous scar tissue in all but 1 sample. Chronic inflammatory cells were present in the stroma of 3 samples. A total of 33 lobular, independent salivary structures of variable sizes were embedded in or near ligaments and/or capsules. Half were multiple in the same joint; 13 were bilaterally located in the joints of a single subject, with 8 small glandular lobules in one TMJ. All glands consisted of histologically normal serous acini except 1 which showed a focal lobule of mucus acini and another comprised only of mucus acini. Serial sections showed no connection to parotid glands. Some choristomas showed the aging phenomena of fatty infiltrates (n = 7) and oncocytosis (n = 7). Additionally, 3 of the 12 TMJ samples contained preauricular lymph nodes, with 3 nodes in 1 joint and bilateral involvement in 1 subject. Of the 5 identified nodes, all but one was hyperplastic, with nonspecific inflammatory histiocytosis., Conclusions: We report, for the first time, independent salivary gland choristomas (n = 33) within the soft tissues of the TMJ (n = 12), with one joint containing 8 such choristomas. All consisted of normal serous tissue except one, a mucus gland. Additionally, a fourth of TMJ surgical samples contained hyperplastic preauricular lymph nodes., Competing Interests: Declaration of interests None., (Copyright © 2024 Elsevier Inc. All rights reserved.)

Objective: The purpose of this study was to determine whether the dental pulp and lesions of pulpal origin (eg, pulp polyps, periapical granulomas, and periapical cysts) exhibit receptors for the sex steroid hormones estrogen, progesterone, and androgen., Study Design: Staining for the receptors of the hormones estrogen, progesterone, and androgen was accomplished through use of available immunohistochemical detection techniques. Pulpal tissues were obtained from freshly extracted human third molars; the other tissues were obtained from the Oral and Maxillofacial Pathology Laboratory archives. Ten samples of each tissue were processed and immunostained for these specific receptors., Results: Staining for estrogen and androgen receptors was essentially negative for all cell populations examined. However, positive progesterone receptor staining of varying degrees was noted in 8 of 10 pulpal specimens. Primarily, pulpal fibroblasts and odontoblasts exhibited positive immunoreactivity., Conclusions: The results of this study suggest that although the dental pulp may be a potential target tissue for progesterone, evidence is lacking with respect to the other sex steroid hormones.

The proto-oncogene bcl-2 is associated with follicular lymphoma involving translocation t(14;18)(q32;q21) and is also overexpressed in various neoplasms. We report deregulation of bcl-2 expression during progression from oral epithelial dysplasia to squamous cell carcinoma. Immunohistochemical analysis with monoclonal antibodies to bcl-2 oncoprotein in formalin-fixed paraffin-embedded tissue sections revealed that severe epithelial dysplasias had a higher percentage of immunoreactivity than did mild and moderate dysplasias and squamous cell carcinomas. Expression of this oncoprotein was directly proportional to the degree of epithelial dysplasia, and nondysplastic basal cells contiguous to neoplastic lesions also expressed bcl-2. These findings, along with down-regulation of bcl-2 in differentiating carcinomas, suggest a role for this oncoprotein in relatively early stages of oral tumor progression. Differentiating neoplastic cells with marginal or no bcl-2 reactivity showed heterogeneous cell labeling of varying intensity for differentiation-associated cytokeratin (CK13), indicating their inverse topographic relationship.

In recent years, the receptor status of the estrogens and progestins and their relationship to the oral mucosa and its disease processes have been described. However, investigations regarding the androgens have largely been neglected. The androgens have diverse physiologic effects throughput the body and mediate their actions through androgen receptors (ARS) in various target organs. One of these, the sebaceous gland of the skin (dermal sebaceous gland, DSG) has been evaluated extensively in regard to ARS status. However, to our knowledge, the ARS status of the oral sebaceous glands (OSG) has not yet been elucidated. We attempt to evaluate the ARS status of 10 cases of OSG, in addition to other tissue components of the oral mucosa, using immunohistochemical techniques with a monoclonal antibody (MoAb) ARS. Sebaceous glands in all cases examined exhibited a moderate to more intense degree in immunoreactivity for ARS. Other tissue components, however, including the overlying epithelium and vascular endothelium, were essentially nonreactive. Our results indicate that, like the DSG, the OSG may be a target for the androgenetic hormones.

We describe a relatively common yet poorly documented condition of the anterior dorsal tongue characterized by one or more moderately painful, transient, red to yellow papules. This study surveyed a number of people on their experiences with these lesions. Although some of the respondants had not had lesions of this sort, most were at least aware of their occurrence in other persons. A summary of respondents' experiences including symptoms and demographics is included. We suggest the term "transient lingual papillitis" to describe this process.

Giant cell lesions have long been of interest as to their origins and pathogenesis. These lesions range from the unusual and rare heritable case of Cherubism to the more often encountered peripheral giant cell lesion (granuloma). While some giant-cell-containing entities appear as innocuous lesions, others form tumorous masses and are locally destructive in nature. Early diagnosis and treatment are important to overall patient health and prevention of local tissue destruction. The learning objective of this article is to familiarize the clinician with the most common of these entities-the peripheral and the central giant cell lesions.

Cases of pyogenic granuloma in pregnant women, nonpregnant women, and men were evaluated for the detection of estrogen and progesterone receptor proteins by immunoperoxidase staining. Immunostaining for estrogen receptors revealed a marked immunoreactivity of the endothelium within lesional tissue and in the overlying mucosal epithelium in many cases. Progesterone receptor immunoreactivity was only present within the epithelium, where it was much less than that of estrogen receptor immunoreactivity in both quantity (proportion of positive cells) and intensity. No characteristic staining pattern or significant quantitative difference among the three study groups could be discerned. These findings suggest that the quantity of estrogen or progesterone receptors in pyogenic granuloma is not the determining factor in the pathogenesis of this lesion. Rather, such a role may be attributed to the levels of circulating hormones. The levels of estrogen and progesterone are markedly increased in pregnancy and could therefore exert a greater effect on the endothelium of the pyogenic granuloma.

It is well known that the central giant cell lesion (granuloma) of the jaws has a distinct female predilection. In addition, occasional cases of central giant cell lesion have been reported to have undergone marked proliferation in pregnant patients and in those undergoing hormonal therapy. As such, we have evaluated 10 central giant cell lesions for the detection of estrogen and progesterone receptor proteins with the use of immunoperoxidase staining. Surprisingly, however, immunostaining for estrogen receptor protein was essentially negative in all cases examined. Although an occasional mononuclear cell stained weakly positive for estrogen receptor protein, these findings suggest that in most cases, factors other than a direct influence of the ovarian hormones, estrogen and progesterone, are responsible for the development and growth of these lesions.

Cases of peripheral giant cell lesions of the jaws (PGCL) were evaluated for the detection of estrogen and progesterone receptor proteins (ERS/PRS) utilizing immunoperoxidase staining. Staining for ERS was strongly positive in three cases when examining the mononuclear cell population. Another two cases were weakly positive. In addition, an occasional ER + multinucleated giant cell could be observed in three of the cases examined. PRS immunoreactivity was essentially negative in all cases. It is well known that the PGCL has a marked female predilection. This, coupled with the present findings, gives further evidence that some PGCL may be at least partially under hormonal influence.

The precancerous nature of the most common of chronic oral mucosal lesions, leukoplakia, is much better understood now than at any time since it was first brought to professional attention by Sir James Paget 143 years ago. Clinical research from the past decade now allows confident identification of high-risk features of oral leukoplakias and of those persons affected by them. This paper summarizes current understanding of this important disease and provides practical suggestions for appropriate management and classification of its various subtypes or "phases."

To examine whether giant cell lesions of the jaws (GCL) of varying behavior could be separated histologically, a number of GCL were studied using the AgNOR staining technique for nucleolar organizer regions. The mean AgNOR count of mononuclear cells from recurrent lesions (1.73 +/- 0.15) was slightly higher than that of the aggressive lesions (1.54 +/- 0.21) and much higher than that of the non-aggressive/non-recurrent lesions (1.33 +/- 0.14). Similarly, the mean AgNOR count of the multinucleate giant cells of the recurrent lesions (1.52 +/- 0.14) was slightly higher than that of aggressive lesions (1.34 +/- 0.092) and much higher than that of non-aggressive/non-recurrent lesions (1.26 +/- 0.05). Statistical analysis showed a significant difference between the mean number of AgNORS of recurrent lesions and non-recurrent/non-aggressive ones in both the mononuclear and multinuclear population (p < 0.05).

The histology, radiographs, and follow-up information for 142 cases of central giant cell lesions of the jaws were reviewed in an effort to determine which, if any, microscopic features could be correlated with clinical behavior. The majority of these lesions were asymptomatic and relatively innocuous. However, some displayed a more aggressive clinical course characterized by root resorption, pain or paresthesia, and cortical perforation. The over-all recurrence rate in the 142 cases was 16%. Adequate follow-up information (mean, 48 months) was only obtained for 47 patients, and 23 (46%) of these experienced one or more recurrences. Statistically significant histologic differences in distribution of giant cells and frequency of osteoid within the lesions were found in lesions that recurred as opposed to those that did not. The concept that giant cell lesions of the jaws are not totally different entities from giant cell tumors is discussed.

Whether the peripheral ameloblastoma (PA) and intraoral basal cell carcinoma (BCC) are two different clinical entities or essentially the same lesion still remains unresolved. The immunophenotypes of neoplastic cells of peripheral and intraosseous ameloblastomas, ameloblastic carcinomas, and BCCs were studied using a panel of monoclonal/polyclonal antibodies and lectins. The major cytokeratins (CKs) of neoplastic cells of ameloblastomas were CKs 5 and 14, whereas co-expression of CKs 8, 18, and 19 was observed in the cells of the stellate reticulum-like areas. Metaplastic squamous and keratinizing cells found in follicular and acanthomatous variants of ameloblastomas expressed CKs 1 and 10, involucrin, and binding sites for the lectins Ulex europeaus agglutinin I and Helix pomatia agglutinin. beta 2-Microglobulin was uniformly negative in all cases of ameloblastomas and ameloblastic carcinomas studied. Cutaneous BCCs also demonstrated similar reactive patterns with the above-mentioned antigens. The most striking feature is the presence of a peritumorous band-like peanut agglutinin staining found in both BCCs and PAs but not in intraosseous ameloblastomas. This unique peanut agglutinin staining pattern of PA may be diagnostically useful for its histopathologic distinction from an intraosseous ameloblastoma that has infiltrated the soft tissue. The neoplastic cells of ameloblastomas express markers of less-differentiated epithelial cells. Despite differences in epithelial origins, PAs are tumors analogous to cutaneous BCCs.

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.

Molluscum contagiosum (MC) presenting as a self-limiting disease of the skin is not uncommon. To date, however, documented cases of MC of the oral cavity have been rare. A case of MC of the palate of a 52-year-old man is reported. The clinical and histopathologic features of this uncommon oral lesion are discussed, and the literature is reviewed.

D-Glucaric acid excretion was followed in psychotic patients treated with phenothiazines for 12 days and in a control group of subjects who had no psychiatric disease. About half the psychiatric patients had a treatment-related rise in D-glucaric acid excretion compatible with enzyme induction. These patients had fewer and less severe neurologic side effects than those who did not have a significant rise in urinary D-glucaric acid levels. It is concluded that individual differences in metabolism of phenothiazines may in part account for the variability in clinical response to these drugs.