Inflammatory pseudotumor was originally described in the lung, but recently has been recognized to occur in various sites. A 56-year-old female was referred to our department with a painless swelling of the right midfacial area since 3 months ago. Clinical examination showed non-specific intraoral findings, but asymmetric facial appearance and numbness of the right midfacial area. Plain radiographs and CT images showed aggressive destruction and irregular thickening of the right maxillary sinus wall, increased antral opacification, and destruction of the zygomatic arch. A relatively well-defined soft tissue mass occupied the right maxillary sinus, nasal cavity, zygoma, and infraorbital region. The soft tissue mass showed mild enhancement on CT. Radiographically, this lesion presented a rapidly enlarging mass demonstrating aggressive behavior, mimicking a malignant tumor. Histopathologic examinations showed plasma cells and inflammatory cells in variable fibrotic tissues and demonstrated positive reactivity for vimentin. No malignent changes could be found.
Female ; Granuloma, Plasma Cell* ; Humans ; Hypesthesia ; Lung ; Maxillary Sinus ; Middle Aged ; Nasal Cavity ; Plasma Cells ; Vimentin ; Zygoma

Inflammatory pseudotumor was originally described in the lung, but recently has been recognized to occur in various sites. A 56-year-old female was referred to our department with a painless swelling of the right midfacial area since 3 months ago. Clinical examination showed non-specific intraoral findings, but asymmetric facial appearance and numbness of the right midfacial area. Plain radiographs and CT images showed aggressive destruction and irregular thickening of the right maxillary sinus wall, increased antral opacification, and destruction of the zygomatic arch. A relatively well-defined soft tissue mass occupied the right maxillary sinus, nasal cavity, zygoma, and infraorbital region. The soft tissue mass showed mild enhancement on CT. Radiographically, this lesion presented a rapidly enlarging mass demonstrating aggressive behavior, mimicking a malignant tumor. Histopathologic examinations showed plasma cells and inflammatory cells in variable fibrotic tissues and demonstrated positive reactivity for vimentin. No malignent changes could be found.
Female ; Granuloma, Plasma Cell* ; Humans ; Hypesthesia ; Lung ; Maxillary Sinus ; Middle Aged ; Nasal Cavity ; Plasma Cells ; Vimentin ; Zygoma

A 66-year-old man visited author's institute complaining of the swelling on the submandibular gland area. Clinically, the exophytic mass penetrated the skin of the submandibular area. On MRI, the lesion occupied the left submandibular space and extended downward, protruding exterior to the subcutaneous fat layer, but the center of the lesion was located on the side of the skin and the growth exterior to the skin was prominent. Demarcation of the lesion and the submandibular gland was unclear. Histopathologically the epithelial nests and keratin production were seen, then the biopsy result was squamous cell carcinoma. The stroma of lesion showed a myxoid characteristic and some ducts showed metaplasia of the ductal cells, which suggested the gland-origin carcinoma. However, lots of keratin production and carcinomatous change of cells continuous to the normal epithelium of the skin, the skin-origin carcinoma invading into the submandibular gland area could not be excluded.
Aged ; Biopsy ; Carcinoma, Squamous Cell* ; Epithelium ; Humans ; Magnetic Resonance Imaging ; Metaplasia ; Skin ; Subcutaneous Fat ; Submandibular Gland

A 66-year-old man visited author's institute complaining of the swelling on the submandibular gland area. Clinically, the exophytic mass penetrated the skin of the submandibular area. On MRI, the lesion occupied the left submandibular space and extended downward, protruding exterior to the subcutaneous fat layer, but the center of the lesion was located on the side of the skin and the growth exterior to the skin was prominent. Demarcation of the lesion and the submandibular gland was unclear. Histopathologically the epithelial nests and keratin production were seen, then the biopsy result was squamous cell carcinoma. The stroma of lesion showed a myxoid characteristic and some ducts showed metaplasia of the ductal cells, which suggested the gland-origin carcinoma. However, lots of keratin production and carcinomatous change of cells continuous to the normal epithelium of the skin, the skin-origin carcinoma invading into the submandibular gland area could not be excluded.
Aged ; Biopsy ; Carcinoma, Squamous Cell* ; Epithelium ; Humans ; Magnetic Resonance Imaging ; Metaplasia ; Skin ; Subcutaneous Fat ; Submandibular Gland

The ameloblastic carcinoma is an extremely rare, aggressive odontogenic neoplasm of the jaws. It is described as an ameloblastoma in which there is histologic evidence of malignancy in the primary or recurrent tumors, regardless of whether it has metastasized. We report an aggressive case of ameloblastic carcinoma of the mandible. A 68-year-old man with the complaint of the left facial swelling and intermittent pain was referred to our hospital. Serial images of panoramic radiograph, computed tomograph, and magnetic resonance imaging showed an ill-defined destructive radiolucent lesion of the left mandible. The lesion had typically aggressive behavior with extensive local destruction of bone and extended to the adjacent soft tissues. Bone scan revealed increased uptakes in the left mandibular body and ramus regions. Histological features were generally resembled with those of an ameloblastoma but with cytologic features of epithelial malignancy.
Aged ; Ameloblastoma ; Ameloblasts* ; Humans ; Jaw ; Magnetic Resonance Imaging ; Mandible*

The ameloblastic carcinoma is an extremely rare, aggressive odontogenic neoplasm of the jaws. It is described as an ameloblastoma in which there is histologic evidence of malignancy in the primary or recurrent tumors, regardless of whether it has metastasized. We report an aggressive case of ameloblastic carcinoma of the mandible. A 68-year-old man with the complaint of the left facial swelling and intermittent pain was referred to our hospital. Serial images of panoramic radiograph, computed tomograph, and magnetic resonance imaging showed an ill-defined destructive radiolucent lesion of the left mandible. The lesion had typically aggressive behavior with extensive local destruction of bone and extended to the adjacent soft tissues. Bone scan revealed increased uptakes in the left mandibular body and ramus regions. Histological features were generally resembled with those of an ameloblastoma but with cytologic features of epithelial malignancy.
Aged ; Ameloblastoma ; Ameloblasts* ; Humans ; Jaw ; Magnetic Resonance Imaging ; Mandible*

PURPOSE: To evaluate the precision of measurements of distances and angle in the cross-sectional views of linear tomogram of panorama and to assess the technique for visualizing the mandibular canal. METHODS: Ten dry mandibles were radiographically examined with 3 continuous cross-sectional views of linear tomogram of panorama and 4 continuous computed tomograms. The distance between the superior border of canal and alveolar crest and the bucco-lingual width of alveolar bone at the level of the superior border of canal and the angle between the two lines above were measured. Measurements were performed by radiologist and implantologist group and compared with measurements on computed radiograms of the same areas. RESULTS: The measurements differences for the distance of alveolar bone height between in panorama and in CT showed 0.9mm+/-0.6mm by radiologists and 1.3mm+/-0.8mm by implantologists. There was no statistically significant difference between two groups' measurements. The differences in measurements for the distance of alveolar bone width between in panorama and in CT showed 0.5mm+/-0.8mm by radiologists and 2.5mm+/-1.4 mm by implantologists. There was significant difference (p<0.05) between two groups' measurements. The average bucco-lingual inclination of alveolar bone above mandibular canal was average 95.8degrees in CT. The difference of measurements between two groups was average 1+/-0.9degrees. Three cross-sectional views of panorama could show that the mandibular canal crosses antero-lingually and slopes inferiorly from the posterior segment of the mandible. Conclusions : The measurements in the linear tomogram of panorama by radiologists gave the accurate values of the distances and the angle compared with the values in computed tomograms.
Mandible*

PURPOSE: To evaluate the precision of measurements of distances and angle in the cross-sectional views of linear tomogram of panorama and to assess the technique for visualizing the mandibular canal. METHODS: Ten dry mandibles were radiographically examined with 3 continuous cross-sectional views of linear tomogram of panorama and 4 continuous computed tomograms. The distance between the superior border of canal and alveolar crest and the bucco-lingual width of alveolar bone at the level of the superior border of canal and the angle between the two lines above were measured. Measurements were performed by radiologist and implantologist group and compared with measurements on computed radiograms of the same areas. RESULTS: The measurements differences for the distance of alveolar bone height between in panorama and in CT showed 0.9mm+/-0.6mm by radiologists and 1.3mm+/-0.8mm by implantologists. There was no statistically significant difference between two groups' measurements. The differences in measurements for the distance of alveolar bone width between in panorama and in CT showed 0.5mm+/-0.8mm by radiologists and 2.5mm+/-1.4 mm by implantologists. There was significant difference (p<0.05) between two groups' measurements. The average bucco-lingual inclination of alveolar bone above mandibular canal was average 95.8degrees in CT. The difference of measurements between two groups was average 1+/-0.9degrees. Three cross-sectional views of panorama could show that the mandibular canal crosses antero-lingually and slopes inferiorly from the posterior segment of the mandible. Conclusions : The measurements in the linear tomogram of panorama by radiologists gave the accurate values of the distances and the angle compared with the values in computed tomograms.
Mandible*

PURPOSE: To analyze the possible association between magnetic resonance imaging signal intensity of temporo-mandibular joint disk and posterior attachment, and the type and extent of disk displacement, disk configuration, effusion and clinical signs in patients with internal derangement. MATERIALS AND METHODS: Magnetic resonance images of the 132 temporomandibular joints of 66 patients with temporomandibular joint displacement were analyzed. The clinical findings were obtained by retrospective review of the patients' records. The type and extent of disk displacement, disk configuration and effusion were evaluated on the proton density MR images. The signal intensity from the anterior band, posterior band and posterior attachment were measured on MR images. The associations between the type and extent of disk displacement, disk configuration, effusion and clinical signs and the MR signal intensity of disk and posterior attachment were statistically analyzed by student's t-test. RESULTS: Of 132 joints, 87 (65.9%) showed anterior disk displacement with reduction (ADR) and 45 (34.1%) showed anterior disk displacement without reduction (ADnR). The signals from posterior attachments were lower in joints with ADnR than those of ADR (p<0.05). The results showed statistically significant (p<0.05) association between the type and extent of disk displacement and disk configuration, and decreased signal intensity of posterior attachment. There were no statistical associations between pain, noise and limited mouth opening, and signal intensity of disk and posterior attachment. Conclusions : The average signal from posterior attachment was lower in joints with ADnR than that of ADR. The type and extent of disk displacement and disk configuration appeared to be correlated with the signal intensity from posterior attachment.
Humans ; Joints ; Magnetic Resonance Imaging* ; Mouth ; Noise ; Protons ; Retrospective Studies ; Temporomandibular Joint Disc* ; Temporomandibular Joint*

PURPOSE: To analyze the possible association between magnetic resonance imaging signal intensity of temporo-mandibular joint disk and posterior attachment, and the type and extent of disk displacement, disk configuration, effusion and clinical signs in patients with internal derangement. MATERIALS AND METHODS: Magnetic resonance images of the 132 temporomandibular joints of 66 patients with temporomandibular joint displacement were analyzed. The clinical findings were obtained by retrospective review of the patients' records. The type and extent of disk displacement, disk configuration and effusion were evaluated on the proton density MR images. The signal intensity from the anterior band, posterior band and posterior attachment were measured on MR images. The associations between the type and extent of disk displacement, disk configuration, effusion and clinical signs and the MR signal intensity of disk and posterior attachment were statistically analyzed by student's t-test. RESULTS: Of 132 joints, 87 (65.9%) showed anterior disk displacement with reduction (ADR) and 45 (34.1%) showed anterior disk displacement without reduction (ADnR). The signals from posterior attachments were lower in joints with ADnR than those of ADR (p<0.05). The results showed statistically significant (p<0.05) association between the type and extent of disk displacement and disk configuration, and decreased signal intensity of posterior attachment. There were no statistical associations between pain, noise and limited mouth opening, and signal intensity of disk and posterior attachment. Conclusions : The average signal from posterior attachment was lower in joints with ADnR than that of ADR. The type and extent of disk displacement and disk configuration appeared to be correlated with the signal intensity from posterior attachment.
Humans ; Joints ; Magnetic Resonance Imaging* ; Mouth ; Noise ; Protons ; Retrospective Studies ; Temporomandibular Joint Disc* ; Temporomandibular Joint*