下唇角化棘皮瘤的诊疗体会

目的:结合相关文献探讨角化棘皮瘤的诊断与治疗方法,为临床医生诊疗此病提供参考方法:问顾4例下唇角化棘皮瘤患者的诊断与治疗,结合病理切片进行分析。结果:1例术中冰冻切片检查时被误诊,但术后病理诊断确诊,4例均治愈。结论:了解角化棘皮瘤临床及病理特点,总结治疗体会,掌握边界无瘤原则的外科切除术,在诊断与治疗中较为重要。     

颊部皮肤角化棘皮瘤1例报告及文献复习

角化棘皮瘤是一种少见的皮肤肿瘤,好发于颌面部,其组织学表现与皮肤鳞状细胞癌相似。作者报告1例颊部角化棘皮瘤,术后经组织病理确诊,病理学特征为表皮向真皮内凹陷,呈“火山口”状,其中充满角化物质及炎症细胞碎片,两侧的上皮细胞形成“唇缘”包绕瘤体。因其有潜在恶性变,颌面部角化棘皮瘤提倡早期完整切除。     

Expression of cytokeratins in odontogenic jaw cysts: monoclonal antibodies reveal distinct variation between different cyst types

Immunostaining with monoclonal antibodies was used to study and compare the cytokeratin content of odontogenic cysts and normal gingival epithelium. Two monoclonal antibodies, PKK2 and KA1, stained the whole epithelium in all cyst samples. In gingiva, PKK2 gave a suprabasal staining and KA1 reacted with all epithelial cell layers. Antibodies PKK1, KM 4.62 and KS 8.12 gave a heterogeneous staining in follicular and radicular cysts. In keratocysts and in gingiva PKK1 and KM 4.62 reacted mainly with basal cells and KS 8.12 gave a suprabasal staining. Antibodies reacting with the simple epithelial cytokeratin polypeptide No. 18 (PKK3, KS 18.18) recognized in gingiva only solitary cells compatible with Merkel cells. In a case of follicular ameloblastoma a distinct staining of tumor epithelium was revealed with these antibodies. In 2 follicular cysts, but not in other cyst types, a layer of cytokeratin 18-positive cells was revealed. KA5 and KK 8.60 antibodies, reacting exclusively with keratinizing epithelia, including normal gingiva, gave no reaction in radicular cysts, keratocysts and ameloblastoma. Two of the follicular cysts, were negative for PKK3 and KS 18.18, but reacted strongly with KA5 and KK 8.60. The present results show that odontogenic jaw cysts have distinct differences in their cytokeratin content. With the exception of some follicular cysts, they lack signs of keratinizing epithelial differentiation. Only follicular cysts appear to share with some types of ameloblastoma the expression of cytokeratin polypeptide No. 18.     

口腔小涎腺腺样囊性癌47例局部复发及转移的临床分析

目的　小涎腺腺样囊性癌的发生率相对较高 ,由于其易发生局部复发和远处转移 ,因此对本病的治疗效果及预后有必要进行一些分析和探讨。方法　通过对 47例小涎腺腺样囊性癌的原发部位、组织分型、治疗方法和疗效等进行分析和统计学的多因素回归分析 ,了解和此病相关的各种因素与预后之间的关系。结果　腭部病灶的局部复发和远处转移率为 5 2 % ,2 9% ;舌部的的局部复发和远处转移率为 6 3% ,38% ;筛状型的局部复发和远处转移率为 33% ,2 5 % ;实体型的局部复发和远处转移率为 80 % ,6 0 % ;早期肿瘤的局部复发和远处转移率为 2 0 % ,2 0 % ;晚期肿瘤的局部复发和远处转移率为 80 % ,5 0 % ;综合治疗的局部复发和远处转移率为 36 % ,18% ;单纯手术治疗的局部复发和远处转移率为 71% ,5 7%。多因素回归分析结果 :肿瘤的临床分期和治疗方法的选择与局部复发和远处转移有明显的相关性。结论　该肿瘤的临床分期 ,手术切除的彻底性及综合治疗的应用是直接影响小涎腺腺样囊性癌的预后重要因素。     

Expression of cytokeratins in odontogenic jaw cysts: monoclonal antibodies reveal distinct variation between different cyst types

Immunostaining with monoclonal antibodies was used to study and compare the cytokeratin content of odontogenic cysts and normal gingival epithelium. Two monoclonal antibodies, PKK2 and KA1, stained the whole epithelium in all cyst samples. In gingivu, PKK2 gave a suprabasal staining and KA1 reacted with all epithelial cell layers. Antibodies PKK1, KM 4.62 and Ks 8.12 gave a heterogeneous staining in follicular and radicular cysts. In keratocysts and in gingiva PKK1 and K_M 4.62 reacted mainly with basal cells and K_s 8.12 gave a suprabasal staining. Antibodies reacting with the simple epithelial cytokeratin polypeptide No. 18 (PKK3, K_s 18.18) recognized in gingiva only solitary cells compatible with Merkel cells. In a case of follicular ameloblastoma a distinct staining of tumor epithelium was revealed with these antibodies. In 2 follicular cysts, but not in other cyst types, a layer of cytokeratin 18-positive cells was revealed. KA5 and K_k 8.60 antibodies, reacting exclusively with keratinizing epithelia, including normal gingiva, gave no reaction in radicular cysts, keratocysts and ameloblastoma. Two of the follicular cysts, were negative for PKK3 and K_s 18.18, but reacted strongly with KA5 and K_k 8.60. The present results show that odontogenic jaw cysts have distinct differences in their cytokeratin content. With the exception of some follicular cysts, they lack signs of keratinizing epithelial differentiation. Only follicular cysts appear to share with some types of ameloblastoma the expression of cytokeratin polypeptide No. 18.     

Toward strategies for the analysis of periodontal disease clinical trials

We consider design, analysis and regulatory issues relating to clinical trials in periodontal disease and identify complications commonly associated with such studies. Alternative statistical procedures that can be used for the analyses of data from periodontal research are reviewed and a case study of the analysis of a Phase II periodontal disease clinical trial is provided to illustrate the use of one of these procedures.     

Chronic pulmonary histoplasmosis with an oral lesion

Histoplasmosis is a fungal disease resulting from inhalation of airborne spores of the organism Histoplasma capsulatum. The disease is endemic to the Ohio and Mississippi river valleys. Oral lesions are not common, but when present, they are usually associated with the severe disseminated form of histoplasmosis. This particular case is presented as an example of chronic pulmonary histoplasmosis in which a localized gingival lesion represented the initial clinical manifestation of the disease. Diagnosis was based on a positive biopsy and the results of chest radiographic examination. If, as in this case, serologic, hematologic, and physical examination results are negative, the biopsy of suspicious lesions is of paramount importance to the clinical differential diagnosis.     

Eosinophilic granulomaA case report with pathologic fracture

Approximately 10% to 20% of all cases of eosinophilic granuloma occur in the jaws. A palpable mass with or without pain is the most frequent presenting clinical feature. Less common clinical signs include gingivitis, loose teeth, and oral ulceration with poor healing. We report a case of monostotic mandibular eosinophilic granuloma in a 38-year-old woman that initially manifested mandibular body fracture, an unusual and poorly documented clinical sign for this disease. The clinical and radiographic features, differential diagnosis, and treatment plan of the case are presented.     

AEC综合征1例报告及文献复习

AEC综合征是一种罕见的以睑缘黏连、外胚层发育不全及面裂为主要临床表征的基因病。目前,国内尚未见该病的报道。本文报告1例AEC综合征病例,根据患者的临床表现,制订相应的治疗方案,手术修复左侧唇裂,术后患者外形有一定改善。通过文献复习,对AEC综合征的病因、临床表现、鉴别诊断及序列治疗进行了讨论。由于AEC综合征临床表现多样,严重影响患者面容及生长发育,因此,应增强对本病的认识,并进行系统序列治疗。     

Lateral gaze deficit suggesting multiple sclerosis

The case of a 26-year-old white man with multiple sclerosis is presented. Although the patient was unaware of his condition, the signs and symptoms that he presented were highly suggestive of multiple sclerosis. The case is unusual in that initial diagnosis was made by a senior dental student in a social rather than a clinical setting and without a presenting complaint by the patient. The significance of a thorough clinical examination and the responsibility of a general practitioner as a primary health provider to be observant of signs of disease such as multiple sclerosis are discussed.     

Multiple suppurative cystic lesions of the lips and buccal mucosa: a case of suppurative stomatitis glandularis

Cheilitis glandularis (CG) is a rare inflammatory salivary gland disease that usually affects the lips. Although the etiology of CG is still unknown, it is believed to be a hereditary disease with an autosomal dominant pattern of inheritance. Three clinical presentations of CG are described in the literature: simple, superficial suppurative, and deep suppurative. A case of deep suppurative CG that extended to the buccal mucosa has been previously reported as suppurative stomatitis glandularis (SSG). Here we report a case of SSG in a 64-year-old white female with a history of bilateral renal transplants for adult polycystic kidney disease, who presented with painful swollen lips and bilateral buccal mucosal lesions. The diagnosis and management of the case is discussed. To the best of our knowledge, this is the second report of SSG, a rare condition affecting the minor salivary glands in the oral cavity.     

Static spinal muscular atrophy causing temporomandibular joint dysfunction

A case of static spinal muscular atrophy is described. The patient presented with temporomandibular joint dysfunction. This case is unusual, not only from the perspective of clinical disease progression, but also that markedly elevated creatine kinase levels were demonstrated. Despite an obvious association of neuromuscular disorders and TMJ disease, reports of primary disorders of muscle and nerve which may predispose to this condition are rare. This case emphasizes the need for careful neuromuscular evaluation in all patients with TMJ dysfunction of nonarticular origin.     

颊部Rosai-Dorfman病1例报告及文献复习

Rosai-Dorfman病是一种病因不明,具有自限性的淋巴结窦被组织细胞浸润和扩张引起的良性病变。其病例报道少见,发生在颌面部则更为罕见。本文报告1例面颊部Rosai-Dorfman病,结合相关文献对其病因、临床表现、诊断、治疗及预后等进行讨论。     

Periodic migrainous neuralgia: a cause of dental pain.

The clinical findings in thirty-five cases of periodic migrainous neuralgia (PMN) are given. Typical case histories are used to illustrate the fact that the condition may mimic dental pain. The nomenclature and association of the condition with migraine are briefly discussed, and a plea is made that the condition always be considered in cases of facial pain, when other clinical features of the disease are present, in order to save needless loss of teeth and delay in treatment.     

Kimura's disease: a case report.

The clinical and histologic features of Kimura's disease are briefly outlined. A case presenting as a subcutaneous nodule in the region of the angle of the right mandible of a 20-year-old male is presented. The relationship of this disease to angiolymphoid hyperplasia with eosinophilia is discussed.     

Eosinophilic granuloma with oral manifestations: a case report

Eosinophilic granuloma is the most benign disorder of the triad commonly known as histocytosis X. In this article a case of a 6 year old female child with multiple eosinophilic granuloma with additional liver dysfunction and its oral manifestation is presented. This case demonstrated that oral findings, may be an early manifestation of the disease, definitive diagnosis needs to be determined by correlation of the clinical findings with histologic features. For the duration of 8 years the case has been followed up, there has been a progressive healing of the lesion, the clinical manifestations of the disease resolved with only chemotherapy and provided a very good prognosis.     

Cold agglutinin disease. Report of a case.

Cold agglutinin disease is an autoimmune hemolytic anemia with varying causes. Two major types are recognized, with different clinical manifestations. Cold agglutinins are circulating antibodies capable of erythrocyte agglutination. However, the reaction is readily reversible. Treatment of the disease is variable. A case is presented to illustrate that minor oral surgical procedures are feasible, provided the proper precautions are taken.     

Gorham's disease: a case (including dental presentation) of vanishing bone disease

A case of multicentric vanishing bone disease with maxillofacial involvement in a 4-year-old boy is presented. The clinical and histologic features are described along with the subsequent management of the disease, and the literature concerning this unusual and rare condition is reviewed.     

Oral lesions of sickle cell anemia: case report and review of the literature

A case report of the oral manifestations of sickle cell anemia is presented, with emphasis on the radiographic features of the disease and the surgical management of periodontal defects. The pathogenesis and clinical course of the disease are discussed, along with a review of clinical characteristics and management protocols. Recommendations for genetic counseling and an update of research in gene therapy of sickle cell anemia are also presented.