Fibroepithelial Hyperplasia Research Articles

Localized juvenile spongiotic gingival hyperplasia possibly originates from the junctional gingival epithelium-an immunohistochemical study.

To immunohistochemically evaluate the cytokeratin (CK) pattern of expression in localized juvenile spongiotic gingival hyperplasia (LJSGH) as compared with the gingival epithelium (GE). Ten cases of LJSGH were semiquantitatively evaluated for the immunohistochemical pattern of CK1/10, CK4, CK8/18, and CK19. GE controls were taken from 10 cases of reactive gingival fibroepithelial hyperplasia. GEs showed mean positivity rates of 80% for both CK1/10 and CK4, and 5% for both CK8/18 and CK19. LJSGHs showed mean positivity rates of 65% for CK19, 60% for CK8/18, 30% for CK4, and 5% for CK1/10. The differences between LJSGHs and GEs were statistically significant (P<0.01). The LJSGH pattern of CK expression is reminiscent of the profile described in the literature for the junctional epithelium (JE). Possibly, JE exteriorized from the gingival sulcus would be more prone to irritation from a variety of sources, resulting in inflammation and hyperplasia, with the subsequent development of LJSGH.

Osteopontin expression in reactive lesions of gingiva.

Reactive proliferations of the gingiva comprise lesions such as pyogenic granuloma (PG), inflammatory fibroepithelial hyperplasia (IFH), peripheral ossifying fibroma (POF), and peripheral giant cell lesion. Osteopontin (OPN) has a dual role, it promotes mineralization when it is bound to solid substrate, and on the other hand, it inhibits mineralization when it is seen in association with solution.Objectives The study aimed to evaluate the expression of osteopontin in normal gingival tissue and different types of focal reactive proliferations of gingival tissue, and its role in the development of calcification within it.Material and Methods The presence and distribution of osteopontin was assessed using immunohistochemistry in five cases of normal gingival tissue and 30 cases of focal reactive proliferations of gingiva.Results There was no expression of osteopontin in normal subjects. Few cases of pyogenic granuloma, inflammatory fibroepithelial hyperplasia, and all the cases of peripheral ossifying fibroma showed positivity for osteopontin in the inflammatory cells, stromal cells, extracellular matrix, and in the calcifications.Conclusion The expression of osteopontin in all the cases of peripheral ossifying fibroma speculates that the majority of the cases of peripheral ossifying fibroma originate from the periodontal ligament cells. The treatment modalities for peripheral ossifying fibroma should differ from other focal reactive proliferations of gingiva.

Oral soft tissue biopsies in Oporto, Portugal: An eight year retrospective analysis.

Background The diseases that affect the oral cavity are wide and diverse, comprising a broad spectrum of either benign or malignant lesions. However, few histological-based studies were performed for the evaluation of oral cavity lesions, and very few directed to oral soft tissue pathology. The aim of this study was to carry out pioneering research, within a Portuguese population, to determine the frequency and characteristics of oral malignancies, potential malignant disorders, and soft benign tissues pathologies submitted for biopsy in a north Portugal (Oporto) hospital population. Material and Methods We performed a retrospective study of soft tissue, oral cavity biopsies, in a hospital north of Portugal (Oporto) between 1999 and 2006. We analysed information on gender, age, location of the lesion, and the histopathological diagnosis. Results A total of 1042 oral biopsies were observed, 557(53.5%) in females and 485 (46.5%) in males, with a mean age of 51.7 years (S.D. ±17.6). The topographic location most frequently affected was labial mucosa (n=306). Considering the nature of the lesions, 700 (67.2%) corresponded to non-neoplasic lesions, 45 (4.3%) to potentially malignant disorders, and 297 (28.5%) to neoplasms (93 benign and 204 malignant). Non-neoplasic lesions were more prevalent in female gender (59.9%) when compared with potentially malignant disorders (46.7%) and neoplasms (39.4%) (P< 0.001). Non-neoplasic lesions presented the lower mean age (49.2±17.6) and potentially malignant disorders the highest mean age (60.5±14.5) (P< 0.001). The most common lesion of entire sample was fibro-epithelial hyperplasia (n=186; 17.9%), followed by squamous cell carcinoma (n=158; 15.1%). Conclusions Fibro-epithelial hyperplasia, followed by squamous cell carcinoma, was the most common pathologies. This pioneering study provided, for the first time, data about the proportion of squamous cell carcinoma when compared with benign conditions in a Portuguese hospital population. Key words:Oral biopsies, oral cavity, oral pathology, Portugal, soft tissue lesions.

Oral mucosal lesions: a retrospective review of one institution's 13-year experience.

To investigate the relative frequency of biopsied nonneoplastic oral mucosal lesions in Ankara, Turkey. Biopsy records of a single center from 2000-2012 were retrospectively collected. Diagnosis was recorded and evaluated with respect to patient demographics (age, sex) and location of the lesion. Of 11,980 biopsies, 1732 (14.5%) were mucosal nonneoplastic lesions. Hyperplastic lesions (n= 1000, 57.7%) with fibroepithelial hyperplasia in 30.9% of patients were the most common type of oral nonneoplastic lesions. The mean age of patients differed with respect to type of mucosal lesion, tending to be lower in patients with reactive lesions. Dermatoses showed a female predominance. Our ,findings revealed that hyperplastic lesions were the most common among nonneoplastic oral mucosa lesions. Geographic and ethnic.differences of patients with various types of oral mucosal lesions require further investigation.

Atypical fibroepithelial hyperplasia of the teats in a Sphynx cat: a case report

This study was conducted on a three-year-old Sphynx breed female cat which was brought to the clinic for masses on the teats. The medical history showed that these masses had developed slowly within the period of six months to one year. Following the clinical examination, these masses were removed via surgery. They were between 0.6 cm and 1.5 cm in diameter. Ulcer areas 2 mm to 5 mm in size were observed over the skin. Their sectional surface was uniformly grayish in colour. Histopathological examination of the masses revealed that the cells originated from the glandular duct and had given rise to hyperplasia; connective tissue was densely attached to the masses. Moreover, inflammatory changes and areas of ulceration were observed. Immunohistochemical analysis showed that the cells surrounding the epithelial hyperplasia were vimentin-positive and the proliferative activity of epithelial cells was measured to be 50% by analysis of proliferating cell nuclear antigen (PCNA). Based on clinical, histological and immunohistochemical findings, it was found the masses were diagnosed as atypical fibroepithelial hyperplasia. This case is the first to present a fibroepithelial hyperplasia in the teats of a cat. &amp;nbsp; &amp;nbsp;

Cowden's Syndrome Diagnosis Based on Oral Manifestations

Cowden's syndrome is a rare autosomal-dominant condition characterized by the presence of multiple mucocutaneous hamartomas, gastrointestinal polyps, and breast neoplasms. This report describes a case in which oral lesions were responsible for the diagnosis. Woman, 34, had a history of benign nodules of the thyroid and breast and came for an evaluation of her oral lesions. Cutaneous examination revealed papules in the nasal region, verrucous growths in the axillary region, and palmoplantar keratosis. Intraoral examination showed several papules in the gingiva and tongue. Histological analysis of the oral lesions was compatible with fibroepithelial hyperplasias. The diagnosis of Cowden's syndrome was reached after analyzing the intraoral findings, cutaneous involvement and previous medical history. This case highlights the importance of the stomatologist in diagnosing this syndrome, which is characterized by a high prevalence of malignant tumors, requiring routine follow-up examinations of the affected patients.

Giant cell fibroma-an unusual case presentation with review and treatment using diode laser

Fibroepithelial hyperplasias of the oral cavity are a variety of lesions that exhibit different clinical and Histologic presentations and types causing diagnostic confusion despite their relatively trivial nature. While stressing upon the importance of histological examination in such cases, A case of large giant cell fibroma presenting over the maxillary gingiva in a 33 years male patient is presented. The lesion is excised using diaod laser and no recurrence is noted over a period of 12 months. The importance of histological examination in such cases is stressed upon.

Immunohistochemical Study of Integrin α5β1, Fibronectin, and Bcl-2 in Normal Oral Mucosa, Inflammatory Fibroepithelial Hyperplasia, Oral Epithelial Dysplasia, and Oral Squamous Cell Carcinoma

The objective of this study was to compare the immunoexpression of integrin α₅β₁, fibronectin, and the Bcl-2 protein in normal oral mucosa (NOM), inflammatory fibroepithelial hyperplasia (IFH), oral epithelial dysplasia (OED), and oral squamous cell carcinoma (OSCC). Eleven cases of NOM, 16 IFH, 20 OED, and 27 OSCC were selected for analysis of the immunoexpression of integrin α₅β₁, fibronectin, and bcl-2 protein. There was an association between the intensity and location of the integrin α₅β₁ expression, especially in the OSCC, that 48.1% of cases showed weak immunoreactivity and 40.7% in the suprabasal layer (P < 0.05). There was an association between the pattern and distribution of fibronectin expression in basement membrane, where 90% of NOM showed a pattern of linear continuous and 80% of OED exhibited focal distribution (P < 0.05). The fibronectin expression in connective tissue was predominantly intense with an association of staining pattern among the different specimens, where 37% of OSCC showed a reticular pattern (P < 0.05). There was an association of bcl-2 protein among the types of specimens, especially in IFH and OSCC, where 100% of the cases exhibited scores 1 of staining (P < 0.05). Within this context, the interaction of integrin α₅β₁ with its main ligand in the extracellular matrix, fibronectin, is suggested to influence the survival of tumor cells and to favor their proliferation by modulating apoptosis through the upregulation of antiapoptotic proteins or the suppression of apoptotic mediators.

Abstract 2979: Wolf-Hirschhorn syndrome candidate 1 plays an important role in the pathogenesis of head and neck cancer.

Abstract Wolf-Hirschhorn syndrome candidate 1 (WHSC1) is a histone lysine methyltransferase (HMT) which was initially found to be deregulated in a subset of multiple myeloma cells with the t(4;14) (p16;q32) translocation and poor prognosis. Recently, our group as well as others found that WHSC1 was overexpressed in a variety of tumors, including lung and esophageal squamous cell carcinomas, with low or no expression in normal tissues except the testis. Long-term survival of patients with squamous cell carcinoma of the head and neck (SCCHN) remains poor and thus new therapeutic strategies are urgently needed. Epigenetic alterations have mainly been studied as a potential mechanism of progression from dysplasia to squamous cell carcinoma. Given the promising potential of HMTs as novel drug targets and the aforementioned interesting expression patterns, we further investigated the role of WHSC1 in carcinogenesis through immunohistochemical analysis (IHC) using tissue microarrays of 123 locoregionally advanced SCCHN patients, and 6 samples of fibroepithelial hyperplasia lesions obtained from oral biopsies. We classified its expression levels with a scoring scale of 0 (no expression), +1 (mild), +2 (moderate) or +3 (strong). WHSC1 expression in the nucleus and cytoplasm was moderate (score +2, 37%) or strong (score +3, 38%) in 75% of SCCHN samples, while 25% showed mild (score +1, 24%) or no (score 0, 1%) expression. WHSC1 staining of normal epithelial regions revealed an exclusively nuclear expression pattern in the basal and parabasal layers. This is consistent with reports suggesting a physiologic role of the Wnt-pathway, which was recently found to be induced by WHSC1, in the differentiation process of the squamous epithelium. We also performed Western blot analysis of WHSC1 in 8 SCCHN cells lines, 3 control fibroblast cell lines and 1 keratinocyte cell line. We observed moderate to strong overexpression of WHSC1 in 4 of 8 SCCHN cell lines, while no expression was detected in the normal keratinocytes or the fibroblast cell lines. These findings support a potential role of the WHSC1 pathway in the pathogenesis of SCCHN and provides a new therapeutic avenue for drug discovery in this fatal disease. Citation Format: Vassiliki Saloura, Hyun-Soo Cho, Mark Lingen, Terri Li, Can Gong, Seiwert Tanguy, Ezra Cohen, Ryuji Hamamoto, Yusuke Nakamura. Wolf-Hirschhorn syndrome candidate 1 plays an important role in the pathogenesis of head and neck cancer. [abstract]. In: Proceedings of the 104th Annual Meeting of the American Association for Cancer Research; 2013 Apr 6-10; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2013;73(8 Suppl):Abstract nr 2979. doi:10.1158/1538-7445.AM2013-2979

LEVANTAMENTO EPIDEMIOLÓGICO DOS DIAGNÓSTICOS HISTOPATOLÓGICOS DE UM CENTRO DE REFERÊNCIA EM PATOLOGIA BUCOMAXILOFACIAL EM UM PERÍODO DE 10 ANOS

The Epidemiological investigation of the diseases affecting the maxillofacial structures is of fundamental importance to the dental clinic. However, few studies on this subject have been published in the literature, despite its relevance to the viability of health programs. In this context, the objective of this work was to assess the frequency and the main types of diseases that are commonly biopsied and sent to the Pathology Department, School of Dentistry from EBMSP. By conducting a retrospective study covering the data collected during the years 2001 to 2010, 1.095 biopsies were evaluated. Considering the histopathological diagnosis of each case, it was also evaluated the frequency of pathological lesions, the overall distribution of the samples by sex and age, lesion location, and clinical and histopathological diagnosis. The most frequent diagnoses were fibroepithelial hyperplasia (16.62%), nonspecific chronic inflammation (6.30%) and radicular cyst / residual (4.87%). The importance of searching for the correct diagnosis of the pathology presented by the patient is so relevant as the choice of methods and techniques to be used in their elimination or control. It is clear that a better and more accurate diagnosis contributes to a well developed treatment.

Gingival overgrowth in partially edentulous ridges in an elderly female patient with epilepsy: a case report

Drug-influenced gingival overgrowth is an unaesthetic overgrowth of gingiva principally associated with intake of drugs like phenytoin, cyclosporin A and nifedipine. Its occurrence in both dentate and edentulous regions of oral cavity is poorly understood. This report highlights clinical and histological description, aetiology and management of gingival overgrowth in a partially edentulous (non-denture wearer) 60-year-old female patient with epilepsy on phenytoin and phenobarbital drugs from past 7 years. Patient's intraoral examination revealed lobulated and fibrotic consistency gingival overgrowth around teeth and on partially edentulous ridges of upper and lower arches along with generalised tooth mobility. Under medical consultation, full mouth extraction, surgical excision of overgrowth followed by complete denture rehabilitation and replacement of combination drugs with sodium valproate were accomplished. Histologically, the lesion showed fibro-epithelial hyperplasia. Clinical results after 6 months demonstrated almost complete resolution of gingival overgrowth. The findings of present case suggest that gingival overgrowth can occur even in partially edentulous ridges (not exposed to denture wear) that could be due to persistence of gingival overgrowth, which may not resolve completely following tooth extraction or occurs because of incorporation of specific subpopulation of gingival fibroblasts in alveolar ridge mucosa.

Fibroepithelial hyperplasia in an entire male cat: cytologic and histopathological features

Fibroepithelial hyperplasia in an entire male cat: cytologic and histopathological features -

Betel‐derived alkaloid up‐regulates keratinocyte alphavbeta6 integrin expression and promotes oral submucous fibrosis

Oral submucous fibrosis (OSF) is a premalignant, fibrosing disorder of the mouth, pharynx, and oesophagus, with a malignant transformation rate of 7-13%. OSF is strongly associated with areca (betel) nut chewing and worldwide, over 5 million people are affected. As αvβ6 integrin is capable of promoting both tissue fibrosis and carcinoma invasion, we examined its expression in fibroepithelial hyperplasia and OSF. αvβ6 was markedly up-regulated in OSF, with high expression detected in 22 of 41 cases (p < 0.001). We investigated the functional role of αvβ6 using oral keratinocyte-derived cells genetically modified to express high αvβ6 (VB6), and also NTERT-immortalized oral keratinocytes, which express low αvβ6 (OKF6/TERT-1). VB6 cells showed significant αvβ6-dependent activation of TGF-β1, which induced transdifferentiation of oral fibroblasts into myofibroblasts and resulted in up-regulation of genes associated with tissue fibrosis. These experimental in vitro findings were confirmed using human clinical samples, where we showed that the stroma of OSF contained myofibroblasts and that TGF-β1-dependent Smad signalling was detectable both in keratinocytes and in myofibroblasts. We also found that arecoline, the major alkaloid of areca nuts, up-regulated keratinocyte αvβ6 expression. This was modulated through the M(4) muscarinic acetylcholine receptor and was suppressed by the M(4) antagonist, tropicamide. Arecoline-dependent αvβ6 up-regulation promoted keratinocyte migration and induced invasion, raising the possibility that this mechanism may support malignant transformation. Over 80% of OSF-related oral cancers examined had moderate/high αvβ6 expression. These data suggest that the pathogenesis of OSF may be epithelial-driven and involve arecoline-dependent up-regulation of αvβ6 integrin.

Bone morphogenetic protein-2/4 and bone morphogenetic protein receptor type IA expression in metastatic and nonmetastatic oral squamous cell carcinoma

Purpose The study aimed to analyze the expression of bone morphogenetic protein-2/4 (BMP-2/4) and its receptor BMPR-IA (BMP receptor type IA) in metastatic and nonmetastatic oral squamous cell carcinoma (OSCC) and its implications for disease prognosis. Materials and methods The experimental group included 16 cases of OSCC without metastasis and 7 cases of OSCC with metastasis. The presence or absence of nodal metastasis was used as a parameter for the evaluation of disease prognosis. Ten cases of oral fibroepithelial hyperplasia were selected as the control group. The expression of BMP-2/4 and BMPR-IA was analyzed by immunohistochemistry. Results In the experimental group with metastasis, strong expression of BMP-2/4 was observed in most cases (71.4%), whereas BMPR-IA exhibited weak expression (85.7%). In the experimental group without metastasis, there was strong expression of BMP-2/4 (62.5%) and BMPR-IA (100%). A significant association was observed between the prognosis of OSCC and the intensity of BMP-2/4 staining ( P = .002). Weak immunoreactivity to BMP-2/4 and BMPR-IA was observed in all control specimens. Conclusions The results suggest that strong expression of BMP-2/4, associated with low expression of BMPR-IA, observed in metastatic OSCC has a prognostic value, with the loss of responsiveness to BMPs through the loss of expression of their receptors being indicative of the development of metastasis.

Gynaecomastia in a tom-cat caused by cyproterone acetate: a case report

The contribution demonstrates gynaecomastia in an adult, noncastrated tom-cat, caused by an antiandrogenic preparation Androcur tablets (Schering AG, BRD), administrated at the dose of 5 mg/day for one week. Two months after the treatment, the enlargement of all mammary glands was apparent and one month later (i.e. three months after the end of drug administration) the mammary chains reached the size of 30 × 15 × 20 cm. The general health state of the animal was altered due to the conspicuous enlargement and inflammation of mammary glands. Radical mastectomy was done under general anaesthesia using Isoflurane Rhone-Poulenc inh. The weight of the extirpated mammary chains was 1.75 kg. The healing of operative wounds and convalescence occurred without complications. Fibroepithelial hyperplasia of mammary glands was diagnosed histologically.

Immunohistochemical evaluation of STAT3-p-tyr705 expression in feline mammary gland tumours and correlation with histologic grade

STAT3 (signal transducer and activator of transcription 3) is a cytoplasmic transcription factor that plays a role in the G1 to S phase cell-cycle transition and is induced by cytokines and growth factors. The expression of STAT3 phosphorylated on tyrosine 705 (STAT3-p-tyr705) in normal, hyperplastic and neoplastic feline mammary gland tissue was assessed by immunohistochemistry in 45 cats. The samples included 4 normal mammary non-lactating tissues, 9 hyperplastic tissues (5 fibroepithelial hyperplasia and 4 lobular epithelial hyperplasia), 2 benign tumours (1 complex adenoma, and 1 simple adenoma), and 30 carcinomas (18 simple tubular papillary, 6 simple tubular, 2 simple solid, 3 cribriform, and 1 adenosquamous carcinoma). For immunohistochemistry, tissue sections were incubated with an anti-STAT3-p-tyr705 monoclonal antibody and visualized with EnVision-DAB polymer. STAT3-p-tyr705 positivity was quantified in a semi-quantitative manner. All positive samples showed cytoplasmic and/or nuclear positivity. Normal non-lactating mammary tissue showed a low number of positive cells, similar to hyperplastic tissue. In neoplastic tissues, a high number of positive cells with a moderate to intense reaction was observed. Moreover, a correlation was observed between nuclear positivity for STAT3-p-tyr705 and histologic grade ( P = 0.013; r = 0.447), tubular formation ( P = 0.043; r = 0.820), and mitotic activity ( P < 0.0001; r = 0.689). In contrast, no such correlations were observed for cytoplasmic reactivity of STAT3-p-tyr705. A significant difference was observed between malignant lesions and hyperplasia with regards to expression of STAT3-p-tyr 705 in the cytoplasm ( P = 0.008; U = 59.00) and nuclei ( P = 0.002; U = 47.00). These results confirm previous our data and reinforce the potential role of STAT3 in malignancy as reported for human breast cancer and other sporadic tumours.

Treatment of Feline Mammary Fibroepithelial Hyperplasia Following a Single Injection of Proligestone

A case of fibroepithelial hyperplasia of the mammary gland in the cat is reported. A seven-monthold female cat was presented for diffuse enlargement of all of the mammary glands. The cat was treated with proligestone (Covinan®) for the suppression of estrus. Four weeks later all 8 mammary glands were asymmetrically enlarged. There was ulceration of one gland. Sonographic imaging of the affected mammary glands showed homogeneous and granular structures. The patient was treated with subcutaneous injections of 10 mg/kg aglépristone (Alizine®) on days 1, 2, 7, 14 and 21. Within six weeks the mammary glands had completely regressed. No side effects were observed. It is the first case of fully documented feline mammary fibroepithelial hyperplasia and its treatment in the Czech Republic.

Clinical, pathological and immunohistochemical study of feline mammary fibroepithelial hyperplasia following a single injection of depot medroxyprogesterone acetate

Feline mammary fibroepithelial hyperplasia (FMFH) following a single injection of depot medroxyprogesterone acetate (MPA) was observed in eight intact young queens. The repository compound is marketed as a veterinary product by a local pharmaceutical company with an indication for contraception in cats. The drug was administered according to the recommended doses and injection frequencies. Serum hormone assays performed immediately before neutering and 3 weeks after neutering detected persistently high levels of progesterone suggesting that depot MPA was still exerting its influence. No corpora lutea were found in those cases ruling out ovaries as the main site of progesterone. Immunohistochemistry performed on the hyperplastic mammary glands detected progesterone receptors in the nuclei of ductal cells, and growth hormone (GH) and insulin-like growth factor-I (IGF-I) in the cytoplasm of ductal epithelium. Overdosing should be considered here as the animals received at least 10 mg/kg of depot MPA in a single injection. Progestin-induced local synthesis of GH and IGF-I in mammary epithelial cells is suggested as one of the pathogenic mechanisms involved in the development of FMFH.

Treatment of fibroepithelial hyperplasia (FEH) of the mammary gland in the cat with the progesterone antagonist Aglépristone (Alizine)

Three cases of fibroepithelial hyperplasia (FEH) of the mammary gland in the cat are reported. A one year old female cat had a distinct enlargement of the middle mammary glands, one on each side, 5 days after the first estrus. One week later the cat was treated with medroxyprogesterone acetate (Depo-Promone). The affected glands, along with the remaining glands, increased further in size. A five year old female cat was treated with Proligeston (Covinan) for the suppression of estrus. Two weeks later fibroepithelial hyperplasia occurred in two glands, one with a well demarcated ulceration. A seven months old male cat was treated with delmadinon acetate (Tarden) because of urine spraying. Two months later he had enlargement of all mammary glands. All three cats were treated with the progesterone antagonist Aglépristone (Alizine). Within 5 to 11 weeks the mammary glands had regressed to normal.

Hiperplasia fibroepitelial mamária em felinos: cinco casos

São descritos cinco casos de hiperplasia fibroepitelial mamária em gatas com idades variando entre 10 meses e 11 anos. A principal queixa por ocasião do atendimento era relacionada à tumefação das mamas com evolução clínica entre 3 e 24 semanas. Em duas das gatas, a condição desenvolveu-se após o tratamento com contraceptivos. Macroscopicamente, as tumorações na glândula mamária eram cobertas por pele, ocasionalmente ulceradas, e tinham superfície de corte brancacenta com nódulos multifocais mais pálidos de 2mm de diâmetro. Histologicamente, esses nódulos multifocais consistiam de proliferação ductal cercadas por crescimento abundante de tecido conjuntivo fibroso.