scholarly journals The Pseudolesions of the Oral Mucosa: Differential Diagnosis and Related Systemic Conditions

2019 ◽  
Vol 9 (12) ◽  
pp. 2412 ◽  
Author(s):  
Fedora della Vella ◽  
Dorina Lauritano ◽  
Carlo Lajolo ◽  
Alberta Lucchese ◽  
Dario Di Stasio ◽  
...  

Pseudolesions are defined as physiological or paraphysiological changes of the oral normal anatomy that can easily be misdiagnosed for pathological conditions such as potentially malignant lesions, infective and immune diseases, or neoplasms. Pseudolesions do not require treatment and a surgical or pharmacological approach can constitute an overtreatment indeed. This review aims to describe the most common pseudolesions of oral soft tissues, their possible differential diagnosis and eventual related systemic diseases or syndromes. The pseudolesions frequently observed in clinical practice and reported in literature include Fordyce granules, leukoedema, geographic tongue, fissured tongue, sublingual varices, lingual fimbriae, vallate papillae, white and black hairy tongue, Steno’s duct hypertrophy, lingual tonsil, white sponge nevus, racial gingival pigmentation, lingual thyroid, and eruptive cyst. They could be misdiagnosed as oral potential malignant disorders, candidiasis, Human Papilloma Virus (HPV)-related affections, oral autoimmune diseases, or benign and malignant tumors. In some cases, pseudolesions feature in a syndromic panel, for example, fissured tongue in Melkersson–Rosenthal syndrome. It is strictly fundamental for dentists to know and to distinguish oral pseudolesions from pathological conditions, in order to avoid overtreatment.

1996 ◽  
Vol 114 (4) ◽  
pp. 1216-1219
Author(s):  
Edmir Américo Lourenço ◽  
Luís Henrique Chechinato Costa

Pediculated lesions of the nasal cavities are relatively common in daily practice, and include inflammatory polyps, benign tumors (papillomas being the most common), malignant tumors, and specific processes, such as polypoid rhinosporidiosis. The authors describe a female patient with a warty, pediculated, and asymptomatic lesion in the nasal septal mucosa. The anatomo-pathological exam showed this to be a"carcinoma in situ." The few bibliographic citations report only an association between the tumor and contact with wood dust, such as oak, ebony and beech. The patient was not exposed to these elements. It is important to emphasize the routine performance of a complete otolaryngological exam for patients seeking out specialists, in order to detect potentially malignant lesions whose early removal would permit a complete cure.


2020 ◽  
Vol 24 (3) ◽  
pp. 63-75
Author(s):  
Yu. A. Stepanova ◽  
M. Z. Alimurzaeva ◽  
D. A. Ionkin

The incidence of focal lesions in the spleen is 3.2–4.2% per 100,000 population. Spleen cysts are rare (incidence 0.75 per 100,000). These are single or multiple, thin- and smooth-walled cavities filled with a transparent liquid. Distinguish between primary (or true) cysts, lined with epithelium, and secondary (or false), devoid of epithelial lining. Among the primary cysts, there are congenital cysts formed in the embryonic period due to the migration of peritoneal cells into the spleen tissue, dermoid and epidermoid cysts. A special group of primary cysts are parasitic cysts. Cystic tumors of the spleen include lymphangioma and lymphoma.The main difficulties in the diagnosis and differential diagnosis of cysts and cystic tumors of the spleen are associated with the rarity of this pathology and, as a consequence, a small number of works, including a significant number of the cases. However, in those works where a large number of the cases are described, most often this is one morphological form and an analysis of its various characteristics.Purpose. Based on the analysis of our own examination data of a significant number of patients with cysts and cystic tumors of the spleen, to assess the possibility of differential diagnosis of individual morphological forms according to ultrasound data.Materials and methods. 323 patients with cysts and cystic tumors of the spleen from 15 to 77 years old (men – 105 (32.5%); women – 218 (67.5%) were treated at A.V. Vishnevsky National Medical Research Center of Surgery for the period from 1980 to 2020. All patients underwent ultrasound during examination. Surgical treatment was carried out in various ways – (85.1%), when making a preoperative diagnosis of an uncomplicated spleen cyst of small size, dynamic observation was carried out (verification by puncture biopsy data).Results. Morphological verification of cysts and cystic tumors of the spleen was presented as follows (taking into account possible difficulties in identifying the epithelial lining): true cyst – 182 (56.4%); dermoid cyst – 3 (0.9%) (malignant – in 1 case); pseudocyst – 16 (5.0%); pancreatogenic – 34 (10.5%); echinococcus – 52 (16.1%); lymphangioma – 24 (7.4%); lymphoma – 10 (3.1%); ovarian cancer metastasis – 2 (0.6%). The article describes the ultrasound signs of the above forms of the lesions with an emphasis on the complexity of diagnosis.Conclusions. Primary and parasitic spleen cysts are well differentiated according to ultrasound; false cysts of the spleen, depending on the cause of their occurrence, can create difficulties in their identification and differentiation (they require careful dynamic control); cystic tumors of the spleen should be differentiated from malignant tumors and metastases of a cystic structure, as a result of which such vigilance should always be present when they are detected.


2019 ◽  
Vol 47 (03) ◽  
pp. 192-195
Author(s):  
Julia Schoiswohl ◽  
Bianca Lambacher ◽  
Andrea Klang ◽  
Reinhild Krametter-Frötscher

AbstractFibrosarcomas are malignant tumors of the connective tissue, which are characterized by proliferation of fibroblasts. Most of these tumors are localized subcutaneously and cause different symptoms depending on their location. The case report describes a dermal tumor on the outside of the pinna in a 7-year-old female Cashmere goat. The tumor was surgically removed and histopathological examination revealed a low grade fibrosarcoma. Although tumors are rare in ruminants because of the animals’ short lifespan (age of slaughtering in most cases < 24 months) in modern production processes, they should be considered as a differential diagnosis.


2021 ◽  
Vol 49 (5) ◽  
pp. 030006052110196
Author(s):  
Xiaotong Peng ◽  
Zhi Duan ◽  
Hongling Yin ◽  
Furong Dai ◽  
Huining Liu

Epithelioid angiosarcoma is a rare and highly aggressive soft tissue angiosarcoma most commonly arising in the deep soft tissues. Given that abundant vascular cavities anastomose with each other, most angiosarcomas prone to metastasis recur quickly, and the overall prognosis is poor. We report a 25-year-old woman at 24 weeks’ gestation who presented with a 1-month history of abdominal distension. Ultrasonography suggested a mass in the right adnexa, and she underwent two operations owing to uncontrolled intraperitoneal bleeding with progressive anemia. The right ovarian tumor and right adnexa were removed successively. Biopsy yielded a diagnosis of primary epithelioid angiosarcoma with mature cystic teratoma. The patient died from uncontrolled progressive bleeding 1 week after the second operation. This case revealed that epithelial angiosarcoma is a highly malignant endothelial cell tumor. The results of surgery and chemoradiotherapy tend to be poor, and the recurrence rate is high. The purpose of this study is to raise clinical awareness of epithelial angiosarcoma and its adverse events and to provide new ideas for the treatment of these adverse events. Immunohistochemical staining of pathological specimens can facilitate diagnosis. Pregnancy with malignant tumors may lead to rapid disease progression, extensive lesions, and a poor prognosis.


Author(s):  
Daniela Alexandra Gonçalves Pereira ◽  
Eliana Patrícia Pereira Teixeira ◽  
Ana Cláudia Martins Lopes ◽  
Ricardo José Pina Sarmento ◽  
Ana Paula Calado Lopes

AbstractThe diagnosis of genital ulcers remains a challenge in clinical practice. Lipschütz ulcer is a non-sexually transmitted rare and, probably, underdiagnosed condition, characterized by the sudden onset of vulvar edema along with painful necrotic ulcerations. Despite its unknown incidence, this seems to be an uncommon entity, with sparse cases reported in the literature. We report the case of an 11-year-old girl who presented at the emergency department with vulvar ulcers. She denied any sexual intercourse. The investigation excluded sexually transmitted infections, so, knowledge of different etiologies of non-venereal ulcers became essential. The differential diagnoses are extensive and include inflammatory processes, drug reactions, trauma, and malignant tumors. Lipschütz ulcer is a diagnosis of exclusion. With the presentation of this case report, the authors aim to describe the etiology, clinical course, and outcomes of this rare disease, to allow differential diagnosis of genital ulceration.


1994 ◽  
Vol 9 (2) ◽  
pp. 63-69 ◽  
Author(s):  
R. Moll

Cytokeratins, which comprise a multigene family of 20 related polypeptides (CKs 1–20), are constituents of the intermediate filaments of epithelial cells, in which they are expressed in various combinations depending on the epithelial type and the degree of differentiation. Of these, CK 19 (400 amino acids; 44.1 kilodaltons) is an example of a widely distributed CK, being expressed in various epithelia, including many simple epithelia. In contrast, the recently identified CK 20 (424 amino acids; 48.6 kilodaltons) is essentially confined to gastrointestinal epithelia, the urothelium and Merkel cells. The differential expression of individual CKs in various types of carcinomas makes them useful markers for histopathological carcinoma subtyping, providing relevant information concerning the differentiation and origin of carcinomas, especially when tumors first present as metastases. The CKs that are of particular value for differential diagnosis include CK 20, as it is mainly expressed in carcinomas derived from CK 20-positive epithelia; it is also found in bile-tract, pancreatic and mucinous ovarian adenocarcinomas, being absent in most other carcinomas. In certain carcinoma types, the changes in the expression of individual CKs that may occur during tumor progression could be of prognostic relevance. It remains to be established whether the serological detection of fragments of not only widely distributed but also more restrictedly expressed CKs may provide useful serological tumor markers in the future.


1978 ◽  
Vol 49 (6) ◽  
pp. 914-920 ◽  
Author(s):  
Darrell J. Harris ◽  
Victor L. Fornasier ◽  
Kenneth E. Livingston

✓ Hemangiopericytoma is a vascular neoplasm consisting of capillaries outlined by an intact basement membrane that separates the endothelial cells of the capillaries from the spindle-shaped tumor cells in the extravascular area. These neoplasms are found in soft tissues but have rarely been shown to involve the spinal canal. This is a report of three such cases. Surgical removal of the tumor from the spinal canal was technically difficult. A high risk of recurrence has been reported but in these three cases adjunctive radiotherapy appeared to be of benefit in controlling the progression of the disease. These cases, added to the six cases in the literature, confirm the existence of hemangiopericytoma involving the vertebral column with extension into the spinal canal. This entity should be included in the differential diagnosis of lesions of the spinal canal. The risk of intraoperative hemorrhage should be anticipated.


2021 ◽  
pp. 172460082199235
Author(s):  
Weina Zhang ◽  
Yu-min Zhang ◽  
Yuan Gao ◽  
Shengmiao Zhang ◽  
Weixin Chu ◽  
...  

Objective: CA-125 is widely used as biomarker of ovarian cancer. However, CA-125 suffers low accuracy. We developed a hybrid analytical model, the Ovarian Cancer Decision Tree (OCDT), employing a two-layer decision tree, which considers genetic alteration information from cell-free DNA along with CA-125 value to distinguish malignant tumors from benign tumors. Methods: We consider major copy number alterations at whole chromosome and chromosome-arm level as the main feature of our detection model. Fifty-eight patients diagnosed with malignant tumors, 66 with borderline tumors, and 10 with benign tumors were enrolled. Results: Genetic analysis revealed significant arm-level imbalances in most malignant tumors, especially in high-grade serous cancers in which 12 chromosome arms with significant aneuploidy ( P<0.01) were identified, including 7 arms with significant gains and 5 with significant losses. The area under receiver operating characteristic curve (AUC) was 0.8985 for copy number variations analysis, compared to 0.8751 of CA125. The OCDT was generated with a cancerous score (CScore) threshold of 5.18 for the first level, and a CA-125 value of 103.1 for the second level. Our most optimized OCDT model achieved an AUC of 0.975. Conclusions: The results suggested that genetic variations extracted from cfDNA can be combined with CA-125, and together improved the differential diagnosis of malignant from benign ovarian tumors. The model would aid in the pre-operative assessment of women with adnexal masses. Future clinical trials need to be conducted to further evaluate the value of CScore in clinical settings and search for the optimal threshold for malignancy detection.


2018 ◽  
Vol 142 (11) ◽  
pp. 1358-1363 ◽  
Author(s):  
Brian S. Soles ◽  
Allecia Wilson ◽  
David R. Lucas ◽  
Amer Heider

Context.— Melanotic neuroectodermal tumor of infancy, albeit rare and generally regarded as benign, is an important tumor to recognize because of its rapid growth, potential for local recurrence, and small round blue cell morphology, which can lead to misdiagnosis of a malignant neoplasm. Objective.— To review its clinical presentation and immunomorphologic findings, and discuss common entities in the differential diagnosis. Data Sources.— The study involved PubMed searches, including multiple review articles, case studies, retrospective studies, selected book chapters, and University of Michigan cases. Conclusions.— Melanotic neuroectodermal tumor of infancy most commonly occurs in the bones of the head and neck region during the first year of life, but it can also present in other locations, including the central nervous system, testes, ovaries, and subcutaneous soft tissues. Histologically, it is composed of a biphasic population of cells, consisting of epithelioid melanin-producing cells and primitive neurogenic cells in a fibrocollagenous stroma. These microscopic findings, especially in small biopsies, can lead to a broad differential diagnosis that includes malignant small round blue cell tumors and malignant melanoma. Melanotic neuroectodermal tumor of infancy commonly has an infiltrative growth pattern, and anatomic constraints often lead to incomplete resection and local recurrence, requiring multiple surgical operations. Because melanotic neuroectodermal tumor of infancy can mimic a more aggressive and aggressively treated malignancy, recognition of this rare tumor is very crucial for pathologists.


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