Fibrous Lesions Research Articles

Non‐ossifying fibroma of the mandible: A case report and review of the literature

AbstractThe case reported here is a large non‐ossifying fibroma (NOF) of the mandible presenting in a 24‐year‐old male patient. The lesion was diagnosed through radiological and histopathological assessment. It remains under observation without surgical intervention, despite its large size, as the extensive surgery to remove it is not currently justifiable. Whilst common at the metaphysis of the long bones in paediatric patients, NOFs are rarely observed in the jaw bones. These benign fibrous lesions are often asymptomatic and may be an incidental radiological finding. Most NOFs of the limbs presenting in children will not require any treatment, and spontaneously resolve when growth ceases. However, regarding mandibular lesions, the majority of historical cases have been successfully treated with curettage and do not recur. Due to their scarcity, the outcomes for untreated NOFs of the gnathic bones are not reliably known. We discuss the clinical, radiological and histopathological findings for this case. A thorough literature review of previous reports of this rare entity reveals the typical characteristics and behaviour of this lesion.

Infiltrative fibrous lesion of the facial nerve mimicking a facial nerve tumor.

To report three cases of facial nerve lesions that were clinically expected to be facial nerve tumors but showed fibrotic infiltration without any apparent signs of a specific tumor on histopathological findings. We also aimed to investigate the clinical characteristics of these cases. Medical records of patients who underwent surgery for facial nerve lesions were reviewed. All three cases initially had House-Brackmann (HB) grade IV-V facial nerve palsy. On radiological imaging, schwannoma or glomus tumor originating from the facial nerve was suspected. All patients underwent complete surgical removal of the neoplasm followed by facial nerve reconstruction using the sural nerve. The lesions were histologically confirmed as infiltrative fibrous lesions without tumor cells. In two cases, facial nerve palsy improved to HB grade III by nine months post-surgery, and there were no signs of recurrence on follow-up MRI. The other case, after 1year of follow-up, showed persistence of HB grade V facial nerve palsy without any evidence of recurrence. Fibrotic lesions of the facial nerve could mimic primary facial nerve tumors. Clinicians should consider this condition even when a facial nerve tumor is suspected.

Lymphocytic Mastitis with Fibroadenoma – A Case Report

Diabetic mastopathy is an uncommon fibrous tissue lesion of the breast which is usually seen in patients with longstanding type 1 diabetes mellitus. We report a case of diabetic mastopathy in an insulin dependent type 2 diabetes mellitus patient. 47-year-old postmenopausal woman, presented with two lumps, one firm mobile mass and another, a firm-hard mass in the upper inner quadrant of the left breast. Mammography and ultrasonography came out to be BIRADS III lesion. Fine-needle aspiration cytology [FNAC] was performed showing features of fibroadenoma with fibrocystic change. Histopathological examination and Immunohistochemistry studies revealed it to be fibroadenoma along with lymphocytic mastopathy. Keywords: Fibroadenoma, Lymphocytic mastitis, Mimicker, Diabetes

Computed tomography findings in patients with pulmonary tuberculosis and diabetes at an infectious disease hospital in China: a retrospective cross-sectional study

BackgroundThis study aimed to investigate the relationship between active pulmonary tuberculosis (TB) and type 2 diabetes mellitus (T2DM) by analysing the clinical features and computed tomography (CT) findings of patients with active pulmonary TB and comorbid T2DM (TB-DM) in the LiangShan Yi regions.MethodsWe collected data from 154 hospitalised patients with TB-DM initially confirmed at an infectious disease hospital in the Liangshan Yi Autonomous Prefecture between 1 and 2019, and 31 December 2021. These were matched by sex and age ± 3 years to 145 hospitalised patients with initially confirmed pulmonary TB without comorbid T2DM (TB-NDM) over the same period. The clinical characteristics of the two groups were analysed separately. Three group-blinded radiologists independently analysed the CT findings and classified them into mild-to-moderate and severe groups. Severe chest CT lesion refers to a lesion that is less diffused or moderately dense and either exceeds the total volume of one lung, a high-density fused lesion greater than one-third of the volume of one lung, or a cavitary lesion with a maximum diameter ≥ 4 cm.ResultsNo significant differences were observed in the presentation of clinical features. Regarding the severity of chest CT manifestation, patients with TB-DM had significantly more severe TB than those with TB-NDM (89.61% vs. 68.97%, P < 0.0001). Regarding CT findings, patients with TB-DM had higher proportions of consolidation (79.22% vs. 52.41%, P < 0.0001), cavitary lesions (85.06% vs. 59.31%, P < 0.0001), bronchiectasis (71.43% vs. 31.03%, P < 0.0001), exudative lesions (88.96% vs. 68.28%, P < 0.0001), and fibrous lesions (93.51% vs. 68.97%, P < 0.0001) than patients with TB-NDM. In conclusion, patients with TB-DM have more severe pulmonary TB CT findings than those without. There were no significant differences in the distribution of lesions in the lung lobes between TB-DM and TB-NDM patients.ConclusionsAmong patients hospitalised with pulmonary TB, those with T2DM had more severe findings on chest CT than those without T2DM. However, the clinical presentation was not significantly different.

Case Report: Schwannoma of the tongue

Schwannomas are benign neoplasms originating from Schwann cells of the peripheral nerve sheath. Intraoral lesions are uncommon. A 58-year-old female patient complained of discomfort at the apex of the tongue. Clinical examination revealed a fibrous, lobulated, delimited, and normochromatic nodular lesion, measuring 3 centimeters in diameter, with 10 years of evolution. Diagnostic hypotheses included schwannoma and neurofibroma, thus, an excisional biopsy was performed. Microscopic analysis showed a proliferation of fusiform cells organized in a more cellularized area, with a palisade arrangement around acellular areas, and a less cellularized area, with dispersed cells, intermingled with loose connective tissue. The neoplastic cells were positive for immunohistochemical reactions for S100, confirming the diagnosis of schwannoma. The patient remained without symptoms and with no signs of recurrence after 18 months of follow-up. The correlation of clinical signs and symptoms is essential for the elaboration of the differential diagnosis, treatment planning, and diagnosis confirmation. Schwannomas are benign neoplasms originating from Schwann cells of the peripheral nerve sheath. Intraoral lesions are uncommon. A 58-year-old female patient complained of discomfort at the apex of the tongue. Clinical examination revealed a fibrous, lobulated, delimited, and normochromatic nodular lesion, measuring 3 centimeters in diameter, with 10 years of evolution. Diagnostic hypotheses included schwannoma and neurofibroma, thus, an excisional biopsy was performed. Microscopic analysis showed a proliferation of fusiform cells organized in a more cellularized area, with a palisade arrangement around acellular areas, and a less cellularized area, with dispersed cells, intermingled with loose connective tissue. The neoplastic cells were positive for immunohistochemical reactions for S100, confirming the diagnosis of schwannoma. The patient remained without symptoms and with no signs of recurrence after 18 months of follow-up. The correlation of clinical signs and symptoms is essential for the elaboration of the differential diagnosis, treatment planning, and diagnosis confirmation.

Riga-Fede disease: a review of the literature and a description of clinical cases

Relevance. Riga-Fede disease (RFD) is a rare pathology that develops as a result of trauma to the mucous membrane of the tongue ventral surface with sharp edges of natal, neonatal or primary teeth erupting in time and manifests in the form of erosion or sublingual fibrous lesion with an ulcerated surface.Purpose. To analyze the literature and present our own RFD clinical cases.Material and methods. A search was performed of articles published in 2001-2023 on the research topic in the main scientific literature databases (PubMed, E-library, Google Scholar, etc.). We analyzed the data from 68 publications and presented three of our own clinical cases of RFD in children aged 5, 6 and 9 months.Results. Analysis of literature data revealed different approaches to the diagnosis and treatment of RFD in children. The diagnosis of RFD should rely on the clinical picture and exclude additional trauma to children by histological examination and lesion excision. Pronounced tooth mobility, ineffective infant feeding and the presence of neurological diseases in patients were the main indications for the extraction of teeth, which caused RFD development. In the absence of tooth mobility, non-surgical treatment methods should be preferable. In the presented clinical cases, erupted primary teeth caused BRF. In two cases, the treatment consisted of smoothing the sharp edges of the teeth and restoration with glass ionomer cement; in one case, a child with a neurological disease experienced extraction of lower central incisors. In all cases, recovery was within 3-4 weeks.Conclusion. Once clinically diagnosed with RFD, treatment method choice should consider tooth mobility and the child's overall health.

Assessment of structural changes in the left atrium myocardium according to cardiac magnetic resonance with contrast before and after balloon cryoablation in patients with persistent atrial fibrillation

Aim. To study the structural changes of the left atrium myocardium according to magnetic resonance imaging with contrast in patients with persistent atrial fibrillation before and after balloon cryoablation and compare the results with the effectiveness of the intervention.Material and methods of research. The study included 28 patients with persistent form of atrial fibrillation. All patients before and after magnetic resonance imaging underwent cardiac magnetic resonance imaging with delayed contrast using a high-resolution MR pulse sequence (voxel size 1,25x1,25x1,25 mm) before and after cryoablation.The severity of atrial fibrous lesion was calculated automatically using a specialized LGE HEART Analyzer program using algorithms based on the myocardial contrast index with a threshold value of 1.38. The clinical efficacy of the intervention was evaluated after 12 months and the relationship was determined structural changes in the myocardium of the left atrium according to contrast magnetic resonance imaging data before and after the cryoablation.Results. The severity of fibrotic myocardial lesion of the left atrium before balloon cryoablation was 1,5 [0,16; 9,3]%. In Utah patients, stage 1 fibrosis was detected in 71,4% (n=20), stage 2 in 14,3% (n=4), stage 3 in 3,6% (n=1), stage 4 in 10,7% (n=3). 3 months after cryoablation, there was an increase in the severity of fibrosis of 2,7 [1,02; 18,8]% (p&lt;0,001). Overall efficiency of the intervention rate was 57,1%. The construction of Kaplan- Meyer curves demonstrated that the intervention was most effective in patients with minimal severity of fibrosis before ablation (Utah I) and least effective in more pronounced fibrotic lesion (stage Utah III and IV)Conclusion. Magnetic resonance imaging of the heart with contrast allows to assess fibrotic lesion of the myocardium of left atrial, which may be one of the factors of the effectiveness of interventional treatment of persistent AF.

Identification of Optical Coherence Tomography-Defined Coronary Plaque Erosion by Preprocedural Computed Tomography Angiography.

Background A previous coronary computed tomography (CT) angiographic study failed to discriminate optical coherence tomography-defined intact fibrous cap culprit lesions (IFC group) from those with ruptured fibrous caps (RFC group) in patients with coronary artery disease. This study aimed to evaluate the diagnostic efficacy of preprocedural coronary CT imaging in identifying subsequently performed optical coherence tomography-defined plaque rupture or erosion at culprit lesions in patients with non-ST-segment-elevation acute myocardial infarction. Methods and Results This study used data from 2 recently published studies that tested the hypothesis that coronary CT angiography (CCTA) before percutaneous coronary intervention may provide diagnostic information on the high-risk atherosclerotic burden in patients with non-ST-segment-elevation acute myocardial infarction. In the analysis of 186 patients, optical coherence tomography identified 106 RFC plaques and 80 IFC plaques as the culprit lesions. On CT, the prevalence of low-attenuation plaque, positive remodeling, napkin-ring sign, and spotty calcification were all significantly lower in the IFC group. The culprit vessel pericoronary adipose tissue inflammation and coronary artery calcium scores were significantly lower in the IFC group than in the RFC group. The absence of low-attenuation plaque, napkin-ring sign, zero coronary artery calcium, and low pericoronary adipose tissue inflammation were independent predictors of IFC. When stratified into 5 subgroups according to the number of these 4 CT factors, the prevalence of IFC was 8.3%, 20.8%, 44.6%, 75.6%, and 100% (P<0.001), respectively. Conclusions Preprocedural comprehensive coronary CT imaging, including coronary artery calcium and pericoronary adipose tissue inflammation assessment, can accurately and noninvasively identify optical coherence tomography-defined IFC or RFC culprit lesions.

Effects of millimeter-wave for preventing joint stiffness in the immobilized knee rat model

AimTo explore the effects and mechanism of millimeter-wave treatment on the development of joint stiffness in the immobilized knee rat model. MethodsTwenty-four Sprague–Dawley (SD) rats were randomly divided into the control group (O, n = 8), the surgical control group (OC, n = 8), and the millimeter-wave treatment group (MO, n = 8). After immobilized knee modeling, the knee mobility and quadriceps diameter was measured at the 6th week. Hematoxylin and eosin and Masson staining were performed to detect the pathology and fibrous lesions of the knee joint. Furthermore, the expression of TGF-β1 and Collagen I was quantified by immunohistochemical assay in the knee capsule, and Western blotting was performed to quantify the protein expression of NF-κB and MuRF1 in skeletal muscle. ResultsCompared with the O group, knee mobility, and quadriceps diameter was decreased (P < 0.01), and articular capsule fibrosis and quadriceps atrophy occurred in all rats with fixed knee joints. Compared with the OC group, millimeter-wave treatment significantly increased articular mobility and the quadriceps diameter; and improved the fibrotic lesions of the joint capsule and quadriceps atrophy. Moreover, levels of TGF-β1, Collagen I, and MuRF1 were upregulated (P < 0.01) by knee immobilization, and collagen fiber content in the articular capsule was also increased (P < 0.01). However, millimeter-wave treatment reversed it. The most noteworthy result was that NF-κB expression was not significantly different in all groups. ConclusionMillimeter-wave treatment reversed joint contracture and quadriceps atrophy caused by joint fixation, inhibited TGF-β1 and Collagen I protein expression of the joint capsule and reduced MuRF1 expression of the quadriceps muscle, thereby inhibiting the development of joint stiffness.

Association between glomerular mTORC1 activation and crescents formation in lupus nephritis patients.

This study aims to explore the association between glomerular mammalian target of rapamycin complex 1 (mTORC1) pathway activation and crescents' degree in lupus nephritis (LN) patients. A total of 159 biopsy-proven LN patients were enrolled in this retrospective study. The clinical and pathological data of them were collected at the time of renal biopsy. mTORC1 pathway activation was measured by immunohistochemistry, expressed by the mean optical density (MOD) of p-RPS6 (ser235/236), and multiplexed immunofluorescence. The association of mTORC1 pathway activation with clinico-pathological features especially renal crescentic lesions, and the composite outcomes in LN patients was further analyzed. mTORC1 pathway activation could be detected in the crescentic lesions and was positively correlated with the percentage of crescents (r=0.479, P<0.001) in LN patients. Subgroup analysis showed mTORC1 pathway was more activated in patients with cellular or fibrocellular crescentic lesions (P<0.001), but not fibrous crescentic lesions (P=0.270). The optimal cutoff value of the MOD of p-RPS6 (ser235/236) was 0.0111299 for predicting the presence of cellular-fibrocellular crescents in >7.39% of the glomeruli by the receiver operating characteristic curve. Cox regression survival analysis showed that mTORC1 pathway activation was an independent risk factor for the worse outcome (defined by composite endpoints of death, end-stage renal disease and a decrease of >30% in eGFR from baseline). Activation of mTORC1 pathway was closely associated with the cellular-fibrocellular crescentic lesions and could be a prognostic marker in LN patients.

Incidence and Risk Factors for Poor Postoperative Visual Outcome After Excision of Orbital Cavernous Venous Malformations.

To determine the incidence and risk factors for poor postoperative visual outcome (PPVO) after removal of orbital cavernous venous malformations (OCVMs). Retrospective case-note and imaging review for patients undergoing excision of OCVMs, with estimation of odds-ratios (ORs) and relative risks (RRs) for visual loss in relation to the position of the mass, surgical approach, and patient factors. The 290 patients (179 female; 62%) presented at a mean age of 46.4 years: 243/287 (85%) OCVMs were intraconal, with 213/243 (88%) located freely in the posterior two-thirds of the orbit, and 30/243 (12%) wedged tightly in the apex. PPVO was observed in 6.9% (20/290) patients, solely after removal of intraconal lesions, Univariate analysis showed increased risk with preoperative relative afferent pupillary defect (RAPD) (14/107 [13%]; RR 2.9; P = 0.011), apical lesions (9/30 [30%]; RR 5.8; P < 0.001), situated below optic nerve (15/115 [13%]; RR 3.3; P = 0.007), fibrous masses (14/78 [18%]; RR 6.7; P = 0.005), or intraoperative diastolic blood pressure below 50mmHg (10/64 [16%]; RR 2.8; P = 0.007). Multivariate analysis found apical extension (OR 4.9; P = 0.036) and fibrous lesions (OR 10.0; P = 0.035) as strongest predictors for PPVO. The incidence of complete visual loss (no light perception) was 4.1% (12/290); half of these patients had preoperative acuity of counting fingers or worse, 8 (67%) had RAPD, 7 (58%) wedged apical lesions, and 8 (67%) were below the optic nerve. PPVO after excision of OCVMs can occur in up to 5% of "free" retrobulbar intraconal lesions and in approximately one-third of apical lesions.

Giant Cell Fibroma in an Elderly Woman: A Report of a Rare, Late and Unusually Large Presentation

BackgroundGiant cell fibroma (GCF) is a rare benign oral fibrous lesion which is predominantly found in the mandible of Caucasians but rarely in the maxilla and black population above the third decade of life.&#x0D; Objective: To draw the attention of clinicians to a rare, late and unusually large presentation of Giant Cell Fibroma&#x0D; Case report: The index case was a 68-year-old fisherwoman with a ten-year-old slow-growing painless swelling occupying the left anterior maxilla. The lesion crossed the midline to the right causing incompetent lips and teeth displacement leading to aesthetics and functional problems. Upon clinical examination, a provisional diagnosis of peripheral giant cell granuloma was made. Radiological essentially revealed a soft tissue mass, histopathological evaluations confirmed the diagnosis of GCF and the patient was prepared for surgical excision. A surgical excision of the soft tissue mass and peripheral ostectomy was performed.&#x0D; Conclusion: GCF has distinct histopathologic features occurring in any age, race, site and decades of life; growing very large causing aesthetics and functional problems. Immunohistochemistry if available is an additional resource to unequivocally establish the diagnosis.

IgG4-Related Kidney Disease: An Overview

IgG4-related disease (IgG4-RD) is an insidious progressive disease characterized by fibrous and inflammatory lesions that can affect almost any tissue or organ

Parathyroid carcinoma: lessons from a rare malignancy of head and neck-a case series.

Parathyroid carcinoma (PC) is a very rare head-neck malignancy. Because the symptoms of parathyroid carcinoma are similar to those of benign causes of hyperparathyroidism, it may be not easy to detect it before surgery. The management of PC after initial surgery will be perplexing because of the adequacy of surgery. We wish to describe the difficulties encountered throughout treatment using a literature review. We conducted a retrospective analysis of individuals with parathyroid carcinoma who had treatment at our department between 2017 and 2022. We gathered data on the clinical profile, investigations, management of hypercalcemia, surgical techniques, histopathological features, adjuvant therapy, and outcomes. We treated three patients with parathyroid carcinoma: Two patients with inferior parathyroid carcinoma and one with superior parathyroid carcinoma. Generalized weakness and bony pain are the predominant symptoms. In all cases, the tumor was located using 99Tc MIBI / SPECT scintigraphy and Ultrasonography. Hemithyroidectomy and tumor excision were done as the surgery of choice. All are disease-free at the 12th-month follow-up. We suggested that parathyroid hormone testing be performed in all bony fibrous lesions to rule out hyperparathyroidism. PC is a likely diagnosis when there is noticeable throat swelling, elevated PTH levels greater than 400IU/L, and serum calcium levels greater than 15mg/dL.

CLINICAL FEATURES OF CONNECTIVE TISSUE DYSPLASIA, OSGOOD-SCHLATTER DISEASE AND MULTIPLE CORTICAL DISORDERS IN A CHILD.

The aim: To analyze scientific data on the problems of disorders of bone morphogenesis in children, in particular, non-ossifying fibroma. To analyze modern methods of diagnosis and treatment of this disease in the context of the latest scientific achievements. Materials and methods: The latest data of scientists from the world's leading clinics describing various forms of fibrous skeletal lesions in children of differ¬ent ages were analyzed. We examined a boy with fibrous lesions of the cortical layer of the knee joint bones and a girl with a large fibrous focus of the distal femoral metaphysis, which resulted in a closed pathological bone fracture. Surgical treatment, osteosynthesis, marginal resection of the tumor, bone grafting and histological examination were conducted. Conclusions: Despite numerous studies of this disease, the etiopathogenesis of this disease has not been studied. There are no early symptoms of fibrous bone lesions in children. Diagnosis is possible only when a pathological fracture of the affected bone occurs due to extensive growth of fibrous tissue and a significant decrease in the mechanical strength of the bone. Most cases of recognition of such a disease occur accidentally when performing X-ray examinations for other reasons - bruises, sprains, arthralgias, osteochondropathy, infectious diseases, etc. It is known that boys are more mobile and require more frequent X-ray examinations for limb injuries than girls, so the likelihood of accidental detection of such changes increases significantly. Thus, long-term observations of children with fibrous bone lesions have shown that after 40 years, patients rarely developed malignant tumors - osteogenic sarcoma, fibrosarcoma, malignant fibroma of tubular bones, pelvic bones. There are no early symptoms of fibrous bone lesions in children. Recognition of such a disease occurs by chance when X-ray examinations are performed for other reasons.

Validating human and mouse tissues commonly used in atherosclerosis research with coronary and aortic reference tissue: similarities but profound differences in disease initiation and plaque stability

ObjectiveCharacterization of the atherosclerotic process fully relies on histological evaluation and staging through a consensus grading system. So far, a head-to-head comparison of atherosclerotic process in experimental models and tissue resources commonly applied in atherosclerosis research with the actual human atherosclerotic process is missing. Material and MethodsAspects of the atherosclerotic process present in established murine atherosclerosis models and human carotid endarterectomy specimen were systematically graded using the modified American Heart Association histological classification (Virmani classification). Aspects were aligned with the atherosclerotic process observed in human coronary artery and aortic atherosclerosis reference tissues that were available through biobanks based on human tissue/organ donor material. ResultsApart from absent intraplaque hemorrhages in aortic lesions, the histological characteristics of the different stages of human coronary and aortic atherosclerosis are similar. Carotid endarterectomy samples all represent end-stage “fibrous calcified plaque” lesions, although secondary, progressive, and vulnerable lesions with gross morphologies similar to coronary/aortic lesions occasionally present along the primary lesions. For the murine lesions, clear histological parallels were observed for the intermediate lesion types (“pathological intimal thickening,” and “early fibroatheroma”). However, none of the murine lesions studied progressed to an equivalent of late fibroatheroma or beyond. Notable contrasts were observed for disease initiation: whereas disease initiation in humans is characterized by a mesenchymal cell influx in the intima, the earliest murine lesions are exclusively intimal, with subendothelial accumulation foam cells. A mesenchymal (and medial) response are absent. In fact, it is concluded that the stage of “adaptive intimal thickening” is absent in all mouse models included in this study. ConclusionsThe Virmani classification for coronary atherosclerosis can be applied for systematically grading experimental and clinical atherosclerosis. Application of this histological grading tool shows clear parallels for intermediate human and murine atherosclerotic lesions. However, clear contrasts are observed for disease initiation, and late stage atherosclerotic lesions. Carotid endarterectomy all represent end-stage fibrous calcified plaque lesions, although secondary earlier lesions may present in a subset of samples.

Epidermal inclusion cyst embedded in benign fibrous histiocytic lesion with prominent epithelioid morphology

Epidermal inclusion cyst embedded in benign fibrous histiocytic lesion with prominent epithelioid morphology

Giant cell Fibroma of Tongue: Entity with unique histopathological features

Giant Cell Fibroma can present as a nodular growth in the oral cavity, representing approximately 2% to 5% of all oral fibrous proliferations. They can be best distinguished from other fibrous lesions by their typical histopathological features of presence of stellate shape fibroblasts. Here, we report a case of a 65-year-old female with a mass on the tongue and discuss its clinical and histopathological differential diagnosis.

Endothelial Dysfunction associated with Diabetes Mellitus linked to extracellular signal-regulated kinase and inflammatory pathways

Endothelial dysfunction and core illnesses are now among the top causes of death on a global scale. Atherogenesis is a prominent risk factor for adverse vascular blockage diseases. People who have hyperglycemia and hyperlipidemia become more prone to developing cerebro-cardiovascular disease and lower limb disorders. Additionally, diabetic metabolic syndrome additionally alters the extracellular signal-regulated kinase and immunosignal pathways, as well as the activation of vascular endothelial growth factor, nuclear factors and cell migration all of which contribute to pathogenesis. The creation of fibrous and fatty lesions in the intimal layer of an artery is referred to as atherogenesis associated vascular problems. In this study, atherogenic lipid particles, markers and inflammatory signaling pathways related to hyperglycemia and hyperlipidemia complications of atherosclerosis are discussed which will aid in the development of a new strategy to treat the macro-vascular complication for future research and treatment.

Immunohistochemical Characterization of Gingival Fibromas.

Gingival fibromas (GFs) are fibrous lesions of the gingiva that are not well defined in the literature. They are histologically similar to peripheral ossifying fibromas (POFs), both being characterized as cellular proliferations of dense fibrous tissue, with POFs differing in that they demonstrate foci of calcification. This study aims to expand upon the immunohistochemical characterization of GFs, and to confirm their osteoblastic phenotype. Formalin fixed, paraffin embedded GFs, POFs and fibroepithelial polyps (FEPs) of the gingiva were examined. Immunohistochemical staining was performed for special AT-rich sequence binding protein 2 (SATB2), runt-related transcription factor 2 (RUNX2), osteocalcin and alpha-smooth muscle actin (αSMA). Sections were evaluated by light microscopy and the immunohistochemical staining patterns were assigned immunoreactive scores (IRS) based on percentage of stained cells and intensity of staining. GFs, POFs, and FEPs of the gingiva expressed osteoblastic markers SATB2, RUNX2 and osteocalcin. GFs and POFs expressed αSMA while FEPs of the gingiva did not. GFs and POFs had similar staining patterns of SATB2, RUNX2 and αSMA. These findings demonstrate that GFs and POFs exhibit a similar immunohistochemical profile, and supports a theory that GFs are osteoblastic lesions possibly related to POFs.