PURPOSE: We investigated the biocompatibility of n-butyl-2-cyanoacrylate (NBCA) in the cervical deep tissues of rats to assess its biocompatibility. METHODS: A total of 30 Sprague-Dawley rats were injected with NBCA. After 30, 90, 180, and 360 days, cubes of tissue (1 cm × 1 cm × 1 cm) surrounding the NBCA and normal tissue from the other side of the neck were excised from each rat. The adhesion of NBCA to adjacent structures was examined histologically. Cells were counted per high-power field (HPF), and fibrosis was graded with the measurement of fibrotic thickening. RESULTS: All animals displayed normal behavior without any symptoms of distress throughout the study. There was no recognizable inflammatory reaction, foreign body reaction, or fibrosis in the 30 control samples. The analyses of experimental samples showed significantly decreased inflammatory cell counts over time (lymphoplasma cell count decreased from 100 (range, 70–100) to 30 (range, 30–50) per HPF, P = 0.010; neutrophil count decreased from 2 (range, 2–30) to 0 (range, 0–2) per HPF, P = 0.017). However, there was no significant difference in the number of multinuclear giant cells throughout the study period (a decrease from 22 [range, 16–34] to 16 [range, 12–22] per HPF, P = 0.287). The level of fibrosis was Common Toxicity Criteria ver. 4.0 Grade 1 without further thickening (P = 0.600). However, maturation of fibrosis progressed gradually. CONCLUSION: NBCA was biologically tolerable in the cervical deep tissues of rats. However, precautions are needed with respect to preventing a sustained foreign body reaction and fibrosis.
Animals ; Biocompatible Materials ; Cell Count ; Chyle ; Cyanoacrylates ; Enbucrilate ; Fibrosis ; Foreign-Body Reaction ; Giant Cells ; Neck ; Neck Dissection ; Neutrophils ; Prospective Studies ; Rats ; Rats, Sprague-Dawley

PURPOSE: The purpose of this study was to elucidate the efficacy and safety of carbonate apatite (CO₃Ap) granules in 2-stage sinus floor augmentation through the radiographic and histomorphometric assessment of bone biopsy specimens.METHODS: Two-stage sinus floor augmentation was performed on 13 patients with a total of 17 implants. Radiographic assessment using panoramic radiographs was performed immediately after augmentation and was also performed 2 additional times, at 7±2 months and 18±2 months post-augmentation, respectively. Bone biopsy specimens taken from planned implant placement sites underwent micro-computed tomography, after which histological sections were prepared.RESULTS: Postoperative healing of the sinus floor augmentation was uneventful in all cases. The mean preoperative residual bone height was 3.5±1.3 mm, and this was increased to 13.3±1.7 mm by augmentation with the CO₃Ap granules. The mean height of the augmented site had decreased to 10.7±1.9 mm by 7±2 months after augmentation; however, implants with lengths in the range of 6.5 to 11.5 mm could still be placed. The mean height of the augmented site had decreased to 9.6±1.4 mm by 18±2 months post-augmentation. No implant failure or complications were observed. Few inflammatory cells or foreign body giant cells were observed in the bone biopsy specimens. Although there were individual differences in the amount of new bone detected, new bone was observed to be in direct contact with the CO₃Ap granules in all cases, without an intermediate layer of fibrous tissue. The amounts of bone and residual CO₃Ap were 33.8%±15.1% and 15.3%±11.9%, respectively.CONCLUSIONS: In this first demonstration, low-crystalline CO₃Ap granules showed excellent biocompatibility, and bone biopsy showed them to be replaced with bone in humans. CO₃Ap granules are a useful and safe bone substitute for two-stage sinus floor augmentation.
Apatites ; Biopsy ; Bone Substitutes ; Carbon ; Dental Implants ; Giant Cells, Foreign-Body ; Humans ; Individuality ; Prospective Studies ; Sinus Floor Augmentation

No abstract available.
Dextrans ; Giant Cells ; Granuloma, Foreign-Body

Leuprorelin acetate is a synthetic analog of luteinizing hormone-releasing hormone (LHRH). Recently, hormone-dependent tumors (prostate cancer and breast cancer) have been treated without surgery using this LHRH agonist. A 74-year-old man presented with a subcutaneous tumor in the abdomen. He had received a subcutaneous injection of depot leuprorelin acetate 2 months previously and radiotherapy for prostate cancer. The subcutaneous tumor was totally excised. Histopathologic findings revealed necrosis of fat tissue, many granulomatous nodules composed of giant cells with vacuoles in the dermis and subcutis, and inflammatory cell infiltrates, including mainly lymphohistiocytes. A diagnosis of foreign body granuloma due to depot injection of leuprorelin acetate was made. He revisited our hospital after 1 month with a subcutaneous tumor on his Lt. upper arm. He had received a subcutaneous injection of leuprorelin acetate 1 week ago on that site. We treated it with intralesional triamcinolone injection. Here, we report a case of granulomatous reaction due to leuprorelin acetate injection, which produced subcutaneous nodules.
Abdomen ; Aged ; Arm ; Breast ; Dermis ; Diagnosis ; Foreign Bodies* ; Giant Cells ; Gonadotropin-Releasing Hormone ; Granuloma, Foreign-Body* ; Humans ; Injections, Subcutaneous* ; Leuprolide* ; Necrosis ; Prostatic Neoplasms ; Radiotherapy ; Triamcinolone ; Vacuoles

Leuprolide acetate is an established luteinizing hormone-releasing hormone (LHRH) agonist used as a first-line treatment in advanced prostate cancer. An 80-year-old man presented with a localized erythematous patch with an indurated plaque and nodule and pustules on the left upper arm. The patient had been treated for metastatic prostate cancer with subcutaneous injections of leuprolide acetate 18 months previously. Histopathologic findings revealed granulomas with multinucleated giant cells from the dermis to the subcutaneous fat layer. The granuloma contained numerous round vacuoles. Cultures from the tissue for bacteria, fungi, and mycobacteria were all negative. The diagnosis of leuprolide acetate-induced foreign body granuloma was made by clinicopathologic findings. Various theories on the mechanism of local reactions to leuprolide have been suggested. The formation of granulomas may be related to the poly (lactic-co-glycolic acid) polymers or leuprolide itself. The depth of injection could have also contributed; therefore, intramuscular injection is recommended to minimize granuloma formation. To the best of our knowledge, there has been no reported case of leuprolide-induced foreign body granuloma in a patient with prostate cancer in the Korean literature. Dermatologists need to know that leuprolide acetate depot injection may cause a granulomatous reaction.
Aged, 80 and over ; Arm ; Bacteria ; Dermis ; Diagnosis ; Foreign Bodies* ; Fungi ; Giant Cells ; Gonadotropin-Releasing Hormone ; Granuloma ; Granuloma, Foreign-Body* ; Humans ; Injections, Intramuscular ; Injections, Subcutaneous ; Leuprolide* ; Polymers ; Prostate* ; Prostatic Neoplasms* ; Subcutaneous Fat ; Vacuoles

Leuprolide acetate is an established luteinizing hormone-releasing hormone (LHRH) agonist used as a first-line treatment in advanced prostate cancer. An 80-year-old man presented with a localized erythematous patch with an indurated plaque and nodule and pustules on the left upper arm. The patient had been treated for metastatic prostate cancer with subcutaneous injections of leuprolide acetate 18 months previously. Histopathologic findings revealed granulomas with multinucleated giant cells from the dermis to the subcutaneous fat layer. The granuloma contained numerous round vacuoles. Cultures from the tissue for bacteria, fungi, and mycobacteria were all negative. The diagnosis of leuprolide acetate-induced foreign body granuloma was made by clinicopathologic findings. Various theories on the mechanism of local reactions to leuprolide have been suggested. The formation of granulomas may be related to the poly (lactic-co-glycolic acid) polymers or leuprolide itself. The depth of injection could have also contributed; therefore, intramuscular injection is recommended to minimize granuloma formation. To the best of our knowledge, there has been no reported case of leuprolide-induced foreign body granuloma in a patient with prostate cancer in the Korean literature. Dermatologists need to know that leuprolide acetate depot injection may cause a granulomatous reaction.
Aged, 80 and over ; Arm ; Bacteria ; Dermis ; Diagnosis ; Foreign Bodies* ; Fungi ; Giant Cells ; Gonadotropin-Releasing Hormone ; Granuloma ; Granuloma, Foreign-Body* ; Humans ; Injections, Intramuscular ; Injections, Subcutaneous ; Leuprolide* ; Polymers ; Prostate* ; Prostatic Neoplasms* ; Subcutaneous Fat ; Vacuoles

A foreign body granuloma is a non-allergic chronic inflammatory reaction that is mainly composed of multinucleated giant cells. Foreign body granulomas may occur after the administration of any dermal filler. Factors such as the volume of the injection, impurities present in the fillers, and the physical properties of fillers affect granuloma formation. The formation of granulomas involves five phases: protein adsorption, macrophage adhesion, macrophage fusion, and crosstalk. The clinical and pathologic features of granulomas vary depending on the type of filler that causes them. Foreign body granulomas can be treated effectively with intralesional corticosteroid injections. Surgical excisions of granulomas tend to be incomplete because granulomas have ill-defined borders and moreover, surgical excisions may leave scars and deformities.
Adsorption ; Cicatrix ; Collagen ; Congenital Abnormalities ; Giant Cells ; Granuloma ; Granuloma, Foreign-Body* ; Hyaluronic Acid ; Macrophages ; Silicone Gels

Cholesterol granuloma is a histopathological diagnosis with features of cholesterol clefts, foreign body giant cells, and macrophages filled with hemosiderin. It is commonly found in the mastoid or petrous apex, but the involvement of paranasal sinuses is very rare. Radiologically, cholesterol granuloma show typical findings of hyperintense signals on both T1- and T2-weighted images on magnetic resonance imaging (MRI). We report two cases of cholesterol granuloma in the sphenoid sinus, which were first misinterpreted as mucoceles due to unusual MRI images.
Cholesterol* ; Diagnosis ; Giant Cells, Foreign-Body ; Granuloma* ; Hemosiderin ; Macrophages ; Magnetic Resonance Imaging ; Mastoid ; Mucocele ; Paranasal Sinuses ; Sphenoid Sinus*

Occupational lung diseases are caused by several toxic substances including heavy metals; however, the exact pathologic mechanisms remain unknown. In the workplace, dental technicians are often exposed to heavy metals such as cobalt, nickel, or beryllium and occasionally develop occupational lung diseases. We described a case of occupational lung disease in a patient who was employed as a dental technician for over a decade. A 31-year-old, non-smoking woman presented with productive cough and shortness of breath of several weeks duration. Chest computed tomography revealed a large number of scattered, bilateral small pulmonary nodules throughout the lung field, and multiple mediastinal lymph nodes enlargement. Percutaneous needle biopsy showed multifocal small granulomas with foreign body type giant cells suggestive of heavy metals inhalation. The patient's condition improved on simple avoidance strategy for several months. This case highlighted the importance of proper workplace safety.
Adult ; Beryllium ; Biopsy, Needle ; Cobalt ; Cough ; Dental Technicians* ; Dyspnea ; Female ; Foreign Bodies* ; Giant Cells, Foreign-Body ; Granuloma ; Humans ; Inhalation ; Lung ; Lung Diseases ; Lymph Nodes ; Metals, Heavy ; Nickel ; Thorax

We report a unique case of a 4-year-old girl with an intriguing fibrohistiocytic tumour. Magnetic resonance imaging scans showed a dural mass of variegated intensity compressing the left occipital pole and apparently extending toward the superior sagittal sinus. Grossly, the cut surface of the surgical specimen was yellow, pale, and soft with reddish kernel-like crusts. Histologically, the yellow areas resembled cholesterol granulomas with widespread coagulative necrosis, cholesterol clefts, powdery calcification, foreign body-type giant cells, and foamy macrophages, while the scattered red spots contained numerous multinucleated giant cells of foreign-body and Touton types, the former with amphophilic to slightly eosinophilic cytoplasm. Immunoperoxidase reactions confirmed the expression of histiocytic markers and vimentin. As far as we know, no tumour displaying these peculiar morphological features has yet been described.
Child, Preschool ; Cholesterol ; Cytoplasm ; Eosinophils ; Female ; Giant Cells ; Giant Cells, Foreign-Body ; Granuloma ; Humans ; Macrophages ; Magnetic Resonance Imaging ; Necrosis ; Superior Sagittal Sinus ; Vimentin