Follicular Type Research Articles

Correlation of BRAF V600E mutation with the clinicopathological features of papillary thyroid carcinoma

Objective To discuss the BRAF V600E mutation rate in papillary thyroid carcinoma (PTC) and its relationship with the clinicopathological features. Methods Two hundred and sixty-five PTC patients (including 226 cases of classical type, 29 cases of follicular type, 3 cases of high cell type, 2 cases of diffuse sclerosis type, 2 cases of eosinophilic type, 3 cases of cystic type) from August 2014 to October in Shanxi Provincial Cancer Hospital, were collected with completely clinical and pathological information. The BRAF V600E mutation was detected by real-time polymerase chain reaction (RT-PCR) method. Pearson χ 2 test and the exact probability method were used to analysis the relationship between gene mutations and clinicopathological data. Results BRAF V600E mutation rate in PTC patients was 73.21% (194/265). There was no significant difference in the mutation rate of BRAF V600E among patients with different age, gender, tumor location, tumor number and extravaginal invasion (all P > 0.05), but the mutation rates of BRAF V600E gene in patients with different tumor size, histopathological subtypes, lymph node metastasis and clinical stage were significantly different (all P < 0.05). Conclusion The PTC patients with positive BRAF V600E mutation have poor clinicopathological features, and BRAF V600E mutation may be a predictor of advanced PTC. Key words: Thyroid neoplasms; Carcinoma, papillary; BRAF V600E mutation; Polymerase chain reaction

Clinico-radiologic features of four cases of Ameloblastoma

Ameloblastomas are jaw tumors that are locally aggressive with a high capacity for recurrence. It arises from the epithelium of the dental lamina. Radiograph remains the first and an essential investigation, despite the development of various cross-sectional imaging modalities. Aim: This article intends to describe the clinical findings and orthopantomograph (OPG) supported by computed tomography scan (CT scan) and MRI of four cases of ameloblastomas in the hospital University Sains Malaysia. Materials and methods: Data concerning the patients’ ages, sex, tumor locations, and surgical treatment history, as well as the radiographic findings, were analysed. Results: The patients’ ages ranged from 23 to 41 years (mean, 30.5 years). The gender of patients were two male (50%) and 2 (50%) females. Three cases (75%) of ameloblastomas located in the mandible and only one case found in the maxilla. The swelling was the most common symptom and experienced by all patients. Radiographically, two cases were unilocular with a well-demarcated border, and the remaining 2 cases were multilocular. Typical features of unicystic ameloblastoma appeared in case 1. This case previously presented with a lesion in the same area diagnosed as a dentigerous cyst. The other 3 cases showed variant types of ameloblastoma. These were Plexiform, Acanthomatous and Granular cell type; follicular and plexiform type; and follicular and plexiform type in case 2, 3 and 4 respectively. Conclusion: In conclusions, determination the location and density of jaws lesion and its margin relation to the tooth using radiological tool accompanied with clinical data, aids in the narrowing of the differential diagnosis and it is necessary for early diagnosis of ameloblastoma. A Long-term follow-up at regular intervals after surgery is recommended for all ameloblastomas cases.

Induction of Lymphangiomas by Freund's Incomplete Adjuvant (FIA) in Fatty Acid Binding Protein (FABP)‐3, 5 and 7 Knock‐out Mice

IntroductionIn an FIA‐induced benign lymphangioma model (Mancardi et al., 1999), we have suggested a sequential transformation from peritoneal mesothelial cells to functional lymphatic vessels via fat storing tumor cells after the FIA stimulation (EB2009 &amp; 2015). However, the actual mechanism of the tumorigenesis and cellular involvement have yet to be established. FABPs are known to be involved in the promotion of cellular uptake and transport of fatty acids and the targeting of them to specific metabolic pathways. The aim of this study is, therefore, to investigate the possible involvement of FABPs during the FIA‐induced tumor development using FABP KO mice.Materials &amp; MethodsLymphangiomas were induced in C57BL/6 (B6) mice and FABP3, 5 and 7 KO mice by an intraperitoneal injection of FIA (0.2 ml emulsion). For histological analyses, tissue cryosections were made and immunostained with various antibodies against FABP3, 4, 5, 7, and various lymphatic markers, such as podoplanin (PDPN), LYVE‐1 and LA102.Results &amp; ConclusionsAfter FIA injection, peritoneal mesothelial cells became tall in height losing their polarity and gradually formed stratified cell masses on the peritoneal surface in B6 mice. The tumors became honeycomb‐like lymphangiomas consisted of ring‐like fat storing cells with various sizes. Some fat storing cells fused with each other and gradually formed either tubular structures like lymphatic vessels or huge follicles. These cells were strongly positive for PDPN, F4/80 and FABP5, but negative for FABP4. The follicular structures mainly consisted of FABP7+ cells. Interestingly, only the functional lymphatic vessel‐like structures expressed LYVE‐1 and LA102. In FABP‐KO mice, there was no significant difference in the incidence of tumors as compared with normal B6 mice. However, tumors developed more vigorously in FABP7 KO mice than other KO strains. Among FABP KO mice, relatively smaller fat storing cells were seen in FABP3 KO mice, whereas follicular type structures were more commonly found in FABP5 KO mice. In contrast, the tumors in FABP7 KO mice showed less fat storing cells with more inflammatory and fibrous components. In conclusion, a close relationship between the extrinsic FIA metabolism and the lymphatic system may be suggested in this tumor model, although the actual role and biological significance of each FABP in the tumorigenesis remain to be further clarified.This abstract is from the Experimental Biology 2018 Meeting. There is no full text article associated with this abstract published in The FASEB Journal.

Noninvasive Follicular Thyroid Neoplasms With Papillary-like Nuclear Features Are Genetically and Biologically Similar to Adenomatous Nodules and Distinct From Papillary Thyroid Carcinomas With Extensive Follicular Growth.

- Proposed noninvasive follicular thyroid neoplasm with papillary-like nuclear features (NIFTPs), formerly noninvasive encapsulated papillary carcinoma, follicular variant (PTC-FV), is an indolent tumor with follicular growth and frequent RAS mutations. - To detect histologic and molecular differences separating NIFTP from follicular adenomas (FAs) and invasive carcinomas, particularly papillary carcinomas with extensive follicular growth (PTC-EFGs) and invasive encapsulated PTC-FV (IE-PTC-FV). - Sixty-one tumors were reviewed histologically and reclassified into 32 NIFTPs (52%), 4 IE-PTC-FVs (7%), 14 PTC-EFGs (23%), and 11 FAs (18%). Next-generation sequencing for mutations in 50 genes was performed. Clinical outcomes were recorded. - The NIFTPs and FAs were well circumscribed and unencapsulated. The FAs had bland nuclei, whereas the NIFTPs showed at least 2 of 3 (67%; sufficient) nuclear features (enlargement, irregular contours, chromatin clearing). The IE-PTC-FVs had follicular growth, sufficient nuclear features, and extensive capsular invasion. The PTC-EFGs had a median of 5% papillae with intrathyroidal invasion (broad-based, sclerotic, or small follicle growth patterns); intranuclear pseudoinclusions were present only in PTC-EFGs (9 of 14; 64%). Mutations included RAS in 20 of the 32 NIFTPs (62%), 4 of the 11 FAs (36%), and 3 of the 4 IE-PTC-FVs (75%); BRAF K601E in 1 NIFTP (3%); BRAF V600E in 5 PTC-EFGs (36%). No NIFTPs or FAs recurred or metastasized. All 4 IE-PTC-FVs (100%) had hematogenous metastasis. Two PTC-EFGs (14%) had lymphatic metastasis. - The morphologic similarity and RAS mutations in FAs, NIFTPs, and IE-PTC-FVs supports the genetic similarity of those follicular neoplasms in contrast to the unique presence of BRAF V600E mutations in PTC-EFGs. Using strict diagnostic criteria supported by molecular testing, tumors with extensive follicular growth can be classified into follicular type or RAS-like (FA, NIFTP, IE-PTC-FV) versus papillary type or BRAF V600E-like (PTC-EFG).

Cicatricial alopecia – a case report with a review of literature

Cicatricial alopecia encompasses a group of clinical entities that affect the hair unit leaving permanent destruction of the follicular ostia, skin atrophy and irreversible loss of hair follicles. Herein, a 43-year-old lady with erythematous follicular papules, resulting into atrophic scars with permanent loss of hairs, slowly progressing for more than 22 years, is presented. The patient has been consulted by numerous dermatologists and no exact histological diagnosis was verified. Upon proper clinico-pathological work-up, a diagnosis of lichen planopilaris was concluded and treatment with intralesionaly corticosteroids and oral hydroxychloroquine was introduced. The patient improved significantly during the 3-month follow-up. Scarring alopecia should always be evaluated clinically and by scalp biopsy to accurately analyze the change in the follicular architecture and type, distribution and extent of the inflammatory infiltrate. This complex diagnostic approach is crucial for the diagnosis and management of all cases of cicatricial alopecias.

Collision tumors of the thyroid: Review of literature and report of a case of papillary–Follicular collision tumor

It is a known fact that thyroid malignancies are the most common of endocrine malignancies. Furthermore, differentiated thyroid malignancies including the papillary and follicular types are the most common among these malignancies of the thyroid. However, it is extremely uncommon to get a combination of two primary malignancies within the same thyroid gland. These combinations can be classified into collision tumors, mixed tumors, and composite tumors. Whenever such tumors have been described, they have almost always been combinations of papillary carcinoma and medullary carcinoma. Recently, a couple of cases of combinations of papillary and follicular carcinomas are being reported. It is difficult to completely explain the occurrence of such tumor types together in the same gland. Various theories have been proposed to explain this simultaneous occurrence such as the stem cell theory, collision theory, and the hostage theory. It is now accepted that these tumors should be considered more aggressive and having a higher risk of recurrence as compared to either of the tumors occurring independently. Treatment should be patient specific and is directed by the more aggressive of the tumors; however, no standardized protocols for diagnosis or treatment have evolved due to lack of significant information on their behavior.

F-18 FDG PET-CT Versus Contrast Enhanced CT in Detection of Extra Nodal Involvement in Patients with Lymphoma.

Aim and Objectives:The aim of this study is to assess the added value of hybrid fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT) in the evaluation of extranodal involvement in patients with lymphoma in comparison to contrast-enhanced CT (CECT).Patients and Methods:All patients had lymphoma, proved by histopathological and immunophenotyping examinations. They underwent CECT and F-18 FDG PET–CT studies. Both CECT and PET/CT studies were done within 30 days.Results:The study included 144 patients 92 (63.9%) males and 52 (36.1%) females with mean age 49.3 years (range 18–80 years). A total of 102 (70.8%) patients had non-Hodgkin lymphoma and 42 patients (18.1%) had Hodgkin disease, diffuse large B-cell lymphoma subtype had the highest prevalence 52.8% (76/144), whereas lymphocytic predominance was the least prevalent 1.4% (2/144) followed by mucosa-associated lymphoid tissue lymphoma 2.8% (4/144) and small lymphocytic type 4.2% (6/144), mixed cellularity (MC), T-cell, and follicular type were equally distributed 6.9% (10/144 each). The lung was the most common site as it was involved in 34 patients followed by bone and bone marrow 32 patients, spleen 18, liver 16, nasopharynx 8, stomach 6, cutaneous and subcutaneous tissue 6, peritoneum, cecum, small intestine, brain, and intramuscular four patients each. However, the parotid and pancreas were the least common sites two patients each. The overall sensitivity, specificity PPV, NPV, and accuracy of PET/CT and CECT are 97%, 20% 94.2%, 33.3% and 91.7% and 89.6%, 60%, 96.8%, 30% and 87.5%, respectively.Conclusion:F-18 FDG-PET/CT can accurately monitor the extranodal lymphoma, it can detect metabolically-active lesions without CT structural changes and identify viable tumor in normal size lymph nodes. FDG-PET/CT is more effective than CECT in evaluating extra nodal lymphomatous infiltration, especially in the spleen, bone, and bone marrow.

Prognosis of Differentiated Thyroid Carcinoma with Initial Distant Metastasis: A Multicenter Study in Korea.

BackgroundMost patients with differentiated thyroid cancer (DTC) have a favorable prognosis. However, patients with DTC and initial distant metastasis have not been commonly found, and their clinical characteristics have seldom been reported. In this study, we analyzed the clinical features and prognosis of patients with DTC and initial distant metastasis in Korea.MethodsWe retrospectively reviewed the clinical data of 242 patients with DTC and initial distant metastasis treated from 1994 to 2013, collected from five tertiary hospitals in Korea.ResultsThe patients' median age was 51 years, and 65% were women. They were followed for a median of 7 years. Lung was the most common site of distant metastasis: only lung 149 patients (62%), only bone 49 (20%), other single site one (pleura), and combined sites 43 (40 were lung and bone, two were bone and other site, and one was lung and other site). At the time of diagnosis, 50 patients (21%) had non-radioactive iodine (RAI) avidity. Five-year disease-specific survival (DSS) was 85% and 10-year DSS was 68%, which were better than those in previous studies. After multivariate analysis, old age, male sex, metastatic site, and histologic type (follicular type) were significant factors for poor prognosis. However, negative RAI avidity status was not a significant prognostic factor after adjusting for other variables.ConclusionThe prognosis of Korean patients with DTC and initial distant metastasis was better than in previous studies. Old age, male sex, metastasis site, and histologic type were significant prognostic factors.

Rare variant of ameloblastoma: A case report

Ameloblastoma is second most common odontogenic tumor of jaws that presents with typical clinical, radiological, and histopathological appearances. Provisional diagnosis of this tumor is based on clinical and radiological features; however, final diagnosis is made by histopathological examination which classifies it in to various types, i.e. follicular, plexiform, acanthomatous, granular cell, desmoplastic, and basal cell type. Follicular and plexiform patterns are most common. Hybrid ameloblastoma (HA) is rare entity in which conventional types (follicular and plexiform) of ameloblastoma co-exist with desmoplastic ameloblastoma (DA). Its radiological appearance differs from conventional ameloblastomas and sometimes resembles fibro-osseous lesions (FOL). There are only 35 cases of HA reported in literature. We present a novel case of hybrid desmoplastic/follicular ameloblastoma of anterior mandible with emphasis on its radiologic features. Differential diagnosis of the lesion from conventional ameloblastomas and FOL are discussed.

Influence of Ki-67 and proliferating cell nuclear antigen expression on the biological behavior of ameloblastomas

Background: Ameloblastomas, the second-most common odontogenic tumors, are locally aggressive benign lesions that derive from cellular components of the enamel organ. Objective: The objective of the study is to assess the possible influence of cell proliferation markers Ki-67 and proliferating cell nuclear antigen (PCNA) on the biological behavior of ameloblastomas. Materials and Methods: A PubMed database search through February 2018, using the following medical subject headings (MeSH) terms were performed: “ameloblastoma” and (“Ki 67 antigen” or “proliferating cell nuclear antigen”). Selection Criteria: Studies with findings on cell proliferation markers in ameloblastoma. There were no restrictions regarding language or date of publication. Data Analysis: The data were analyzed using statistical software RevMan 5.3 (The Cochrane Collaboration, Oxford, UK). For continuous outcomes, the estimates of effects of an intervention were expressed as mean differences using the inverse variance method together with 95% confidence intervals. Results: Fourteen studies on cell proliferation markers in ameloblastoma were included in this meta-analysis. A greater significant Ki-67 expression in recurrent ameloblastomas (P < 0.01), in follicular type of solid/multicystic ameloblastomas (P < 0.05) and maxilla located ameloblastomas (P < 0.05) was found. In contrast, no significant influence of Ki-67 expression was observed in the following parameters: clinical type of ameloblastoma, histological type of unicystic ameloblastoma, age, gender, or size of the lesion. Finally, PCNA expression had no significant influence in any case. Conclusions: Ki-67 but not PCNA antigens seem to have an influence on the biological behavior of ameloblastomas.

Adenomatoid odontogenic tumor in mandible: A rare case

Adenomatoid odontogenic tumor is a benign (hamartomatous), noninvasive lesion with slow but progressive growth. It develops from the dental lamina or its remnants. There are two variants of this tumor: Central and Peripheral. Central variant further get classified as follicular and extrafollicular on the basis of its association with the unerrupted tooth. Clinically this tumor has resemblance with other odontogenic lesions like dentigerous cysts, ameloblastoma etc. Thus histopathological examination is an important aid to confirm its diagnosis. Here we report a rare case of follicular type of Adenomatoid odontogenic tumor associated with impacted mandibular premolar.

Role of activin C in normal ovaries and granulosa cell tumours of mice and humans.

Activins and inhibins play important roles in the development, growth and function of the ovary. Mice lacking inhibin develop granulosa cell tumours in their ovaries that secrete activin A, and these tumours are modulated by increased activin C expression. The aim of the present study was to identify where activin C is expressed in mouse and human ovaries and whether overexpression of activin C modulates normal follicular development in mice. Immunohistochemical staining for the activin βC subunit was performed on sections from mouse and human ovaries and human adult granulosa cell tumours. Stereology techniques were used to quantify oocyte and follicular diameters, and the percentage of different follicular types in ovaries from wild-type mice and those underexpressing inhibin α and/or overexpressing activin C. Staining for activin βC was observed in the oocytes, granulosa cells, thecal cells and surface epithelium of mouse and human ovaries, and in the granulosa-like cells of adult granulosa cell tumours. Overexpression of activin C in mice did not alter follicular development compared with wild-type mice, but it did modulate the development of abnormal early stage follicles in inhibin α-null mice. These results provide further evidence of a role for activin C in the ovary.

Effects of vitrification and transplantation on follicular development and expression of EphrinB1 and PDGFA in mouse ovaries

The aim of this study was to assess the follicular development and the patterns of EphrinB1 and PDGFA immunostaining in vitrified mouse ovarian tissue (OT) with and without transplantation. Histological evaluation was performed on fresh and vitrified OTs, whether transplanted or not. RT-PCR was performed on fresh and vitrified ovarian samples (OSs) and vitrified OS graft. Vitrification alone did not significantly reduce the normal primordial, primary, and secondary follicles except antral ones (p > 0.05). However, transplantation decreased all the follicle types. The EphrinB1 immunoexpression showed high intensity in all follicular types in vitrified OT and the significant increased was detected in secondary and antral follicles (p < 0.05). PDGFA protein immunoexpression of primordial and primary follicles was decreased in vitrified OT (p < 0.05). However, the lowest immunoexpression of EphrinB1 and PDGFA was detected after transplantation (p < 0.05). The levels of ephrinb1 and pdgfa mRNA expressions in vitrified OS and vitrified OS grafts were found as comparable to the fresh OS. In conclusion, vitrification has no detrimental effect on the follicles at the different developmental stages, majority of ovarian follicular loss takes place after transplantation rather than vitrification. Overall, vitrification and grafting do not change the ephrinb1 and pdgfa gene expressions. In addition, EphrinB1 and PDGFA are expressed during different stages of folliculogenesis in a different manner in fresh, vitrified, or grafted OTs. Vitrification and/or grafting appear to affect the follicular expression of EphrinB1 and PDGFA. These findings suggest that these proteins could have several functions related to the development of follicles and angiogenesis after transplantation.

Analysis of Histological Variants of Ameloblastomas of Jaws in Relation to their Clinical Presentations

Ameloblastoma is an odontogenic tumour with variable clinical characteristics and histological patterns.This study was done to find out the relationship between clinical presentation and histological types of ameloblastoma to provide a base line data for better and appropriate patient management. A cross sectional study on consecutive 50 histologically diagnosed Ameloblastoma patients attended to the department of Oral and Maxillofacial Surgery, Dhaka Dental College and Hospital from July 2011 to June 2012 were included in the study. 75% clinically solid types were associated with histological follicular type and 62.5% cystic types were histological plexiform type.Plexiform type was found commonly in younger age group of patients than the follicular types. Desmoplastic ameloblastoma were found solely in anterior mandible.J Bangladesh Coll Phys Surg 2017; 35(2): 61-67

Abstract 5632: Thyroid carcinoma in The Sudan

Abstract Introduction: Goiter is endemic in Sudan and thyroidectomy is a daily practice in most surgical lists across the country. The most common indications are cosmoses and pressure with respiratory choking. In 10% of cases a surprise histopathology on cancer is reported . This study aims to report on thyroid carcinoma on patients presenting to the surgical department in Khartoum Teaching Hospital. Methods: This study is an overview on pattern, clinical presentation a management of thyroid carcinoma in Khartoum during the period 2007 - 2014. Thyroidectomy was the standard procedure when feasible and postoperative radio iodine given. External radiotherapy was given in aggressive anaplastic carcinoma. Results: 166 patients with thyroid cancer were studied. The mean age was 51 +/-SD 17yrs and the age range between 15 - 85 years. Male to female ratio was 1.0:2.4. Clinical presentation was a goiter that was showing a recent rapidly growth with either respiratory choking, pain and dysphagia. Follicular carcinoma was 43%,papillary 27%, anaplastic 10% 2%medullary. Sarcoma and lymphoma 5% and missing data in 13%. Six per cent of patients presented with lung and bone metastasis. 20 patients had long standing goiter before development of cancer. Different types of total thyroidectomy done in 81%, no surgery in 7% and missing data in 12%. 18 patients needed postoperative tracheostomy, 7 developed permanent hypocalcaemia, 15 recurrent nerve palsy and a 30 days mortality was 10% and all were anaplastic carcinoma where recurrence occurred within weeks following thyroidectomy or dublking in most cases. Conclusion: Patients with thyroid cancer presents late. The dominance of follicular type indicates the significance of underlying endemic goiter in its etiology. Anaplastic is very aggressive and lethal outcome. Citation Format: Mohamed ElMakki Ahmed. Thyroid carcinoma in The Sudan [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2017; 2017 Apr 1-5; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2017;77(13 Suppl):Abstract nr 5632. doi:10.1158/1538-7445.AM2017-5632

Comparison of response to chemotherapy in non-Hodgkin lymphoma patients depending on their myeloid derived suppressor cell status: Insight on new immune target.

e23155 Background: Non Hodgkin’s Lymphoma shows different disease status after completion of standard 1st line treatment. Low grade follicular lymphoma remains stable after standard treatment for a long time and some times it autoregress . In High grade Lymphoma (Commonly diffuse B-cell lymphoma) relapsed 30-40% after 1stline treatment. Immunological target for this differentiation in tumor biology is sought for. Methods: Twenty Five CD20+NonHodgkin's Lymphoma(NHL) patients and one T cell lymphoma were treated with standard chemotherapy (6-8 cycles of RCHOP/CHOP). Within these 25 patients, 10 patients were disease free or exhibited stable disease for two years following the completion of treatment. Rest of the patients showed early relapse (within 6 months) or late relapse (within 18 to 24 months). Eight among 10 disease free patients was suffering from NHL of low grade follicular type. In order to correlate the immune cell status with lymphoma relapse, we have studied a panel of T cells, memory T cells, suppressor cells, after completion of chemotherapy and subsequently in every 6 month interval till relapse. Among several parameters studied a direct correlation between myeloid derived suppressor cells (MDSCs) profile and relapse was noted. Results: CD33+CD11b+MDSCs were remarkably high in high grade NHL patients in comparison to disease free low grade follicular lymphoma patients (p &lt; 0.01). Moreover, all of these NHL patients possessed significantly greater proportion of MDSCs than normal healthy individuals (p &lt; 0.001). Interestingly, single responding T cell lymphoma patient showed completely normal level of MDSCs. Studies are also being conducted to correlate with the status of memory T cells with disease relapse. Conclusions: Observed correlation between greater proportions of MDSCs with the relapse of diseases suggest MDSCs might be the potential target to enhance the relapse free survival of NHL patients, thus, demands further extensive investigation.

Characteristics of orbital lymphoma: a clinicopathological study of 26 cases.

Evaluation of the medical data of patients with orbital and adnexal lymphoma. Cohort study of all cases diagnosed with orbital or adnexal lymphoma at Meir Medical Center between 1993 and 2007. Twenty-six patients, with intraorbital or subconjunctival masses with orbital involvement, were examined and followed up between 1 and 8years. Examined data included: clinical presentation, age, gender, imaging, tumor location, surgical management, and pathological diagnosis. Presenting signs and symptoms included proptosis, eyelid lesions, tearing, chemosis, decreased visual acuity, ptosis, pain, squint, and optic nerve compression. In five cases, lymphoma was misdiagnosed on neuroimaging. Bone changes were seen in four patients. All cases were B cell lymphomas; with the majority (22 cases) of small B cell type; consisting of primary extranodal marginal zone lymphoma of mucosa-associated lymphoid tissue and two cases of small cell lymphoma. One small cell lymphomas was of follicular type on a background of CLL, and the other was CLL/SLL type. Fourteen cases were primary orbital disease, and 12 cases were systemic disease. Macroscopic appearance of lymphoma at open biopsy was characteristic in most cases. Flow cytometry phenotyping gave rapid reliable diagnosis of the disease. Epiphora or chemosis in the presence of an orbital mass should alert the ophthalmologist to suspect lymphoma. Lymphoma may be easily misinterpreted on neuroimaging for other diseases. Bone changes seen on CT are more common than is generally perceived. Macroscopic appearance at open biopsy was characteristic.

Analysis of Prevalence and Clinical Features of Ameloblastoma and its Histopathological Subtypes in Southeast Myanmar and Lower Northern Thailand Populations: A 13-Year Retrospective Study.

Prevalence of ameloblastomas has been established worldwide but collective data of ameloblastoma in Southeast Asian countries has not been well analyzed. Aim of this study was to report analysis and comparison of the prevalence and demographic data of clinical features of ameloblastoma and its histopathological variants in Southeast Myanmar and lower Northern Thailand populations. A retrospective study on ameloblastoma was performed based on the availability of oral biopsy specimens in Faculty of Dentistry, Naresuan University, Phitsanulok, Thailand, between January 2002 and August 2015. The collected data were subjected to descriptive statistical analyses with the SPSS version 17.0 statistical software package (SPSS Inc., Chicago, USA). Pearson's chi square (χ2) test and t-test were employed. The critical level of significance was set at p<0.05. Total of 616 cases were reviewed, 30 cases (5%) were diagnosed as ameloblastoma with male:female ratio of 1.14:1. The mean age of the patients was 31.3±15.6 years. The predominance anatomical distribution was observed in the mandible (86.7%). Posterior body-ramus-angle region was the most common site. Almost all cases were asyptomatic and most common clinical manifestation was swelling of affected region. Multilocular radiolucency was observed in 70% of cases, whereas 30% were unilocular. Three subtypes of ameloblastomas were diagnosed: unicystic ameloblastoma (20%), conventional solid/multicystic ameloblastoma (70%), and desmoplastic ameloblastoma (10%). The most common histologic pattern was the plexiform type (57.2%) followed by follicular type (23.8%). Prevalence of ameloblastoma in Southeast Myanmar and lower Northern Thailand populations correspond with data from other geographic areas of Thailand and other Asian countries. However, some demographic and histopathological profiles are different, with plexiform ameloblastoma being the most common subtype in this study.

Extrafollicular Adenomatoid Odontogenic Tumor: A Case Report

Odontogenic tumors are a group of heterogeneous lesions. Adenomatoid odontogenic tumor (AOT) is a benign, hamartomatous, slow-growing lesion, which is usually located in the anterior maxilla and is more prevalent in females. Although the follicular type is more frequently described in literature, here we report a case of extrafollicular type of AOT in the maxillary anterior region in a 16-year-old female.

Cyclophosphamide and Doxorubicin Induced Melanonychia: A Case Report

Chemotherapeutic agents may rarely cause discoloration and hyperpigmentation of the nails. We present a patient who developed blackish discoloration of nails also referred as melanonychia during six cycles of R-CHOP chemotherapy regimen (rituximab, cyclophosphamide, doxorubicin, vincristine and prednisone) for the treatment of Non Hodgkin Lymphoma (NHL) follicular type. The patient developed blackish brown discoloration in all the nails. As suggested by previous literature evidence the melanonychia could be associated with cyclophosphamide and doxorubicin. According to the Naranjo causality assessment scale, we established that there was a 'probable' association of nail discoloration with the drug.