Oral squamous cell carcinoma (OSCC) is the most common type of head and neck cancer and is associated with high recurrence, poor treatment, and low survival rates. Hypoxia-inducible factor-1α (HIF-1α) is a transcription factor that regulates the response to hypoxia, a major factor in the tumor microenvironment that affects tumor development and progression in various cancer types. However, microRNA (miRNA) sequence analysis revealed that only a few miRNAs targeting HIF-1α had been discovered. In the present study, we investigated HIF-1α expression in OSCC and the effect of HIF-1α-targeting miRNAs on the progression and metastatic potential of OSCC. We analyzed public databases to explore which miRNAs target HIF-1α expression. In addition, the expression of proteins involved in the cell cycle, proliferation, and apoptosis in HSC-2 cells was analyzed after miRNA-126 mimic treatment. Furthermore, to investigate the effect of miRNA-126 on the proliferation and invasion ability of OSCC cells, 5-ethynyl-2′-deoxyuridine and Transwell assays were performed. The activities of MMP-2 and MMP-9 were evaluated via gelatin zymography. Our results showed that miRNA-126, which targets HIF-1α, enhances OSCC cell proliferation by regulating the cell cycle and reinforces the cell mobility of OSCC via HIF-1α expression. These findings suggest that miRNA-126 may be a novel marker for OSCC treatment and the development of new tools for patients with OSCC.
Background : Mucoepidermoid carcinoma (MEC) is the most common primary epithelial malignant salivary gland tumor in both adults and children. Histological grading of MEC is subjective, but plays an important role in predicting patient prognosis. Immunohistochemistry can accurately diagnose diseases and help with treatment and prognosis. The review of this paper was intended to be helpful in the differential diagnosis of mucinous epidermoid carcinoma. Methods : A PubMed search was carried out. Well-known biomarkers for mucoepidermoid carcinoma were searched in PubMed, and their differences with oral squamous cell carcinoma were compared. Results : When PubMed searched “oral mucoepidermoid carcinoma, biomarker”, a total of 241 papers were found, among which cytokeratin(22), Muc1(membrane-bound mucin1, 9), Muc4( membrane-bound mucin4, 6), Muc5ac (membrane-bound mucin5ac, 4), Muc5b (membrane-bound mucin5b, 3), p63 (15), PCNA (15), p53 (20), EGFR (Epidermal growth factor receptor, 21), c-erbB2 (HER2, 14), and pAKT (2) were searched and investigated. The biomarkers retrieved above were compared with those expressed in squamous cell carcinoma. Conclusion : Due to the above biomarkers, it is possible to classify mucoepidermoid carcinoma and differentiate it from other salivary gland tumors or oral squamous cell carcinoma.
A 31 years old female had been suffered from a bony swelling in right premolar region of the mandible for 12 years, recently grown rapidly. A fistula tract developed on the right anterior mandibular border, but the lesion was relatively asymptomatic. In the radiological examination, the tumor mass was irregularly mixed with radiolucent and radiopaque areas, forming multiple cystic spaces. Under the diagnosis of calcifying odontogenic cyst, the mandibular mass was resected and examined pathologically. After decalcification, the dissected tumor mass showed multiple small cystic spaces and calcifying fibrous tissue, mimicking calcifying odontogenic cyst or ameloblastoma. Histological observation showed many calcifying cementoid materials and ossifying trabeculae. The cystic spaces were turned out to be dilated vascular channels lined by endothelial cells, containing plasma fluid. However, the main lesion was diagnosed as cemento-ossifying fibroma (COF), and the atypical vascular channels were greatly dilated and gradually expanded the whole tumor mass. The present COF was examined through immunohistochemical (IHC) array, and investigated for tumor cell characteristics, exhibiting abnormal ossification and aneurysmal cystic changes. IHC array disclosed that the tumor cells grew progressively in the lack of apoptosis, and that they showed lower expression of RUNX2 than BMP-2, RANKL, and OPG, and increases of protein expression in HIF-1α, VEGF-A, and CMG2. These data suggested that the reduced expression of RUNX2, osteoblast differentiation factor, be relevant to abnormal ossification of COF, and that the consistent expressions of angiogenesis factors be relevant to de novo angiogenesis in COF, subsequently resulted in aneurysmal cystic changes.
A nineteen years old male patient showed a cystic lesion in left maxillary canine to premolar area (#23-#25). This lesion was asymptomatic, and found during his routine radiological check in local clinic. In the radiological observation the cystic lesion showed round radiolucent image containing many calcified bodies which were usually small but irregular in shape, expanding tumorously and resulted in the displacement of canine and second premolar in the absence of first premolar. The lesion was surgically enucleated, and a cystic fibrous tissue containing abnormal teeth was removed and examined pathologically. With the histological observation of tumorous odontogenic epithelium including many ghost cells, which were closely associated with abortive teeth, the lesion was finally diagnosed as CCOT associated with complex odontoma. The ghost cells of CCOT was strongly positive for β-catenin, GADD45, and LC3, and slightly positive for MMP-9, while they were rarely positive for BCL2, Wnt1, HSP-70, and p38. Therefore, it was presumed that the ghost cells of CCOT might undergo dormant cell state through altered cytodifferentiation stimulated by severe growth arrest, DNA damage signaling, and abundant autophage formation.
Aneurysmal bone cyst (ABC) in maxilla is a rare and benign lesion but shows extensive bony destruction, occasionally accompanied with secondary osseous lesions, i.e., central giant cell granuloma, ossifying fibroma, fibrous dysplasia, etc. As the pathogenesis of ABC has not been clearly defined, ABC is diagnostically challenged due to its variable histological features. A 17-year-old boy showed a huge radiolucent lesion at right anterior maxilla, which was accidentally found in routine dental-radiological examination for orthodontic treatment. He had no medical history of systemic disease, and did not remember any traumatic experience on his right anterior maxilla. The radiolucent lesion involved periapical area from right central incisor to right first premolar, and was clinically diagnosed as odontogenic keratocyst. During surgical operation a cyst-like sac was enucleated with severe hemorrhage. In the histological observation the thick fibrous sac showed no lining epithelium, and its luminal side disclosed multiple aneurysmal spaces which were shrunken and almost obliterated. The fibrous sac itself was hyperplastic with abundant vascular channels, and produced fibromatous thickening associated with ossifying trabecular bones. This fibro-osseous tissue was hamartomatous, which was not directly connected and organized with marrow bone of maxilla. Finally, the present case was diagnosed as secondary type ABC differentially from traumatic bone cyst (TBC), odontogenic cyst, and central reparative granuloma. And it was presumed that the hamartomatous proliferation of fibro-osseous tissue in the cystic sac of ABC could produce the swelling pressure effect in the bone marrow similar to the overgrowth of central giant cell granuloma, ossifying fibroma, fibrous dysplasia, etc., in the secondary type ABC.
An 81-years-old woman presented multiple mucosa ulcers with a chief complaint of pain during wearing the lower denture. She had been wearing upper and lower complete dentures for five months, and received multiple drugs for the treatment of angina pectoris, constipation, neurosis, hypertension and arthritis (calcium channel blockers, furosemide, captopril, nonsteroidal anti-inflammatory agents and penicillamine, respectively), but no history of immune-diseases and viral infection symptom. The present lesion was primarily diagnosed as traumatic ulcer, candidiasis and lichen planus in the clinical observation, thereby conservatively treated with denture relining, antifungal agent, and steroidal agent. However, the ulcer lesion was not healed for two months and rather increased in size. With the diagnosis of viral infection the immunohistochemical (IHC) staining of IL28 and E6, and polymerase chain reaction (PCR) using herpes simplex virus (HSV)-1 primer sets was done but entirely showed negative reaction. Therefore, with the patient’s medical history and IHC findings exhibiting strong positive reaction of CD3 and CD28, but rare/weak reaction of NFkB, CD20, IgK and p38, the ulcer lesion was finally diagnosed as drug-induced pemphigoid ulceration which was not an inflammatory granulomatous lesion but related to the retrogressive acantholytic degeneration of epithelial cells caused by multiple drug abuse.
Caliber persistent artery (CPA) is a vascular anomaly presenting as a bluish and pulsatile artery in the subepithelial tissue. Although the incidence of CPA was debated, many CPAs occurred in the perioral and facial tissues at which the embryonal strapedial artery networks were distributed. The present study demonstrated a case of CPA occurred in the retromolar buccal mucosa in a 37 years old male. The lesion showed many pinkish granular spots, but was asymptomatic except biting irritation during mastication. It had slowly increased in size up to 20 × 25 mm for 3 years, and recently became hemorrhagic due to the biting injury between left upper and lower second molars. With the fear of oral cancer an incisional biopsy was performed, and followed by histological and immunohistochemical study. Histologically the lesion showed many tortuous artery localized at the submucosa area, and the arterial wall was thick and its lumen was narrowed and shrunken. In the immunochemistry α-SMA was positive for thick smooth muscle layer of artery and arterioles, TGase 2 was weakly positive for the luminal surface of arterial intima, and bFGF was consistently positive for the perivascular fibrous tissue. But PCNA, VEGF, CD31, CMG2, TGF-β1, HSP-70, and 14-3-3 were almost negative for the vascular tissue. Therefore, it was presumed that the lesion was not actively proliferative nor degenerative but still retained its cellular stability and slow growing potential. It was finally diagnosed as CPA differentially from arterio-venous malformation, hemangioma, lymphangioma, and squamous cell carcinoma. The retromolar buccal mucosa CPA is first reported in this study and may present usual clinical findings depending on its size and location. This asymptomatic lesion could be severely hemorrhagic by minor biting injury, therefore, precise differential diagnosis should be made through biopsy, and careful therapy be followed.
A 57 years old female received xenogenic bone graft for the extraction socket augmentation of right maxillary molars and for the sinus floor elevation six months ago. The bone graft sites were healed uneventfully and showed marked radiopacity in the postoperative X-ray view. Before dental implant insertion the bone biopsy was made using trephine bur and examined pathologically. The graft bones showed minimum new bone deposition with dysplastic epithelium. The epithelium was proliferative on the surface of graft bones forming epithelial strands and nests, similar to the odontogenic epithelium. The immunohistochemical study was performed using different antisera of odontogenic markers, growth factors, oncogenes, etc. The epithelial cells were strongly positive for pan-keratins, EGF, pAKT, and HSP-70, consistently positive for PCNA, p53, EGFR, 14-3-3, and survivin, slightly positive for ameloblastin, but rarely positive for amelogenin. Particularly the matrix of graft bone was slightly positive for EGF. Taken together, it is presumed that the abnormal epithelium on the graft bones was derived from odontogenic epithelial elements, Malassez epithelial rests, distributed at the periodontal tissue of maxillary molars, and that they might undergo dysplastic proliferation affected by the release of growth factors and osteogenic proteins from the graft bones. It is also suggested that the graft bone substitutes inserted for the dental implant possibly have a potential to induce the proliferation of odontogenic epithelial rests leading to the pathogenesis of odontogenic cysts and tumors.
An 18 years old female patient suffered from cerebrovascular occlusive disease, moyamoya disease, showed a huge cyst in her left mandibular body in the radiological observation. The lesion was asymptomatic and found during routine dental check. She had no experience of traumatic injury on her jaw. The cystic lesion was ovoid with irregular scalloping margin and multilobular image, and occupied the whole marrow space of mandibular body with slight expansion of buccal cortical bone. During operation the lesion showed an empty space covered with grayish white fibrous tissue. The luminal fibrous tissue and underlying bony tissue were curettaged and examined pathologically. In the histological observation the lesion was a pseudocyst lined by thick fibrous tissue. Some large vessels underwent atherosclerotic change, exhibiting thickened vessel walls which were partly distorted with hemorrhage and thrombi, and some small capillaries were extremely dilated with hemorrhage and subsequently resulted in perivascular ischemic change with chronic vasculitis. This mandibular cystic lesion was finally diagnosed as simple bone cyst (SBC) associated with moyamoya disease differentially from aneurysmal bone cyst (ABC), traumatic bone cyst (TBC), periapical odontogenic keratocyst, and central giant cell granuloma. Therefore, it was presumed that the thromboembolic and atherosclerotic vessels of moyamoya disease might increase the hemodynamic pressure of mandibular bone marrow tissue and subsequently was able to induce SBC.
Oral galvanism is known to induce chronic irritation on oral mucosa, but the related pathology rarely occurs. A 65 years old male complained of linear horizontal ulcerations on his bilateral buccal mucosa for one month. The oral ulcerations were parallel and approximated to his occlusal plane. He had multiple metallic crowns using gold and nickel cobalt alloy at bilateral upper and lower molar teeth, and also had accustomed to heavy smoking for more than twenty years. Biopsy examination was performed with immunohistochemical staining using antisera of PCNA, D2-40, and PARP. The epithelial ulcer had clear margin and was replaced by granulation tissue containing many dilated lymphatic vessels, which were positive for D2-40, but showed no feature of pseudo-necrotic membrane. Nearby epithelium showed the typical features of leukoedema, characterized by edematous keratinocytes with clear cytoplasms and pyknotic nuclei, low rete ridges, and rough superficial epithelial layer, where PCNA was rarely positive. Some superficial edematous keratinocytes showed perinuclear cytoplasmic vacuolization, and their peripheral nuclear chromatins were positive for PARP. Taken together, the present mucosa ulceration was different from aphthous stomatitis, herpes stomititis, oral lichen planus, etc., thus it was postulated that the galvanic current generated from between the upper and lower dissimilar metal crowns could affect the precedent leukoedema caused by heavy smoking habit and produce the linear horizontal buccal ulceration. Therefore, the present case was diagnosed as galvanic mucositis associated with leukoedema, and it was also hypothesized that the mild and persistent galvanic current was able to deplete the cytoplasmic fluid of leukoedema keratinocytes via the osmotic pressure difference elicited by increased ionic concentration of galvanism, and followed by severe keratinocyte apoptosis and oral mucosa ulceration.
The molecular mechanisms of the carcinogenesis of oral squamous cell carcinomas (OSCCs) are highly variable and result in different features of tumor progression, i.e., local tissue destruction and metastasis to regional lymph nodes. A case of OSCC arising from proliferative verrucous leukoplakia (PVL) was analyzed for its protein expression profile by immunoprecipitation (IP) – high performance liquid chromatography (IP-HPLC) by using 72 antisera and comparing results with those of KB cells. OSCC arising from PVL showed stronger expressions of proteins associated with cell proliferation (MPM2, PCNA, eiF5A, DHS, DOHH), cell survival (pAKT, MDM2, survivin), matrix proteolysis (elaffin), tumor suppression (p16, p21, PTCH1), the WNT/β-catenin pathway (SHH, WNT1, APC, β-catenin, snail), proinflammation (TNFα), angiogenesis (HIF, CMG2, vWF), and cellular protection (HSP-70, FAK, caveolin) and of oncoproteins (STAT3, 14-3-3, K-RAS, PUMA, PIM1) and growth factors (EGFR, bFGF) than KB cells. On the other hand, KB cells showed stronger expressions of proteins associated with apoptosis (caspase-3, caspase-8, caspase-9, PARP, FAS, FASL, TGase-1, BCL2, BAD, BID, BAK, FLIP), matrix proteolysis (MMP-2, MMP-9), transcription signaling (NFkB, p38, E2F-1, HO-1), and tumor suppression (p53, RB1, PTEN) and of oncoproteins (DMBT1, CEA) and growth factor (TGF-β1, c-erbB2, VEGF) than OSCC arising from PVL. These data indicate the cells of OSCC arising from PVL are more resistant and more robust than KB cells. Furthermore, they suggest the oncogenic signalings of OSCC arising from PVL play important roles in the aggressive growth and rapid tumor metastasis to regional lymph nodes
The nasopalatine duct, the most dominant developmental tubule formed by the emergence of premaxilla and both sides of anterior palatal processes. This duct normally disappears in humans but remains latent and provides communication between the oral and nasal cavities in some mammals. However, the duct is obliterated and degenerated before birth in human, thus the persisting or patent nasopalatine duct in postnatal life is considered a developmental anomaly. Two cases of patent nasopalatine duct were presented in this study. Although the ducts were not sectioned longitudinally, they were probably connected each other and contained mucous materials secreted from the associated mucous glands. In the immunohistochemical study the ductal epithelium was consistently positive for the growth-related biomarkers including TGFβ1, c-erbB2, EGFR, CTGF, FGFb, HGF, eiF5A, FAK, and pAKT. And many columnar epithelial cells of the duct were positive for PCNA. Particularly, TNFα was clearly positive in the ductal epithelium together with β-defensin-2, -3 and MMP-3, -9. These findings may imply that the ducts have a growth potential postnatally and also can induce inflammatory reaction. Therefore, it was presumed that the present cases of patent nasopalatine ducts were caused by the latent proliferation of ductal epithelia in the vascular environment of nasopalatine canal without cyst formation, and also suggested that the patent nasopalatine ducts connected with functioning mucous glands were partly open to oral/nasal cavity and should be differentially diagnosed from the nasopalatine duct cyst.
A 78 year-old male complained of mild pain at a gingival mass on his anterior mandible, injured and ulcerated by autobicycle accident six months ago. He had suffered from uncontrolled diabetes. The tumor specimens from his chin and gingiva were examined by immunohistochemical method, and their microsections showed poorly differentiated polygonal tumor cells, occasionally formed ductal structures. The tumor cells grew infiltratively into adjacent fibromuscular tissue with frequent atypical mitosis, exhibiting the features of poorly differentiated adenocarcinoma. However, in the computed tomography(CT) view a tumor mass was also found in his lung, and diagnosed lung cancer. In the immunohistochemical observation the tumor cells were strongly positive for thyroid transcription factor 1(TTF-1), cytokeratin 7, PCNA, p53, and PIM-1, occasionally positive for p63, but sparsely positive for survivin. The tumor cells were almost negative for S-100, cytokeratin 14, and α-SMA, while the vascular structures in the tumor tissue were conspicuously demarcated by the stains of α-SMA. Taken together, the present case was finally diagnosed poorly differentiated adenocarcinoma, metastasized from lung adenocarcinoma. And it was presumed that the metastatic tumor cells tended to be anchored in the traumatized area of anterior mandible, where the wound healing was undergoing with de novo angiogenesis and the activation of different cytokines and growth factors
Oral squamous cell papillomas(OSCPs) showed various features in their etiology, histology, and prognosis. Therefore, it is necessary to diagnose differentially according to their pathological examinations. In the present study total 14 cases of OSCPs were evaluated and characterized to be three types of OSCPs, i.e., papillary papilloma, verrucous papilloma, and inverted papilloma. The present study demonstrated that among 14 cases of OSCPs papillary papilloma (n＝6) showed the typical papillary projection of squamous epithelium with severe acanthosis of upper spinous layer cells, accompanying frequent nuclear vacuolization. And verrucous papilloma (n＝7) showed the diffuse acanthosis of whole spinous layer cells with severe basal hyperplasia, resulted in the thick squamous epithelium exhibiting verrucous surface and irregularly ingrowing rete pegs. One case of inverted papilloma showed the typical ingrowth of basal layer cells deeply into underlying connective tissue, resulted in the formation of multiple fissures on the surface area. The present study also revealed the predominant nuclear vacuolization suspicious for viral infection in papillary papilloma, and also heavy smoking history in the verrucous papilloma. On the other hand, as the epithelium of inverted papilloma ingrew into the underlying deep connective tissue up to the muscular layer, it is supposed that the inverted papilloma has a potential of basal layer proliferation strong enough to invade the protecting barrier of underlying connective tissue, or that the underlying connective tissue was too weak to prevent the ingrowth of basal layer epithelium. Taken together, because the OSCPs show heterogenous origins and variable pathological prognosis, it is suggested that the OSCPs should be differentially diagnosed at least into three types, i.e., papillary papilloma, verrucous papilloma, and inverted papilloma.
목 적: 본 연구는 한국인의 백내장과 녹내장의 유병률에 대해 알아 보고자 하였다. 방 법: 백내장과 녹내장의 유병률은 2007년도 국민건강영양조사 자료에서 30세 이상의 2,643명(남성: 1,101명, 여성: 1,543명)을 대상으로 하였다. 본 연구는 서베이분석법인 PROC SURVEYFREQ를 사용하여 사회경제적 위험요인과의 관계에 따른 유병률의 변화를 보았다. 모든 통계분석은 SAS 9.2 통계패키지를 사용하였으며, 유의성 검정은 0.05 이하로 하였다. 결 과: 2007년도 한국인은 3.0%(남성 9.8%, 여성 4.6%)가 백내장을 가지고 있었고, 7.8%(남성 5.7%, 여성 9.8%)가 백내장을 앓은 경험이 있었다. 녹내장 유병률과 경험률은 각각 0.2% (남성 0.4%, 여성 0.2%)와 0.5% (남성: 0.5%, 여성 0.4%)이었다. 65세 이상 남성 노인에서, 백내장 경험률 및 유병률은 19.9%와 4.1%이었으며, 여성에서는 38.3%와 17.2% 이었다. 그러나 30-64세 사이의 젊은 사람들에게 백내장 경험과 유병률이 남성에서 3.4%와 0.8%이었으며, 여성에서 1.6%와 3.0%이었다. 65세 이상 노인에서, 녹내장 경험률과 유병률은 남성에서 1.6%와 1.1%이었으며, 여성에서는 1.6%와 0.8%이었다. 젊은 사람들에게서 녹내장의 경험률과 유병률은 남성에서 0.3%와 0.1%이었으며, 여성에서는 모두 0.1% 이었다. 또한, 교육수준이나 소득이 낮은 경우, 비경제인구이거나 실업자의 경우 백내장과 녹내장의 유병률과 경험률이 높았다. 결 론: 30세 이상의 한국인에서 백내장의 유병률은 3.0%, 녹내장의 유병률은 0.2%였다. 본 연구결과는 한국인에서 안보건과 안질환의 적절한 건강관리 정책을 만드는데 있어 중요한 결과라고 할 수 있다.
Oral lichen planus (OLP) is an atypically keratinized and ulcerative lesion, producing severe pain and discomforts in the involved patients. Nevertheless, the etiological factor or the pathogenetic mechanism has not been clearly elucidated. In the present study, the different gene expressions were screened in 21 cases of OLP by immunohistochemical (IHC) array method using 80 antibodies, and found that the pathway of E-cadherin/β-catenin was abnormally expressed compared to the other essential genetic pathways. Particularly, the expressions of eIF5A, DHS, and DOHH, which are the biomarkers of protein translation, were remarkably reduced, nevertheless the expression of β-catenin was strongly positive in the 7 cases among 21 cases of OLP. The other expressions of p53, BCL-2, MDM-2, PAKT, BAX, BAK, BAD, NFkB, HO-1, etc, were usually weak or sparse, while the expressions of PCNA, CDK4, and HSP-70 were markedly increased. Taken together, it is presumed that the overexpression of β-catenin indicates the derangement of E-cad/β-catenin/NFkB pathway, causing the transcription of cellular proliferating genes in downstream events, i.e., PCNA and CDK4, and that it may be eventually relevant to the malignant potential of OLP epithelial cells. It is also suggested that the activation of β-catenin/TCF/LEF1 pathway be closely relevant to the immunological reaction of OLP with the accumulation of T-cells underneath the mucosal epithelium.
Human pituitary tumor transforming gene 1 (PTTG1), which is a newly identified proto-oncogene, is highly expressed in normal pituitary tissues containing proliferating cells and in several cancers. Also, PTTG1 has been known as a securin to involve in the regulation of c ell-cycle and in t he p rogression o f tumor. B u t the effect o f PTTG1 in o ral squamous cell carcinoma (oral SCC) h as not b een studied yet. The objective of this study is to analyze the expression of PTTG1 in oral SCC cell lines (YD-10B and YD-15) and to evaluate the effect of PTTG1 on oral SCC cell lines for the migration effect by PTTG1 siRNA treatment. Western blot, migration assay, and zymography were performed to evaluate the effects of PTTG1 on the expression of MMP-2/-9 and migration activity after PTTG1 siRNA treatment. PTTG1 was expressed in oral SCC cells lines, otherwise, significantly decreased after PTTG1 siRNA treatment. There is no difference in expression of MMP-2 regardless of PTTG1 siRNA treatment. However, the enzyme activity of MMP-9 was significantly decreased. In addition, the migration activities of oral SCC cells were significantly decreased after PTTG1 siRNA treatment (p<0.001). These results suggested that the down-regulated PTTG1 could inhibit the migration of human oral SCC cells through the low MMP-9 expressions. Therefore, these findings provide a useful guideline for the migration mechanism of oral SCC depend on PTTG1 expression.
The present case occurred in the cervical area of 51 years old male, who was generally healthy but recently complained of cervical swelling with mild pain. The tumor recently grew rapidly for 5 months. He was referred from local hospital in the diagnosis of metastatic tumor in cervical lymph. In the biopsy procedure, the tumor mass was ill-defined and not associated with cervical lymph node. The microsection showed a highly proliferative fibrous tissue infiltrative growth into the periphery. The spindle tumor cells were stained red in Masson trichrome stain, and strongly positive for PCNA and β-catenine, and partly positive for α-smooth muscle actin (α-SMA), but negative for S-100 and desmin. The differential diagnosis in primary biopsy examination was made as leiomyosarcoma, malignant schwannoma, and mesenchymal sarcoma. Under the diagnosis of sarcoma the patient was operated for tumor resection including cervical lymph nodes. The tumor mass was tightly attached on the lower border of left mandibular body. After the surgical operation the tumor tissue was more investigated with further immunohistochemical stainings, and discussed with several pathologists in Gangneung area. Finally the tumor was turned out to be a nodular fasciitis with pseudosarcomatous proliferation, and also confirmed that the pseudosarcomatous spindle cells belonged to the myofibroblasts originated from the fibrovascular fascial tissue. The present study demonstrated a rare case of nodular fasciitis, which should be differentially diagnosed from the malignant head and neck tumors.
A 37 years old male patient had suffered from fibrous nasal polyp for more than 10 years even though careful medical treatment, and recently aggravated with severe nasal stiffness and pain. In the radiological observation the lesion was continuously extended into the ipsilateral maxillary sinus by poly cystic radiopacities gradually destroying the anterior wall of antrum. During the Caldwell-Luc operation a cystic fibrous granulomatous tissue was removed, and its microsections showed multicystic and tunnel-like spaces, of which lumens were usually round and filled with parts of parasitic worm e xhibiting parasitic t eguments and eggs. The granulomatous l esion showed relatively mild inflammatory reaction with the infiltration of eosinophilic PMNs. The histological features of tunnel-like penetration of parasitic worms, and their teguments and eggs were competent with the diagnosis of sparganosis. Especially, although the patient had no experience of raw foods such as frog or snake, he used to drink the untreated natural stream water obtained in the mountain area of Gangwon prefecture in Korea. Therefore, the present study demonstrated a rare lesion of antral spanganosis, and we suppose that the frequent incident of oral sparganosis in Gangwon prefecture is possibly related to the usage of untreated stream water in the mountain area of Gangwon prefecture in Korea
Krox-25, a Kruppel type zinc finger protein, may play an important role for the morphogenesis of tooth in ectomesenchymal interaction between enamel epithelium and odontogenic mesenchyme. The interrupted expression of Krox-25 by antisense inhibition is supposed to affect the abnormal development of tooth germ similar to the deranged proliferation of odontogenic tumors. This study was performed to know the histomorphogenetic effect of Krox-25 antisense inhibition in tooth germs of mouse embryos and to understand the abnormal expressions of Krox-25 in different odontogenic tumors which proliferate in aberrant direction of ecto-mesenchymal interaction. Total 95 tooth germs obtained from pregnant mice in the 13th day of fertilization were cultured with antisense oligonucleotides targeting mouse Krox-25 gene, and their histological patterns were compared with those of different odontogenic tumors, i.e., ameloblastic fibro-odontoma (n=5), ameloblastoma (n=8), and ameloblastic carcinoma (n=2). Resultantly, the cultured tooth germs treated with antisense oligodeoxynucleotides produced primitive dentine and enamel by odontoblasts and ameloblasts, respectively, but they aberrantly grew and formed abnormal tooth organs. Especially, the harmonious growth of enamel and dentine formation was greatly deranged by the antisense inhibition in the organ culture system. These findings were much similar to the abnormal growth of odontogenic tumors. The relatively well differentiated enamel epithelium of ameloblastic fibro-odontoma showed irregularly strong reaction of Krox-25, while the poorly differentiated enamel epithelium of ameloblastic carcinoma showed weak reaction. These data suggest that Krox-25 may play important roles for the histomorphogenesis of tooth germ by signaling the ecto-mesenchymal interaction between odontoblasts and ameloblasts in normal tooth germ development of mouse embryos as well as in cytodifferentiation of odontogenic tumors.