Pathologic conditions of the oral mucosa associated with ill-fitting dentures: II: Inflammatory papillary hyperplasia of the palate.
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Biomedical subjects
Publications and source records attributed to A Buchner.
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Chondrosarcomas of the jaws are rare tumors; an additional case in the maxilla is described. The literature that discusses the pathogenesis of the tumor, its biological behavior, and the preferred treatment is reviewed. The histologic differentiation between chondrosarcoma and benign cartilagenous tumors is discussed.
Denture-induced changes of the oral mucosa comprise, besides denture stomatitis and inflammatory papillary hyperplasia, the so called folds and redundancies in sulci and flabby ridges. The present article deals with these two tissue reactions which are associated with chronically ill-fitting dentures.
Amyloid as defined by positive Congo red green birefringence and STB red birefringence was observed in the stroma of a tubular carcinoma of minor salivary gland origin. The amyloid exhibited additional histochemical characteristics of immunamyloid, viz., positive DMAB-nitrate and DC-reactions and spontaneous autofluorescence. Electron microscopic studies of the epithelial tumor cells displayed large amounts of cytoplasmic microfilaments similar to those present in the extracellular amyloid masses. It is suggested that the amyloid is derived from spontaneous assembly or polymerization of cytoplasmic microfibrils of the dying tumor cells as has been proposed for the amyloid associated with the calcifying epithelial odontogenic tumor (CEOT).
Reported is a rare case of multiple fibroepithelial hyperplasias of the oral cavity, and the suggestion is made that several previous authors may have confused this lesion with focal epithelial hyperplasia (Heck's disease). The differential diagnosis of multiple fibroepithelial hyperplasias is discussed in order to elucidate some of the confusions in the diagnosis of cases of multiple papules and nodules of the oral mucosa.
The occurrence of focal epithelial hyperplasia (Heck's disease) in seven Israeli families is reported. All the cases involved children and young adults whose parents had immigrated to Israel from Libya. The familial occurrence and possible etiologic factors of the condition are discussed. A genetic predisposition for the disease is suggested.
Lipofuscin granules were observed in normal salivary glands (parotid, submandibular, and minor salivary glands). The pigment was confined mainly to the epithelial cells of the intralobular ducts, but isolated granules were also found in acinar cells and myoepithelial cells. In chronic sialadenitis pigment granules were found in the intralobular epithelial cells and in macrophages in the surrounding ionnective tissue. In benign epithelial tumors pigment granules were observed within neoplastic epithelial cells and in macrophages in the stroma, while malignant tumors displayed pigmented granules only in macrophages in the stroma.
Round or polyhedral, acellular, lamellated or amorphous eosinophilic structures were observed in the cystic spaces of adenolymphomas. These eosinophilic bodies ahd several of the histochemical characteristics of amyloid, viz., pink color with green specific birefringence and bright red fluorescence with alkaline Congo red; positive DMAB-nitrite and DC reactions, and spontaneous autofluorescence. It is suggested that these bodies are derived from spontaneous assembly or polymerization of microfibrils of desquamated epithelial cells lining the cystic spaces of the tumor, as has been described to occur in prostatic corpora amylacea.
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A study of 105 odontogenic cysts revealed the presence of pigmented cells in the cyst wall in 38% of the cases. The frequency of pigmented cells was higher in the inflammatory odontogenic cysts than in the development cysts. Although isolated pigmented cells were seen within the epithelial lining and cyst cavity, the larger collections were closely associated with cholesterol crystals and hemosiderin deposits; they contained light brown cytoplasmic pigment which manifested sudanophilia, acid-fastness, silver reduction capacity, PAS positivity and yellow autofluorescence in ultraviolet light. The morphology, histochemical reactions and autofluorescence suggest that the pigmented cells are macrophages containing ceroids. It has been suggested that the hemosiderin which is found in the cyst wall serves as an oxidation catalyst for the locally liberated lipids, the end result of which is the formation of the ceroid pigment.
Talon cusp is a rare dental anomaly hitherto considered to affect permanent dentition only. A case of talon cusp in a deciduous maxillary incisor is described, suggesting that both dentitions may be affected by this anomaly.
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A case is described of Burkitt's lymphoma in a nine-year-old Arab boy. The presenting symptom was swelling of the right maxilla, originally diagnosed as a dento-alveolar abscess. The clinical features of African and American Burkitt's lymphoma are compared, and the occurrence of the tumor mainly in the Arab population of Israel is noted.
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A study of a series of adenolymphomas showed the presence of pigmented cells in the lymphoid stroma in 85% of the cases. The pigmented cells contained light brown cytoplasmic pigment and manifested sudanophila, acid-fastness, silver reduction capacity, PAS positivity and yellow autofluorescence in ultraviolet light. The morphology, histochemical reactions and autofluorescence suggest that the pigmented cells are macrophages containing ceroid derived from breakdown of damaged organelles of the epithelial tumor cells. It is possible that these cells play a role in the elimination of undigestable pigment material present in the cystic spaces of the tumor.
A study was made of a series of 302 consecutive cases of localized hyperplastic lesions of the gingiva (epulides). The lesions were classified into five groups: pyogenic granuloma, calcifying fibroblastic granuloma, fibrous hyperplasia, peripheral giant cell granuloma and denture hyperplasia. The study indicates that there are some differences in age and sex distribution as well as in location between the different histological groups. Pyogenic granuloma was found to be the most common lesion on the gingiva. Pyogenic granuloma and calcifying fibroblastic granuloma occur in younger patients more often than fibrous hyperplasia, and thus may represent a stage in the development of fibrous hyperplasia. Denture hyperplasia occurs predominantly in females and it is suggested that its formation may be affected by hormonal alterations in the menopause.
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