Oral candidiasis in cancer patients

Oral candidiasis in cancer patients is an infection for which inconsistent diagnostic and therapeutic strategies currently prevail. Recent studies have shown its potential importance in the development of systemic candidiasis. A clinical and cytologic study was undertaken on 52 consecutive cancer patients admitted to our institution. Although the incidence of clinical candidiasis was low (8%), 27% of patients harbored evidence of subclinical colonization by Candida. In addition, a significant correlation was found between candidal colonization and low absolute lymphocyte counts. The significance of these findings in relation to systemic candidiasis and rationale for therapy are discussed.

Oral manifestations of the chronic graft-v-host reaction

The graft-v-host reaction (GVHR), a major complication of bone marrow transplantation, is a complex immunologic phenomenon with a diverse and often confounding presentation. After reviewing major systemic manifestations, this report details the clinical and pathological oral findings of chronic GVHR. The reaction is characterized clinically by a mucosal lichenoid keratosis. Pathological findings resemble mucosal lichen planus, and minor salivary gland show lesions similar to those of Sjögren's syndrome. These oral findings are potentially valuable in the early recognition and follow-up of chronic GVHR. The differential diagnosis includes viral infections and chemotherapeutic drug toxicity, but these can usually be eliminated from consideration by viral cultures and temporal correlation of symptoms, respectively.

Aggressive fibromatosis involving the paramandibular soft tissues. A study with the aid of electron microscopy

The distinction at the level of light microscopy between aggressive fibromatosis and low-grade malignancies with fibroblastic features may be difficult. An electron microscopic study of four cases of aggressive fibromatosis of the mandibular soft tissue was undertaken to determine whether any ultrastructural characteristics could be identified that would aid in a more uniform distinction between these lesions. The pertinent findings include the identification of cells of fibroblastic derivation showing a range of organelle-poor to organelle-rich features, cytoplasmic microfibrils, and dilated rough endoplasmic reticulum profiles. These features are discussed in the light of previously published findings of other forms of aggressive fibromatosis and closely related lesions. The study reaffirms that although electron microscopy may be useful in confirming the cell of origin in these lesions, the accurate diagnosis of fibrous tumors still rests with the proper correlation of clinical and light microscopic features. Clinical follow-up of the cases supports both the diagnosis of aggressive fibromatosis and the recommended treatment of adequate local excision.