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Three hundred and one salivary gland lesions (162 benign, 72 malignant, and 67 benign non-neoplastic) of 677 cases were evaluated by use of intraoperative frozen sections by 66 pathologists. In seven patients, the diagnosis was deferred... more
Three hundred and one salivary gland lesions (162 benign, 72 malignant, and 67 benign non-neoplastic) of 677 cases were evaluated by use of intraoperative frozen sections by 66 pathologists. In seven patients, the diagnosis was deferred for permanent sections. In four cases (1.3%), the diagnosis at permanent section changed from one category of benign tumor to another, and in five cases (1.7%), from one category of malignant tumor to another. In four tumors, a frozen section diagnosis of benign was changed to malignant on permanent sectioning; all four involved acinic cell carcinomas. Only two tumors were incorrectly diagnosed as malignant. We conclude that diagnoses of most salivary gland lesions based on frozen section examination are reliable and accurate. However, the literature does indicate that caution should be exercised when malignant tumors are dealt with.
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A congenital oral duplication cyst of the ventral surface of the tongue was found to contain both gastrointestinal and respiratory epithelium. The literature is reviewed, with emphasis on the possible histogenesis of this extremely rare... more
A congenital oral duplication cyst of the ventral surface of the tongue was found to contain both gastrointestinal and respiratory epithelium. The literature is reviewed, with emphasis on the possible histogenesis of this extremely rare lesion, as well on the clinical differential diagnosis.
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A Federally sponsored program for reducing unnecessary exposures from dental radiographic procedures is monitored over four years. The results are encouraging.
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ABSTRACT No abstract available.
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Research Interests: Face, Adolescent, Humans, Oral Surgery, Male, and 5 morePheochromocytoma, Carcinoma, Mouth, Calcitonin, and Syndrome
A variety of uncommon benign lesions occur in the paranasal sinuses and have been reported to masquerade as carcinomas. Nearly all of such cases have been limited to the frontal, sphenoid, and ethmoid sinuses with an isolated report of... more
A variety of uncommon benign lesions occur in the paranasal sinuses and have been reported to masquerade as carcinomas. Nearly all of such cases have been limited to the frontal, sphenoid, and ethmoid sinuses with an isolated report of maxillary sinus involvement. The classic roentgenologic picture is that of bony destruction. Heretofore described destructive lesions of the maxillary sinus include the mucocele, mucous retention cyst, pseudocyst, pyocele and cholesteatoma. This report deals with a previously undescribed entity, the mucin impaction tumor located in a septate maxillary sinus. This inflammatory, non-neoplastic tumor-like condition, presents as chronic sinusitis with periorbital edema, malar swelling and tenderness. Radiologic examination reveals total destruction of the bony walls of the nose, of the orbital rim and floor and of the maxillary sinus. The importance of recognizing this lesion lies in its benign nature but destructive capabilities. The destruction may poss...
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Two children of Austrian Ashkenazic Jewish background, related as second cousins, have a variant of opalescent dentin in their deciduous teeth. This has been classified by Witkop as Brandywine isolate hereditary opalescent dentin and by... more
Two children of Austrian Ashkenazic Jewish background, related as second cousins, have a variant of opalescent dentin in their deciduous teeth. This has been classified by Witkop as Brandywine isolate hereditary opalescent dentin and by Shields as dentinogenesis imperfecta type III. One of the children also has dysmorphic facial features, seizures, and severe mental retardation. Her mother has dysmorphic facial features and mild mental retardation. The mothers of both children and several other family members have classic opalescent dentin (dentinogenesis imperfecta type II). Radiographs of the deciduous and permanent dentitions of one mother showed obliterated pulp chambers. Confirmation of obliterated pulp chambers in the deciduous teeth of the mother of a child with Brandywine isolate hereditary opalescent dentin makes it unlikely that classic opalescent dentin and Brandywine isolate hereditary opalescent dentin are separate genetic disorders. Evidence from this family supports t...
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An unusual case is reported in which sarcoidosis presented originally as a cheek mass unrelated to the parotid or submandibular glands. The clinical findings were highly suggestive of a neoplastic process. A general review of sarcoidosis... more
An unusual case is reported in which sarcoidosis presented originally as a cheek mass unrelated to the parotid or submandibular glands. The clinical findings were highly suggestive of a neoplastic process. A general review of sarcoidosis follows the case report.
Research Interests: Sarcoidosis, Humans, Female, Differential Diagnosis, Mouth Diseases, and 3 moreAdult, Mouth mucosa, and Cheek
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Peripheral (extraosseous or soft tissue) odontogenic tumors are rare lesions that occur in the soft tissue overlying the tooth-bearing areas of the mandible and the maxilla. A review of the English-language literature revealed only 48... more
Peripheral (extraosseous or soft tissue) odontogenic tumors are rare lesions that occur in the soft tissue overlying the tooth-bearing areas of the mandible and the maxilla. A review of the English-language literature revealed only 48 well-documented cases of peripheral epithelial odontogenic tumors. Thirty-two were peripheral ameloblastomas; six were peripheral adenomatoid odontogenic tumors; nine were peripheral calcifying epithelial odontogenic tumors; and one was a peripheral squamous odontogenic tumor. An additional four cases were reported as peripheral ameloblastomas in extragingival locations, but their odontogenic origin is debatable. Although the peripheral ameloblastoma is histologically similar to its central counterpart, it differs in its clinical features and biologic behavior. It does not exhibit an aggressive, destructive behavior and does not invade the underlying bone. Conservative excision of the tumor with minimal but adequate margins is the treatment of choice a...
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A case of juvenile osteopetrosis in a 10-year-old girl, including the skeletal, hematologic, and neurologic features, is described. Ankylosis of cementum to bone was evident in histologic sections, providing a possible explanation for the... more
A case of juvenile osteopetrosis in a 10-year-old girl, including the skeletal, hematologic, and neurologic features, is described. Ankylosis of cementum to bone was evident in histologic sections, providing a possible explanation for the delayed or impaired eruption of teeth. A summary of the literature on the pathogenesis of osteopetrosis is presented.
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Two cases of the Klippel-Trenaunay-Weber syndrome are presented. In one of the cases postsurgical complications arose in association with the vascular component of the syndrome complex. Oral surgeons and dentists must remain aware of the... more
Two cases of the Klippel-Trenaunay-Weber syndrome are presented. In one of the cases postsurgical complications arose in association with the vascular component of the syndrome complex. Oral surgeons and dentists must remain aware of the potentially serious complications of dental and/or surgical procedures in such cases. Other stigmata of the syndrome are discussed and related to similar conditions.
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Research Interests: Case Report, Humans, Female, Oral Surgery, Middle Aged, and 3 moreMouth Neoplasms, Mouth mucosa, and Cheek
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Tissue from an amelanotic melanoma which involved the lung and brain was studied by electron microscopy. Endothelial fenestrae were found in the intrinsic tumor capillaries at both locations, a finding which does not appear to have been... more
Tissue from an amelanotic melanoma which involved the lung and brain was studied by electron microscopy. Endothelial fenestrae were found in the intrinsic tumor capillaries at both locations, a finding which does not appear to have been previously reported for amelanotic melanoma. Pitfalls in the diagnosis of this rare tumor are discussed.
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A 60-year-old woman was referred to the Department of Dental Medicine at Long Island Jewish Medical Center for evaluation of multiple lesions of the tongue. She reported a long history of recurrent papular cutaneous eruptions that waxed... more
A 60-year-old woman was referred to the Department of Dental Medicine at Long Island Jewish Medical Center for evaluation of multiple lesions of the tongue. She reported a long history of recurrent papular cutaneous eruptions that waxed and waned. A biopsy specimen of one of the cutaneous lesions was diagnosed as lymphomatoid papulosis. Sporadic, recurrent oral ulcers that resolved spontaneously were noted 10 to 14 days before the initial visit. These ulcers had recurred for the past 17 years. The most recent oral lesion was an erythematous, irregular, solitary ulcerated area on the middle third dorsum of tongue. The area quickly enlarged, ultimately developing extensive surface necrosis. Shortly after, a similar lesion on the posterior dorsum of the tongue developed. Biopsy specimens of the former lesion showed numerous, large, atypical, pleomorphic, and hyperchromatic cells with abundant mitoses. The large, atypical cells were immunohistochemically proven to be T lymphocytes. A diagnosis of lymphomatoid papulosis was made. Two weeks later, the tongue lesions had spontaneously and totally resolved. The clinical, histomorphologic, and immunohistochemical features, as well as gene rearrangement studies of this rare entity, are presented.
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An unusual intraoral form of amyloidosis, the nodular form, is discussed. Attention is directed to clinical, microscopic and immunohistochemical features. More specifically, the nodular form of this condition and the specific relationship... more
An unusual intraoral form of amyloidosis, the nodular form, is discussed. Attention is directed to clinical, microscopic and immunohistochemical features. More specifically, the nodular form of this condition and the specific relationship in this patient to chronic hemodialysis and associated beta-2-microglobulin deposition is highlighted. An overview of other forms of amyloidosis is provided along with the chemical identity of each.
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The fine structural characteristics of five adenoid cystic carcinomas of human minor salivary galnds and a quantitative assessment of the relative volumes occupied by morphologically defined cell types in these tumors are reported. We... more
The fine structural characteristics of five adenoid cystic carcinomas of human minor salivary galnds and a quantitative assessment of the relative volumes occupied by morphologically defined cell types in these tumors are reported. We observed that the cyst-like spaces which give the characteristic cribriform pattern to the adenoid cystic carcinoma contain replicated basement membrane-like materail. Material comprisimg aggregates of fine tubules having a median diameter of 270 A, and rounded, electron dense bodies were noted within duct-like lumena of one tumor. In addition, dilatation of the intercellular spaces and squamous metaplasia were noted. From 500 electronmicrographs obtained by standardized techniques and used for the morphological part of the study, 175 were selected by a random sampling method and analyzed by the stereological technique of point counting. This method demonstrated that duct type cells occupied 75% by volume of the tumor in these glands; myoepithelial cells occupied 3%, acinar cells occupied 2%, and other tissues occupied 22% of the tumors. These proportions differ significantly (P less than 0.001) from our previously published figures for normal specimens of these glands.
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To evaluate the clinical presentation and outcomes of treatment for patients with chondrosarcomas involving the skull base and temporal bone. Retrospective review. Tertiary medical centre. Cases of histologically confirmed chondrosarcoma... more
To evaluate the clinical presentation and outcomes of treatment for patients with chondrosarcomas involving the skull base and temporal bone. Retrospective review. Tertiary medical centre. Cases of histologically confirmed chondrosarcoma involving the skull base and temporal bones. Surgery. Demographic features of presenting patients; presenting symptoms and signs; surgical approach employed; use of post-operative radiation therapy; histological grade of tumour; and interval of post-operative follow up. Twelve patients were identified with chondrosarcomas involving the skull base, with post-operative follow up ranging from three to 33 years. The average age at presentation was 42 years. The most common presenting symptoms were diplopia, decreased visual acuity and headaches. Five of the 12 patients required multiple surgical procedures. Patients with chondrosarcoma involving the skull base and temporal bone may present in a variety of ways. Surgical resection, even subtotal, in combination with radiation therapy, can often provide good tumour control over many years for these rare tumours.
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A clinico-pathologic study of 12 patients, each harboring a hitherto not delineated adenocarcinoma of salivary origin is presented. The authors have designated this histologically unique carcinoma as 'terminal duct... more
A clinico-pathologic study of 12 patients, each harboring a hitherto not delineated adenocarcinoma of salivary origin is presented. The authors have designated this histologically unique carcinoma as 'terminal duct adenocarcinoma' in deference not only to its light-optic appearance, but also to a putative origin from the reserve cells (epithelial and myoepithelial) of the intercalated duct. The tumors' local invasive properties with extension into nerves and adjacent bone suggest their biologic behavior is like that of adenoid cystic carcinomas.
Research Interests: Humans, Female, Male, The, Clinical Sciences, and 6 moreAged, Middle Aged, Adult, Mouth mucosa, Oral Cavity, and Adenocarcinoma
Research Interests: Quality of life, Treatment Outcome, Infectious Diseases, Adolescent, England, and 23 moreHIV, Biological Sciences, Humans, United States, Female, Male, Placebos, Pediatric, Infectious, Ethnic Groups, Clinical Sciences, Human immunodeficiency virus, Adult, New England, Ulcer, Tumor necrosis factor-alpha, Oral Ulcer, Hiv seropositivity, New England Journalof Medicine, Crohn Disease, Thalidomide, The American, and Acquired immunodeficiency syndrome
Research Interests: Cancer, Tobacco, Humans, Smoking, Female, and 8 moreMale, Polymerase Chain Reaction, Aged, Middle Aged, Adult, Oral Cavity, Base Sequence, and P
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We describe six cases of terminal duct carcinoma of the minor salivary glands. All were localized to the oral cavity, without regional nodal or distant metastases. Histologically, five were originally mistaken for adenoid cystic... more
We describe six cases of terminal duct carcinoma of the minor salivary glands. All were localized to the oral cavity, without regional nodal or distant metastases. Histologically, five were originally mistaken for adenoid cystic carcinoma; one was interpreted as monomorphic adenoma with areas of adenoid cystic carcinoma. Treatment consisted of wide resection with or without radiation therapy, with no incidence of recurrence or metastasis. The characteristics of this recently described pathologic entity are reviewed. The less aggressive behavior of this tumor compared with adenoid cystic carcinoma should call for less radical therapy, with a favorable prognosis in most cases. Recognition of this tumor as a distinct clinical and pathologic entity is therefore important.
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Cutaneous mucoepidermoid carcinoma is quite rare. We describe a case of extrasalivary cutaneous mucoepidermoid carcinoma in the head and neck region. The theories dealing with the origin of these tumors in the sweat and salivary glands... more
Cutaneous mucoepidermoid carcinoma is quite rare. We describe a case of extrasalivary cutaneous mucoepidermoid carcinoma in the head and neck region. The theories dealing with the origin of these tumors in the sweat and salivary glands are discussed, and the literature concerning these lesions reviewed. We believe this to be the first description of an extrasalivary mucoepidermoid carcinoma in the head and neck region or other sites that normally contain mucous glands.
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Since its initial description, there have been approximately sixty cases of massive osteolysis reported, involving virtually every bone in the body. This case represents only the fifteenth report of this disease affecting maxillofacial... more
Since its initial description, there have been approximately sixty cases of massive osteolysis reported, involving virtually every bone in the body. This case represents only the fifteenth report of this disease affecting maxillofacial bones. Clinically and radiographically, the progressive nature of this disease was observed over a 5-year period. Attempts at treatment were without success. From the light and electron-microscopic studies, it can be concluded that this disease process is nonneoplastic in nature, showing features of an exuberant proliferative response of vascular and supportive elements.
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This is the third in a series of articles dealing with oral presentations in non-Hodgkin's lymphoma. In this section the authors discuss the clinical and microscopic features of six cases occurring in children, four of which qualified... more
This is the third in a series of articles dealing with oral presentations in non-Hodgkin's lymphoma. In this section the authors discuss the clinical and microscopic features of six cases occurring in children, four of which qualified as Burkitt's lymphoma.