W. Yih’s research while affiliated with Oregon Health & Science University and other places

Purpose: Minor salivary gland tumors (MSGTs) constitute a heterogeneous group of neoplasms with great histomorphologic variation. This study reviews a large series of benign and malignant salivary gland tumors of the oral region and determines the incidence and the correlation of the histopathologic features with the clinical characteristics. Materials and Methods: Two hundred thirteen cases of MSGT were retrospectively studied. Hematoxylin-eosin-stained slides were examined in all cases. Special stains and immunohistochemical stains were used in selected cases. Clinical characteristics of the neoplasms were also noted. Results: One hundred nineteen tumors were benign (56%), and 94 tumors were malignant (44%). Pleomorphic adenoma was the most common benign tumor (93 of 119). Canalicular adenoma was the second most common benign MSGT in our series (25 of 119). Of the 94 malignant MSGTs, mucoepidermoid carcinoma (MEC) (45 of 94), adenoid cystic carcinoma (22 of 94), and polymorphous low-grade adenocarcinoma (18 of 94) were the most common. Most MECs (34 of 45) were low-grade lesions. Of 5 central MECs, 3 cases occurred in the maxilla and 2 cases arose in the mandible. Conclusions: Benign intraoral MSGTs are slightly more common than malignant MSGTs. Pleomorphic adenoma is the most common MSGT, and MEC is the most common malignant variety. The palate is the most common site for minor gland neoplasms. Benign labial salivary gland neoplasms are more common in the upper lip, and malignant labial tumors are more common in the lower lip. © 2005 American Association of Oral and Maxillofacial Surgeons.

We are reporting a case of ameloblastoma with ghost cells as a prominent feature and support the acceptance of “ghost cell ameloblastoma” as a microscopic variant of ameloblastoma. Ameloblastoma is a common odontogenic tumor. Several microscopic subtypes including follicular, plexiform, acanthomatous, granular cell, desmoplastic, and basal cell have been described in the literature. Ghost cell ameloblastoma has not been reported as such, but ghost cells in ameloblastoma have been alluded to in the literature and has been suggested as a variant. A 69-year-old white female presented with a multilocular radiolucency from teeth numbers 21 to 22. She had a history of enucleation of a lesion in the same area 2 years previously. The microscopic diagnosis of the previous lesion had been ameloblastoma and demonstrated the classic microscopic features of ameloblastoma. The lesion had recurred and had increased in size. Ghost cell elements appeared in the recurrence of this ameloblastoma. The nomenclature of ghost cell containing odontogenic neoplasms and the aggressiveness of these tumors will be discussed.

Introduction: Six cases are reported, each presented at the 11th Biennial Congress of the International Association of Oral Pathologists as an instructive case for differential diagnosis on the basis of clinical, imaging or histological features. Clinical picture: Case diagnoses included a large, possibly intraosseous, myofibroma presenting with an oral mass; Langerhans cell histiocytosis with facial skin lesions; an intraosseous vascular hamartoma of the maxilla with worrying radiological features; an unusual mixed radiolucency of the jaw caused by cemento-ossifying fibroma; an osteosarcoma of the posterior mandible causing a well-defined radiolucency and an intraoral squamous cell carcinoma in a child.

A case of angiocentric T-cell lymphoma presenting as a midface destructive lesion is reported. Angiocentric T-cell lymphoma typically manifests as an aggressive, progressively destructive, and necrotizing disorder, often with a fatal outcome. This case was characterized microscopically by the presence of an atypical lymphoid population that expressed a CD45+, CD3+ cytoplasmic, CD5+, and CD56- T-cell phenotype within a background of a polymorphous inflammatory infiltrate. Because of the rarity of the disorder, the differential diagnosis is discussed. Recent advances in clinical immunodiagnostics, the variations in therapeutic modalities, and the prognosis of the disease as reported in the recent literature are reviewed.

Noma, or cancrum oris, has been described as a gangrenous infection of the soft and hard tissues of the oronasal region. Prior to the advent of antibiotics the disease was commonly fatal. Now many survive the acute phase of the disease and present the surgeon with formidable problems of repair. This is a report of a presumed case of noma that resulted in bony ankylosis of the maxilla and mandible. Three-dimensional shaded surface CT reconstruction images were especially useful in demonstrating the architecture of the abnormal bone.

Chronic desquamative gingivitis (DG) is a common condition often first recognized by periodontists. DG is characterized clinically by erythema with epithelial desquamation, ulceration, and/or the presence of vesiculobullous lesions of the free and attached gingiva. However, DG is actually a clinical manifestation of several different disease processes, particularly lichen planus and benign mucous membrane pemphigoid. Correct diagnosis in DG is critical since proper treatment and follow-up will depend on which disease is involved. However, the diseases that cause DG frequently present diagnostic problems because their lesions often resemble each other clinically and routine histological examination sometimes cannot differentiate between them. Thus, immunohistology, particularly immunofluorescence, is increasingly being used with routine histology to more accurately diagnose DG diseases. This article reviews our experience over the past 10 years in the diagnosis of 72 cases of DG using direct immunofluorescent (DIF) in conjunction with histology and clinical evaluation. Of the 72 DG cases in this study, 30 cases were diagnosed as erosive lichen planus or lichenoid mucositis; 29 cases were diagnosed as benign mucous membrane pemphigoid; 2 cases each of linear IgA disease and pemphigus vulgaris were diagnosed; there was 1 case of bullous pemphigoid; and 1 suspected case of paraneoplastic pemphigus. Even with DIF analysis, 7 cases could not be definitively assigned a particular cause. DIF analysis is not only proving very useful for differential diagnosis, but also adds insight into possible pathogenic mechanisms of DG.

Cytomegalovirus (CMV) has been implicated as a possible initiating factor in the development of Kaposi' s sarcoma (KS). The relationship between CMV and KS has been very controversial and most investigators admit that a causative association has not been proven. A number of studies have demonstrated the presence of CMV DNA and/or antigens in both extraoral and intraoral KS. Several investigators have reported the presence of CMV-type inclusions, by light microscopy, in cases of KS but there is only a rare intraoral example. We reviewed 12 cases of intraoral KS and noted two of those cases demonstrated CMV-type inclusions by light microscopy. Immunohistochemical staining with antibodies against CMV were positive in those two cases. Electron microscopy demonstrated herpes-type viral particles c/w CMV. These light findings may be a manifestation of generalized CMV infection rather than a sole causative factor.