Oral Mucosa Research Articles

Assessment of optical coherence tomography and optical coherence microscope for oral cancer diagnosis: a clinical accuracy study

Objective: To explore and evaluate the feasibility and accuracy of using optical coherence tomography and optical coherence microscope (OCT/OCM) for diagnosis of oral cancer. Methods: In this study, OCT/OCM was utilized to image the oral mucosa specimens. A total of 289 ex vivo oral mucosa specimens were collected from 68 patients with oral cancer who were hospitalized at Department of Oral and Maxillofacial Head and Neck Tumors, Capital Medical University School of Stomatology, between January 2021 and February 2023, resulting in a dataset of 1 445 OCT/OCM images. By observing the characteristic patterns in the OCT/OCM images, including normal oral mucosa, epithelial abnormal proliferation (mild, moderate, severe), and oral cancer, these patterns were matched with corresponding pathological images. A diagnostic study was conducted, employing pathological diagnosis as the gold standard and utilizing a double-blind experimental design involving three diagnostic evaluators who participated in the analysis and diagnosis of OCT/OCM images. Results: The OCT/OCM images demonstrated good correlation with the corresponding pathological images, and diagnostic criteria were established based on the comparative results. In the diagnostic study involving three investigators, the accuracy was 82%, sensitivity was 84% (95%CI: 80%-88%), and specificity was 81% (95%CI: 77%-85%). There was a high level of agreement among the observers (κ=0.614), indicating substantial concordance in the diagnostic results among the three investigators. Conclusions: This study demonstrates the potential of OCT/OCM for diagnosis of oral cancer. The technology accurately distinguishes between normal oral mucosa, epithelial abnormal proliferation and oral cancer.

Use of autofluorescent stomatoscopy in the diagnostic algorithm for oral mucosal and vermilion border lesions in adolescents

Relevance. There is currently significant interest in studying the prevalence of diseases affecting the oral mucosa and lip vermilion border in adolescents. A promising approach in this field is the use of modern non-invasive optical technologies, which not only offer additional insights into the patient's oral health status but also enhance their compliance.Materials and methods. A total of 71 adolescents (9th to 11th grade students) aged 15 to 17 years (mean age — 16.2 ± 0.8 years) were examined. The oral mucosa and lip vermilion border were assessed for abnormalities under natural light and through endogenous fluorescence using autofluorescent stomatoscopy. Various optical filters were applied, and clinical images were compared with autofluorescent images. A visual analog scale was used to assess the clarity of the diagnostic test results for the participant. Recommendations were provided, and treatment was prescribed according to the established diagnoses.Results. Oral mucosal lesions and lesions of the lip vermilion border were observed in 45% of cases, all of benign origin, without visible changes to the naked eye or pain. The most frequently diagnosed lesions were morsicatio buccarum and chapped lips. Distinct autofluorescent characteristics of the identified lesions were observed and documented. Participant-reported feedback was positive in 100% of cases during autofluorescent stomatoscopy. The mean score for the clarity of diagnostic results, assessed using the visual analog scale, was 9.3±0.12, indicating a high level of diagnostic visibility.Conclusion. Implementing a qualified clinical approach focused on preventing oral diseases in adolescent patients is recommended with the use of autofluorescent stomatoscopy. This technique not only offers real-time insights into the patient’s oral health status but also actively engages young patients, increasing their motivation to maintain good oral health.

PARACOCCIDIOIDOMICOSE NA ODONTOLOGIA

Paracoccidioidomycosis is a fungal disease caused by the fungus Paracoccidioides brasiliensis, which prefers humid and warm places. Male individuals between 30 and 60 years of age are generally the most affected by this disease, especially those who work in rural areas or gardening. The objective of this study was to conduct a literature review addressing the topic of paracoccidioidomycosis in dentistry, highlighting its oral clinical aspects, increasing the knowledge of dentists so that they can help in the early recognition and diagnosis of the lesion. Diagnosis can be made through fungal culture, incisional biopsy, serological tests, histopathological analysis of the skin and mucous membranes, and chest X-rays to check for possible lung involvement. The most frequent clinical signs appear in the alveolar mucosa, gums, palate, and tongue, but other areas of the body can also be affected by the condition. In most cases, the disease is identified through oral clinical characteristics, and the dentist is the first professional to treat these patients. Treatment for paracoccidioidomycosis is prolonged and varies according to the severity of the lesions, involving the use of various antifungals such as itraconazole and cotrimoxazole. To increase the patient's life expectancy and prevent the spread of the disease, it is essential that the dentist recognizes the oral clinical manifestations, performs tests, and correctly refers the patient for appropriate medical treatment.

Nano-emulgel formulation of lemongrass extract (Cymbopogon citratus) as herbal–based topical drug for oral mucositis: A review

Background: Oral mucositis is a condition characterized by inflammation and ulceration of the oral mucosa, commonly affecting cancer patients undergoing chemotherapy or radiotherapy, with MRSA infection as a significant contributing factor. This condition impairs mucosal barrier function, increasing susceptibility to secondary infections, especially from MRSA, which thrives in the moist environment of the oral cavity. Secondary infections by MRSA exacerbate symptoms, delay healing, and complicate the clinical presentation of mucositis through the production of virulence factors like enterotoxins and exfoliative toxins. Purpose: Explaining the potential of lemongrass extract and its combination with nanoemulgel formulation as herbal intervention against oral mucositis. Method: A literature review of studies published within the past five years from sources like ResearchGate, ScienceDirect, PubMed, and Google Scholar. Result: Lemongrass extract comprises prominent amount of citral, emphasizing anti-inflammatory and antioxidant capabilities. Combination with nanoemulgel phase will provide stability and enhanced therapeutic capabilities of lemongrass extract into the targeted oral site. Conclusion: The formulation of lemongrass extract nanoemulgel equipped can be a futuristic solution as an over-the-counter drug for minimally invasive therapy of oral mucositis.

Towards the identification of body fluids using RT-LAMP isothermal amplification coupled with CRISPR-Cas12a

While often necessary in sexual assault cases, confirmatory identification of body fluids can be a lengthy and/or costly process. In particular, the detection of vaginal fluid and menstrual fluid in forensic casework is limited to endpoint reverse-transcription PCR to detect fluid-specific messenger RNA (mRNA) markers as there are no robust chemical or enzymatic techniques available for these fluids. Similarly, testing for rectal mucosa is not possible with standard methods, the presence of which would provide probative value in cases of alleged anal penetration, although mRNA-based markers have recently been described. Reverse-transcription loop-mediated isothermal amplification (RT-LAMP) is an alternative technique that enables detection of mRNA at a single temperature (usually 60–65℃) for 10–30 minutes and has comparable sensitivity to PCR. We describe the coupling of RT-LAMP amplification (60℃ for 30 minutes) with CRISPR-mediated fluorescent detection of the body fluid specific mRNA markers MMP3 (menstrual fluid), CYP2B7P (vaginal material), TNP1 (spermatozoa), KLK2 (semen), and MUC12 (rectal mucosa). Following temperature optimization and final selection of RT-LAMP-CRISPR assays, their specificity across circulatory blood, buccal, menstrual fluid, vaginal material, semen, and rectal mucosa was assessed. Most assays were specific for their intended target body fluid, although MMP3 and CYP2B7P were detected in some rectal mucosa samples, the latter of which has been observed previously in the literature. A preliminary sensitivity assessment in target fluids was determined by a dilution series over six logs of RNA input. A range of assay approaches were investigated to develop a protocol suitable for use in a forensic screening laboratory. This included the determination of fluorescent assay results by eye, use of lyophilised reagents, and RT-LAMP and CRISPR reactions undertaken in one-tube in a lower resource setting.

Soft-tissue keratocyst: report of 3 new cases from Brazil.

To describe the clinicopathological features of 3 new cases of soft-tissue keratocyst (STK) of the buccal mucosa from Brazil. Clinical data from 3 patients diagnosed with STK were obtained from the archives of the Laboratory of Oral Pathology at the Federal University of Rio de Janeiro- Brazil from 2020 to 2023. Two oral pathologists reviewed conventional hematoxylin and eosin-stained slides of each case. Immunohistochemical stainings for CK19, Bcl-2, CD138, D2-40, EMA, and Ki-67 were performed in all cases. Case 1 was a 58-year-old man with a 2-year history of painless swelling of the right buccal mucosa, measuring approximately 5cm. Case 2 was of a 44-year-old man with a painful swelling in the left buccal mucosa lasting 3 years with drainage to the oral cavity. Case 3 was of a 74-year-old woman with a painful swelling in the left buccal mucosa of unknown duration. Microscopic evaluation of all 3 cases revealed a cyst lined with a few cell layers composed of columnar palisading basal cells and a corrugated parakeratin surface. The capsule comprised fibrous connective tissue with variable amounts of blood vessels with hemorrhage, nerve bundles, fat tissue, striated muscle fibers, and the absence of pilosebaceous units. No recurrence was observed after complete surgical removal. All epithelial layers of the 3 cases expressed positivity for CK19 and CD138, the basal cells were positive for Bcl-2 and D2-40, and the superficial epithelial layer was positive for EMA. All cases demonstrated a low proliferation index by Ki-67. This study represents a series of 3 cases of STK that affected the posterior buccal mucosa of middle-aged patients from Brazil, sharing histopathological and immunohistochemical features with odontogenic keratocyst.

The condition of the oral mucosa in somatic pathology

Lesions of the oral mucosa (SOPR) are often the primary pronounced clinical symptom of somatic diseases. It is possible to find out which pathogenetic mechanisms and links of somatic pathology create conditions for the implementation of risk factors, the implementation and development of structural and functional disorders in the oral mucosa, with the aim of targeted therapeutic effects on changes in the SOPR and the general condition of the body as a whole. The purpose of the study was to establish the structure of diseases of the oral mucosa depending on gender and age in patients with various somatic pathology. Materials and methods: A survey was conducted of 164 patients who sought advice from the Dental Hospital of Khabarovsk. Between the ages of 18 and 89. The average age of patients was (55.7 ± 1.38) years. All the subjects were divided into 4 groups depending on their age and the presence of diseases of internal organs. The comparison group included 30 somatically preserved patients of similar age and gender, by random sampling. Results: It was found that with pathology of the oral mucosa, women out of the total number of cases were 2.5 times more than men. The greatest number of patients’ complaints about the diseases of COPD was in the age group of 60-74 years, unlike other age groups: 18-44 years by 1.8 times; 45–59 years by 1.2 times; 75–89 years by 2.7 times, respectively. Most diseases of the oral mucosa are manifested in the presence of systemic pathology. Somatic diseases were detected in 62.2 % of patients with COPD. Pathology of internal organs and systems affects 70.42 % of patients with lichen planus, 50 % of patients with leukoplakia, 80 % of patients with candidiasis, 26.32 % of patients with chronic aphthous stomatitis and 79.17 % of patients with glossitis. Diseases of the gastrointestinal tract are 1.2 and 2.8 times more dominant in the structure of the lesions of the SOPR compared to the pathology of the cardiovascular and endocrine system. Findings: The revealed pattern of manifestations of pathological changes in the oral mucosa against the background of somatic pathology is of great diagnostic importance not only for dentists of various profiles, but also for clinicians of specialized departments, since ultimately all this affects the timeliness and quality of medical and diagnostic care for this category of patients.

Lack of oral involvement in a large cohort of women with vulvar lichen sclerosus - a multicenter prospective study.

We assessed the prevalence of oral lichen sclerosus in a cohort of women affected with vulvar lichen sclerosus (VLS). This prospective, observational study included adult female patients with a histologically proven VLS who attended the Vulva Clinics of three Dermatology Units from January 2020 to July 2023. During this period, all VLS patients were asked to be examined in their oral cavities in order to detect any possible sign of oral diseases, which were then biopsied. Three hundred women (mean age 64.5 ±13.0years) were included, of whom 21 (7%) had a concurrent extragenital LS. In six (2%) patients, white, non-removable lesions were found at oral inspection and biopsied. All cases were histologically lichen planus. No other clinically relevant oral lesions were found. The six women with histologically proven oral lichen planus had more frequent periodontal and autoimmune diseases than the other included subjects. Our findings confirm the absolute rarity of oral involvement in patients with VLS. They suggest that the oral mucosa, unlike the genitals, is a setting which weakly leads to development of LS, also in predisposed subjects.

Use of polyphyte oil in the treatment of chronic gingivitis in orthodontic patients

The study presents the results of research on the treatment of chronic catarrhal gingivitis in patients undergoing long-term orthodontic treatment with fixed appliances. A domestic product based on plant components, a four-component polyphyte oil «Fitoleum® Oil for Gums and Teeth», was used for treatment. The study involved 36 patients diagnosed with chronic catarrhal gingivitis who had been undergoing orthodontic treatment with bracket systems for six to eighteen months. All patients were divided into two groups: the main group (20 persons), using the four-component polyphyte oil, and the control group (16 persons), receiving standard treatment.The therapeutic effect was assessed based on the absence of complaints of itching and discomfort in the gums, as well as indicators of the sulcus bleeding index (SBI) according to Mühlemann and the degree of inflammation using the papillary-marginal-alveolar index (PMA). Measurements were taken on the first, third, and fifth days of the study. The results showed a positive dynamic in clinical and index indicators on the fifth day of using the four-component polyphyte oil «Fitoleum® Oil for Gums and Teeth» in all patients of the main group.Thus, the use of this oil demonstrated high effectiveness in treating chronic catarrhal gingivitis that developed during orthodontic treatment with bracket systems. The advantages of using the four-component polyphyte oil include reducing inflammatory processes, decreasing the level of gum bleeding, and improving the overall condition of the oral mucosa. The obtained results confirm that this method can be recommended for widespread use in clinical practice for patients undergoing orthodontic treatment.

Cross-modal representation of chewing food in posterior parietal and visual cortex.

Even though the oral cavity is not visible, food chewing can be performed without damaging the tongue, oral mucosa, or other intraoral parts, with cross-modal perception of chewing possibly critical for appropriate recognition of its performance. This study was conducted to clarify the relationship of chewing food cross-modal perception with cortex activities based on examinations of the posterior parietal cortex (PPC) and visual cortex during chewing in comparison with sham chewing without food, imaginary chewing, and rest using functional near-infrared spectroscopy. Additionally, the effects of a deafferent tongue dorsum on PPC/visual cortex activities during chewing performance were examined. The results showed that chewing food increased activity in the PPC/visual cortex as compared with imaginary chewing, sham chewing without food, and rest. Nevertheless, those activities were not significantly different during imaginary chewing or sham chewing without food as compared with rest. Moreover, subjects with a deafferent tongue dorsum showed reduced PPC/visual cortex activities during chewing food performance. These findings suggest that chewing of food involves cross-modal recognition, while an oral somatosensory deficit may modulate such cross-modal activities.

Morphological changes in purulent wound defect of the oral mucosa when using a non-woven polymer membrane with vancomycin (experimental study)

Currently, the problem of effective treatment of purulent wounds of the oral mucosa is relevant, scientists are improving dressing materials, creating new coatings. The study tested for the first time a non-woven polymer membrane from a copolymer of vinylidene fluoride with tetrafluoroethylene with Vancomycin, presumably which will meet the requirements of an ideal dressing material. The purpose of the study is to determine the effect of a non-woven polymer membrane with Vancomycin on the regeneration of a purulent wound defect of the oral mucosa in experiment. 35 white Wistar rats were divided into three groups: first group (n = 15), in which the wound defect was left open according to the standard procedure of the wound process in the oral cavity; second group (n = 15), in which the wound defect was covered with a non-woven polymer membrane with Vancomycin; third group (served as control group), in which the rats had intact oral mucosa (n = 5). Tissue samples were collected from the area of the purulent wound on the 3rd, 7th and 14th days of the study and histological sections were prepared using a standard procedure. The indicators were calculated using the AxioVision SE64 Rel program. 4.9.1: area of loose fibrous connective tissue (%), cellular infiltration (%), granulation tissue (%).The statistical analysis of the obtained data was performed using Mann–Whitney and Wilcoxon tests in Statistica 8.0 (StatSoft, USA) software. Differences were considered statistically significant at p 0.05. It has been established that the non-woven polymer membrane from a copolymer of vinylidene fluoride with tetrafluoroethylene with Vancomycin has a beneficial effect on the regeneration of the oral mucosa in the postoperative period and reduces scar changes in the later stages of healing.

Oral Health Status among Postmenopausal Women Attending Tertiary Hospital of Bharatpur, Nepal

Introduction: Menopause is a biological process occurring in middle aged women causing changes in the level of circulating hormones. Changes in the oral flora, oral mucosa and decrease in bone mineral density leads to many menopauses related oral findings. Objective: This study was conducted with the objective to assess the oral health status of postmenopausal women visiting tertiary health care centre in Bharatpur, Chitwan. Methods: Analytical cross-sectional study was conducted among 224 postmenopausal women attending dental OPD in a tertiary health care centre. Comprehensive oral examination was done where CPITN index was used to record periodontal health and DMFT index was used to record caries experience of the patient. Data entry was done in Microsoft Excel and statistical analysis was done using SPSS version 20. Results: Total 224 patients were examined with age range of 45 to 78 years and the mean age of 56.71 years. 113 study participants comprising 50.4%, showed supra or subgingival calculus followed by gingival bleeding in 54 (24.1%). Mean decayed score among study participants was found to be 2.71±2.85, mean missing score was found to be 4.29±7.83. Conclusion: Mean score for missing teeth suggestive of sequel of dental caries and periodontitis was found higher among the post-menopausal women followed by mean decayed score. Dental caries score was high probably due to dryness of mouth and other predisposing factors.

Forehead Flap - A Salvage Option for Failed Anterolateral Thigh Flap in Buccal Mucosa Carcinoma Reconstruction

Introduction: Pedicled lateral forehead flap could be a valuable option for reconstruction in the floor of the orbit and floor of the mouth in the absence of other resources available. Case presentation: A-57-year-old male with multiple comorbidities, underwent partial maxillectomy, hemi mandibulectomy and hemiglossectomy with infratemporal fossa clearance due to a rapidly spreading buccal mucosa carcinoma on the left side. The last resort was the pedicled lateral forehead flap after unsuccessful reconstructive attempts with an anterolateral thigh flap. Discussion: The pedicled forehead flap which has rich vascularity, decreased donor site morbidity and reliable anatomy made it a favorable locoregional flap for oral reconstruction. Conclusion: Flaps should be chosen considering the patient’s condition and resources available. Forehead flap due to its proximity is an ideal option for reconstruction of oral cavity defects.

Histological Determination of Cinnamon and Olive Oil Extract on Traumatic Oral Ulcer in Laboratory Rabbit

Background: The mucosa of oral cavity is the mucous membrane which covers the tissues of the mouth cavity. In order to repair damage from a local aggressor, many cell strains and their byproducts work together throughout the vital physiological process of wound healing. This process culminates in tissue repair and starts relatively early in the inflammatory phase. . The supplements of cinnamon and olive oil can dramatically raise blood levels of antioxidants while lowering those of inflammatory indicators like C-reactive protein. Objective: The aim of the study was to determine the local histological effect of topical application of cinnamon and olive oil extract on the rabbit oral mucosa Patients and Methods: 20 adult male rabbits that weight about 700-900 Kg and age about (6-8) months where used in this experimental study. Ulcer induction: Prior to the creation of the ulcers, rats were fixed on their backs and all animals were anaesthetized and induction the ulcer with round filter papers 5.5 mm in diameter were soaked in 15 ml of 50% acetic acid. In order to create round ulcer, an acid-soaked filter paper was pressed onto the right buccal mucosa for 60 seconds. Then divided the groups according to the healing time with 10 rabbits as a control group left healed normally and 10 rabbits as an experimental group that daily used mixture of cinnamon extract and olive oil ready extract topically applied on the traumatic ulcer. The animals were sacrificed along three- and seven-days healing periods and then prepared H&E stain for analyzed the results. Results: In comparison to the control group, the histological results of oral ulcers that were created and treated with a daily application of a herbal mixture consisting of cinnamon extract and olive oil extract showed greater epithelization, reduced inflammation, and increased angiogenesis, all of which sped up the healing process. Furthermore, there was a noteworthy distinction in the formation of extracellular matrix and collagen fiber synthesis between the experimental and control groups. Conclusion: Topical treatment using ready herbal extracts of olive oil and cinnamon was more successful in facilitating the recovery of traumatic ulcers.

The environmental impact on aging: Insights from buccal mucosa and molecular biomarkers

Buccal epithelial cells serve as a primary barrier against the inhalation and ingestion of harmful substances, working alongside immune system cells such as natural killer cells to protect the body from health-damaging factors. These epithelial cells can also be used as an alternative tissue source for monitoring the genotoxic effects of external factors such as chemical exposure. This assessment can be performed using molecular biomarkers of aging, which reflect biological age and indicate cellular aging acceleration due to internal and external damage factors, such as environmental hazards. In contrast to chronological age, which merely reflects the passage of time, biological age accounts for individual variation in aging processes. Molecular biomarkers are crucial for distinguishing between normal and pathological processes in the body and for identifying the effects of external factors such as chemical exposures. The identification of specific biomarkers enhances the ability to detect and monitor adverse biological responses and accelerated aging. This review aims to highlight the routes through which environmental hazards enter the body, the application of buccal epithelial cells in assessing genetic modifications, and the introduction of potential molecular biomarkers. However, further research is necessary to elucidate the roles of these biomarkers in determining aging rates and individual variability. Understanding their implications may also help identify new therapeutic targets for preventing premature aging, treating age-related diseases, and developing potential treatments.

Preliminary Characterisation of Immune Cell Populations in the Oral Mucosa of a Small Cohort of Healthy Dogs (Canis lupus familiaris).

Pre-determined anatomical locations in the oral cavity were biopsied, and their histomorphology was characterised using haematoxylin and eosin staining (H&E). The most abundant cell type was of dendritic morphology. Lymphocyte foci were not evident in the palatoglossal folds or the gingiva. Immunohistochemical staining (IHC) for validated leukocyte markers followed, including CD3, CD20, CD79α, CD204, andIba1. Consistent with H&E findings, CD204 immunoreactivity predominated amongst all niches. With the exception of the alveolar mucosa and palatoglossal folds, we also demonstrate a significant difference in the population of macrophages by region for only the Iba1 antigen (p < 0.0001). B lymphocytes were found, and a significant difference was noted in the sub-epithelium where CD20-positive cells outnumbered those labelled as CD79a positive (p = 0.001), suggesting the possibility that these cells are in an active state in health. A similar significant difference was found in the subepithelial tissue for myeloid cells, as there were more cells labelled as CD204 positive over Iba1, which, along with their distribution pattern, indicates a possible functional and morphological overlap between these cells. No significant difference was found in epithelial tissues for cells of either myeloid or lymphoid origins. The results from this study suggest different regions of the oral cavity exhibit variations in the distribution of immune cells, particularly macrophages and B lymphocytes. Though more studies would be needed to confirm these findings, these differences may have implications for the immune response and overall health of the oral mucosa.

Extensively harvested hay contaminated with common windgrass induced an ulcerative stomatitis–gingivitis outbreak in horses

SummaryAfter starting feeding on a new batch of hay, 29 out of 33 horses showed clinical signs of oral ulcerative and bleeding papules and mucous membrane erythema of the gingiva of the mandible within 2–3 days. The results of the complete blood cell count and biochemistry analysis did not yield significant findings in relation to horses affected by ulcerative stomatitis. Swab analyses of the oral mucosa for vesicular stomatitis virus (VS, Type Indiana and Type New Jersey) were negative in all horses (n = 33). Common windgrass with long awns in the deeper stomal‐gingival ulcerations was confirmed through botanical analysis by botanical identification. The hay batch fed to the affected horses was assessed via botanical analysis, finding 15% common windgrass (Apera spica‐venti). After the removal of the contaminated hay batch, full recovery was seen in all horses within 2–6 weeks depending on the severity of the lesions. The grassland from which the hay was harvested belonged to a semi‐natural landscape restored to increase biodiversity and as a protection zone in case of overflow of the river Rhine. In conclusion, feeding forages harvested from these semi‐natural landscapes may be harmful to the health of horses.

Different faces of Mycoplasma pneumoniae in children - cardiological and skin complications- case reports and literature review

Mycoplasma pneumoniae is one of the main pathogens responsible for atypical pneumonia, especially in children over the age of 5, where it accounts for about 40% of cases of extramedullary pneumonia. In addition to respiratory-related symptoms, it can lead to a variety of extrapulmonary manifestations associated with involvement of other organs. In this article, we present case reports of two pediatric patients with detected M. pneumoniae infection with associated cardiac and skin complications. The first case report describes an 11.5-year-old boy who was admitted to the Department of Pediatrics because of chest pain, fever and moist cough for several days, who was diagnosed with myocarditis during M. pneumoniae infection. The second case report describes a 17-year-old girl with a recent respiratory infection who was admitted to the hospital for pain, swelling, blistering of the lips and oral mucosa. Mycoplasma pneumoniae infection can lead to extrapulmonary complications in children, which can produce nonspecific symptoms, so clinical vigilance and early recognition are important to minimize the risk of complications.

Histology-Proven Gastrointestinal Metastasis from Nongastrointestinal Malignancies: Experience of This Rare Occurrence in a Single Center

Introduction Lymph nodes, lung, liver, bone, and brain are the commonest metastatic sites for malignancies arising in various body sites. Gastrointestinal (GI) tract is a very uncommon metastatic site and the present study describes the single-center experience of GI metastases from non-GI malignancies. Aims and Objectives To study the spectrum of metastatic tumors to GI tract and elucidate their clinicopathological characteristics. Materials and Methods This was a retrospective study done on cases diagnosed from 2015 to 2023 at our institute. All cases of non-GI malignancies metastatic to hollow GI tract were included. Cases with GI primary, hematological malignancies, cases with exclusive serosal deposits, and direct invasion of a GI organ from an adjacent primary tumor were excluded. Apart from hematoxylin &amp; eosin (H&amp;E)-stained slides, immunohistochemistry findings of these were reviewed. Results Thirty-six patients were histologically proven GI metastases from non-GI malignancies diagnosed during the study period. Most cases were seen in 5th to 7th decade with a significant female preponderance (M:F of 1:8). The commonest metastatic GI sites were small bowel (n = 11), sigmoid colon (n = 9), and rectum (n = 7), followed by stomach (n = 3), appendix (n = 3), gall bladder (n = 2), and ampulla (n = 1). Stricture, perforation, and nodular mucosa were the most common endoscopic findings. The most common primary malignancies in females were ovarian serous carcinoma (n =21) followed by squamous cell carcinoma (SCC) of cervix (n = 8). In males, there was no site preference, and the primary sites included prostate, lung, kidney, and oral mucosa. Conclusion The study highlights the rare occurrence of GI metastases from non-GI malignancies. Females are at greater risk of such metastases primarily from ovarian serous carcinoma and cervical SCCs.

Single cell transcriptional analysis of human adenoids identifies molecular features of airway microfold cells.

The nasal, oropharyngeal, and bronchial mucosa are primary contact points for airborne pathogens like Mycobacterium tuberculosis (Mtb), SARS-CoV-2, and influenza virus. While mucosal surfaces can function as both entry points and barriers to infection, mucosa-associated lymphoid tissues (MALT) facilitate early immune responses to mucosal antigens. MALT contains a variety of specialized epithelial cells, including a rare cell type called a microfold cell (M cell) that functions to transport apical antigens to basolateral antigen-presenting cells, a crucial step in the initiation of mucosal immunity. M cells have been extensively characterized in the gastrointestinal (GI) tract in murine and human models. However, the precise development and functions of human airway M cells is unknown. Here, using single-nucleus RNA sequencing (snRNA-seq), we generated an atlas of cells from the human adenoid and identified 16 unique cell types representing basal, club, hillock, and hematopoietic lineages, defined their developmental trajectories, and determined cell-cell relationships. Using trajectory analysis, we found that human airway M cells develop from progenitor club cells and express a gene signature distinct from intestinal M cells. Surprisingly, we also identified a heretofore unknown epithelial cell type demonstrating a robust interferon-stimulated gene signature. Our analysis of human adenoid cells enhances our understanding of mucosal immune responses and the role of M cells in airway immunity. This work also provides a resource for understanding early interactions of pathogens with airway mucosa and a platform for development of mucosal vaccines.