Mucosa-associated lymphoid tissue (MALT) lymphoma (ML) is a type of non-Hodgkin’s lymphoma involving MALT, commonly the stomach or salivary glands, although virtually any mucosal site can be affected. ML originates from B cells in the marginal zone of MALT, and is also called extranodal marginal zone B cell lymphoma. It is a slow-growing cancer that usually responds well to treatment. A 59-year-old female presented with a 1-day history of quadriparesis and dysarthria. Up arrival at the hospital, motor power in the right upper and lower extremities was grade 3/5 according to the Medical Research Council scale, while that in the left leg was 4/5. The patient had been diagnosed with gastric ML 1 year prior, and had received antibiotics during the previous 2 weeks. The emergency magnetic resonance imaging of the brain performed at the time of presentation showed multifocal embolic infarction in the cerebral hemisphere bilaterally, which did not have a cardiac origin. Magnetic resonance angiography revealed no stenotic or occlusive lesions. Secondary prophylaxis with daily administration of 300 mg aspirin was prescribed. The patient was discharged with residual right hemiparesis 2 weeks after the onset of symptoms. Herein, we present a rare case of multifocal cerebral infarction in a gastric ML patient.

Cellular myxoma is an uncommon type of myxoid benign tumor, predominantly occurring in adult female patients aged >40 years. This report aims to document a case of cellular myxoma that occurred in the buccal mucosa. Compared to intramuscular myxomas, cellular myxoma demonstrates hypercellularity and vascularity. Its manifestation in the soft tissue of the head and neck area is exceptionally rare. Generally, cellular myxoma manifests as a firm and immovable mass covered with normal oral mucosa, with no associated clinical symptoms. Homogenous low signal intensity on T1-weighted scans and high-signal intensity on T2-weighted magnetic resonance scans reveal cellular myxoma, as most lesions show well-defined margins and heterogeneous contrast enhancement. The significant histologic features include a focal or diffuse increase in cellularity with fibroblast-like cells and vascularity with an abundant collagenous matrix. Our presented case reflects these facts examinations, based on which a final diagnosis of cellular myxoma was made. Immunohistochemistry revealed locally and diffusely positive SMA and CD34. The clinical tendency of cellular myxoma with hypercellularity may affect the production of myxoid and collagenous substrates, and if complete resection is not performed, the possibility of local recurrence in the primarily affected region remains. Hence, complete surgical excision was performed under general anesthesia, and follow-up until a year after treatment revealed no observed recurrence. To achieve precise diagnosis and complete treatment without local recurrence, several diagnostic examinations should be considered.

It is well documented that giant cells can be observed in some types of odontogenic tumors such as central odontogenic tumor and dentinogenic ghost cell tumor. However, the presence of stromal giant cells has only rarely been reported in ameloblastoma, although being the most common epithelial odontogenic tumor. In this study, we present a novel case of peripheral ameloblastoma associated with peripheral giant cell granuloma arising in the mandibular alveolar mucosa of a 65-year-old male patient. The possible pathogenesis of this combined lesion will be discussed, in addition to the review of previous reports of ameloblastoma accompanied by stromal giant cells.

Extranodal intraoral Hodgkin lymphoma is not common. We report the case of a 78-year-old male patient with ulcer of the mandibular oral mucosa that was not cured for about 3 weeks. In biopsy and histopathologic examination, it was found to be extranodal intraoral Hodgkin lymphoma. Early diagnosis of oral lesions led to early detection of lesions of the opposite neck lymph node in an additional PET-CT scan. We report this case and review relevant literature.

Oral adenosquamous carcinoma (ASC) is a rare and aggressive type of squamous cell carcinoma (SCC). It is characterized by a squamous component originating at the mucosa and a deep glandular component. ASC may be misdiagnosed as SCC by superficial incisional biopsy including only the squamous component. ASC has a worse prognosis than general variants of SCC, so accurate diagnosis is essential for patient survival. We present a case report of a large ASC arising in the buccal mucosa, first mistaken as general SCC.

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.

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.

Dermoid and epidermoid cysts in the oral cavity are uncommon and account for less than 0.01% of all oral cysts. The large majority of cases arise in the floor of the mouth and there are rare in other sites. We would like to report an unusual case of epidermoid cyst at the buccal mucosa in a 66-year-old male with a review of literature.

Soy and fermented soy are popular and recognized as a health food among Koreans. Since soy proteins are known to be protease resistant, even to pepsin and pancreatin, it is hypothesized that soy proteins may interact with the intestinal tract and trigger certain physiological reactions. To test this hypothesis, mice were fed diets supplemented with soy, Chunkukjang, or casein. The differentially expressed proteins were analyzed using 2-D gels and identified by peptide mass fingerprinting using mass spectrometry. The majority of the differentially expressed proteins could be functionally grouped into metabolic enzymes and calcium-binding proteins. The differential protein expression by the soy-fed groups was also verified based on a representative protein, tropomyosin, using a Western blotting analysis. In addition, the soy-fed groups exhibited a taller villi structure. Therefore, this study suggests that soy proteins can be an effective nutrient and physiological stimulant for the intestines.

Oral squamous cell carcinoma (OSCC) develops through multistep process, that is, from normal mucosa to hyperplastic area and progressed to dysplasia, carcinoma in situ, and finally to invasive carcinoma. The purpose of this study is to investigate the histological types of the transitional area from normal oral mucosa to invasive carcinoma for the baseline data to search intermediate end point markers for early detection of OSCC. For this purpose, we reviewed the 85 patients who were diagnosed as OSCC in the Department of Oral Pathology, Yonsei University College of Dentistry, from 2002 to 2008. We classified these histopathologic findings by light-microscopy, according to the histologic pattern of transitional areas. As results, stepwise transformation from normal oral mucosa, to dysplasia and to OSCC was shown in 47 patients. Intermittent lesions were seen in 16 patients, in which normal oral mucosa, dysplasia, and OSCC were alternately arranged. Twenty two patients showed abruptly transformed to OSCC from normal oral mucosa. These preliminary data will be used for searching biomarkers for early detection of OSCC.

The sublingual locus has recently received great attention as a delivery site for various immunotherapies, including those that induce allergen-specific tolerance, and for vaccines that generate protective immunity. To further understand the immune functions of the human sublingual mucosa, we characterized the distribution of various immunocytes therein by immunohistochemistry. We identified professional antigen presenting cells (APCs), including Langerhans cells (LCs) and macrophages. CD1α+ and longerin+ LCs were further found to be distributed in the basal and supra-basal layers of the epithelium, and macrophages were identified in the lamina propria. HLA-DR+ cells were observed in both the epithelium and the lamina propria, which mirrors the tissue distribution of LCs and macrophages within these tissues. CD3+, CD4+, and CD8+ T cells were found to be distributed along the basal layer of the epithelium and also in the lamina propria. Although B cells, plasma cells, and Foxp3+ regulatory T cells (Tregs) were only occasionally observed in the human sublingual mucosa in the absence of inflammation, they did show enrichment at inflammatory sites. Hence, we have further elucidated the immune cell component distribution in human sublingual mucosa.

Traumatic eosinoph ilic gra nul oma(TEG) of the oral mucosa is considered to be a reactive benign lesion, which commonly ma nifests as an ulcer with eleva ted and indurated borders Clinically. this lesion simulates a maligna nt tumor Hi s to logy shows a diffut;e‘ dense. polymorphic. and eosinophil-rich cellular infiltrate. which extends deeply into the un derl ying soft ti ss ues‘ A major constituent of infïltrates is a population of mitotically active, large. atypical monol1 uclear cell s . Immunohi stologic eval uation of the large atypical cells has suggested a myofibroblastic 0 1' histi ocyti c origi 1γ However ‘ recent reports have shown that these cells are positive for CD30 antigen. We have descr ibed a case of ora l mucosal lesions with featu res of TEG that had a CD68 posite atypical cells. The large cells showed s trong pos itive for CD68‘ but negative for CD30. The sma ll Iymphocy tic cells exprerssed CD3. This case was interpreted as an atypical histiocytic g ran uloma .

Oral mucosa is made of stra tifi ed oral epithelium(that forms the surface) and subjacent connective tissues Alt hough oral mucosa lines the oral cavity, and thus provides a barrier between external and inte1'na l(tissue) envi1'onment, it exp1'esses regional va1'ia tions in its clinical appearance based on its structu1'e(ker atini zation/ non- ke1'atini zation; nature of connective tissues ; vascul arity, etc.) . The structu1'e of or al mucosa a lso reflects its flln ctional adapta ti on. Available liter ature indicates t hat oral mucosa may be viewed as masticat ory, lining 0 1' specialized types, aJl of which remains continuously moist and unexposed to light. Oral mucosa, however, is subj ected to daily wear and tear due t o the natllre of food , environmental chernicals , t oxins and met abolites. Hence, an understanding of the biological behavior of its constituents cells and ext1'acellular matrice s , tha t• are in constant s tate of adapt ive changes, is usefll l. Oral epithelium is a multi - Iayered and multi - functional dynarnic system that separates the o1'al environment f1'om the va1'ied nature of the s llbj acent connective tlsslles The connective tissue is eithe1' loose or dense collagen ous, muscula r or osseous, and may contain glands. Thus,oral epithelia play a critical 1'ole in the mainten ance of homeost atic effi ciency of the environment of both the o1'al cavi ty and subj acent connective tisslles. The structure and fllncti ons of the oral epithelial cells are regulated by a complex interplay between genetic and environmental fa cto1's, the knowl edge of which is unfolding only recently. The fundamental prernise on whi ch 3-dimensional organization of oral epithelial integrity and st a bility are maintained is the principl e of st eady-state syst em. The basic featU1'e of the steady- st ate syst em is t he 1'egulation of cellula1' and t issue homeost atic mechanisms. Since during its ontogeny, oral epithelial cells are subj ect ed to daily wear and tear , resulting from external mechanical and chernical facto1's, a 1'eservoi1' of cells, with regene1'ative capacity(va1'iously labeled in lite1'ature as p1'ecurso1' ceJls, p1'ogeni tor cells OI‘ stem cell s) that can maintain the steady-state system of oral epi thelia, are 1'equired. Such a reservoir of cells are located in the basal layer of oral epithelia. These cells proliferates, differentiate into ker atinocyt es, and are lost through desquamation or a poptosis to maintain the steady-state syst em and thus equilibrium of tissue homeostasis

This study was carried out to evaluate the irritant potential of P-toothpaste in hamster cheek pouch. The test materials were applied once at the beginning of this study into right pouches of hamsters and maintained for 14 days. Animals were administered with P-toothpaste, Bamboo salt toothpaste, D.W. and control solution, respectively. In order to evaluate the irritant potential in mucosa of hamster cheek pouch, we observed clinical signs, mortality, body weights and gross and histopathological findings for 14 days. In all groups, there were neither dead animals nor significant changes of body weights. In addition, there were no differences between D.W. and Ptoothpaste treated group in gross and histopathological findings. Therefore, these results suggest that there was little irritant potential of P-toothpaste in hamster cheek pouch.