Unusual foreign body presenting as a palatal tumor: case report.
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Biomedical subjects
Publications and source records attributed to A S Miller.
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Inverted follicular keratosis, a benign tumor of the skin believed to arise from the infundibular portion of the hair follicle that can involve perioral skin, has a unique histologic picture. It can be confused with forms of skin cancer; with knowledge of this entity, oral and maxillofacial surgeons may be able to avoid unnecessary surgery. The clinical and microscopic findings of 12 cases of inverted follicular keratosis are reported.
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Myxoid lipoma is an unusual histologic type of lipoma. This article reports four cases of myxoid lipoma that arose in the mouth. In frozen sections stained with oil red O, the cytoplasm of tumor cells stained strongly positive. Intercellular mucoid material was PAS-positive and diastase-resistant. It also stained positively with alcian blue. Electron microscopic observations revealed that adipocytes were in different stages of differentiation, with lipid globules of variable size observed in the cytoplasm. Many pinocytotic vesicles appeared at the plasma membrane. Mature adipocytes were surrounded by a basal lamina. Fibroblasts, collagen fibers, and mucoid material were scattered among adipocytes. It appears possible that, in the histogenesis of myxoid lipoma, multipotent mesenchymal cells undergo multidirectional differentiation. Some cells differentiate to produce mucosubstance, while others differentiate to become adipocytes.
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Immunohistochemistry applied to whole-mount preparations was used to investigate the presence and distribution of vasoactive intestinal polypeptide (VIP) immunoreactive nerves in the non-retinal part of the human eye. The choroid has a dense perivascular supply of VIP immunoreactive nerve fibers, and some free nerve endings within the stroma. These nerves enter the choroid in ciliary nerves and also as perivascular networks around the ciliary arteries. Occasional choroidal VIP immunoreactive nerve cell bodies are seen. The ciliary body stroma, close to the iris root has a dense circumferential plexus of VIP immunoreactive nerve fibers that occur both singly and in bundles. The iris root has a circumferential arrangement of bundles from which VIP immunoreactive nerve fibres travel radially in the stroma. They supply the pupillary region with numerous free nerve endings; the sphincter pupillae is not supplied by these nerves. The cornea is devoid of VIP immunoreactive nerves. These findings, together with existing knowledge of the physiological actions of VIP, indicate that VIP immunoreactive nerves are likely to be involved in the functioning of several ocular tissues.
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Four cases of inverted ductal papilloma are presented. Their origin is the excretory duct reserve cell of minor salivary gland and they appear clinically as a submucosal mass. All tumors occurred in adults and there was equal distribution between men and women. Treatment is complete surgical excision and no recurrences have been reported thus far.
Deposition of calcium oxalate in the periodontium with accompanying bone loss and tooth resorption, occurred in a 55-year-old woman on long-term renal dialysis for end-stage renal disease. These deposits were birefringent upon examination with polarized light. Scanning electron microscopy of the deposits revealed clusters of sharply angular oblong and needlelike crystals. Microincineration followed by staining with alizarin red S was positive for calcium oxalate. X-ray diffraction studies of the crystals in the tissue specimen revealed a pattern identical to that of commercially prepared calcium oxalate monohydrate. It is postulated that pre-existing inflammatory periodontal disease may have provided the appropriate milieu for the deposition and precipitation of crystals. These deposits, acting as a foreign body, further intensified the inflammatory response, resulting in extensive alveolar bone loss and external tooth resorption.
A survey of tissue-diagnostic services in United States dental schools was conducted, covering the services' activities during 1980. This survey was compared to similar surveys done in 1953, 1958, 1969, and 1975. A significant increase in the number of specimens processed has occurred, and there has been a parallel increase in the number of malignant specimens. The percentage of malignancies in relation to total specimens remains stable at 2.0 percent. As could be expected, higher fees are being charged by the schools for processing specimens.
A 45-year-old woman had a mass in the left side of the tongue. Histologic examination of the tumor revealed it to be an extraskeletal osteogenic sarcoma. Pulmonary metastases were seen on admission. The patient had a rapid downhill course and died. Extraskeletal osteogenic sarcomas are well-recognized albeit rare neoplasms. In a search of the literature we were unable to find a single case arising in the tongue. The electron microscopic findings are also presented.
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Hyaline bodies are sometimes encountered in the connective tissue wall of odontogenic cysts. In this study, various histomorphologic types of hyaline bodies were observed in a dentigerous cyst and a residual apical periodontal cyst. Some hyaline bodies appeared to be a coagulum of serum fluid surrounded by a small number of fibroblasts. Others appeared to be composed of fibrillar structures. Still others appeared to be a mixture of various amounts of serum coagulum and fibrillar structures. Immunoperoxidase procedures revealed various amounts of serum proteins in hyaline bodies. Gomori's trichrome stain and Mallory's staining technique showed that fibrillar structures were collagenous in nature. Electron microscopy showed that fibrillar structures were frayed collagen fibrils. These observations suggest that various histologic types of hyaline bodies represent different stages of development and that the basic pathogenic mechanism is pooling of extravasated serum followed by fibrosis.