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Mucous cell proliferation in a periapical radicular cyst from a patient with a family history of colonic malignancies and multiple sebaceous neoplasms of the skin, so-called Muir-Torre syndrome, is reported. Such goblet cell hyperplasia has not been previously reported to be associated with any known syndrome. We believe the finding of mucous cell hyperplasia in an odontogenic cyst may not simply be coincidental, but should raise suspicion of paraneoplastic potential and warrant further evaluation for possible occult neoplastic disease.

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A primary hepatocellular carcinoma associated with underlying hemochromatosis appeared as a metastatic mandibular lesion. A swelling of the retromolar area and mandibular paresthesia were the presenting complaints. Hepatocellular carcinoma rarely metastasizes to the orofacial area. To our knowledge, only 18 cases have been reported. The clinical, radiographic, and histologic features of an additional case of hepatocellular carcinoma metastatic to the left posterior alveolar ridge is reported, and the literature is reviewed.

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This study examines chemically and histologically the relative abilities of inositol monophosphate (IP1), inorganic phosphate (Pi), ethane-1-hydroxy-1, 1-diphosphonate (EHDP) and dichloromethylene disphosphonate (Cl2MDP) to inhibit parathyroid hormone (PTH)--induced resorption of fetal rat long bones in organ culture. Pregnant rats injected with 45Ca on the 18th day of gestation were killed the next day and their fetuses removed. Half of each pair of dissected long bones was incubated in a chemically defined control medium while the contralateral half was incubated in medium containing PTH or PTH plus the compound to be tested. 45Ca released into the medium was indicative of the amount of bone resorption. Bones were then processed histologically and examined microscopically. All compounds inhibited resorption to some extent with IP1 and Pi being less effective than EHDP or C12MDP at comparable phosphate concentrations. However, the disphosphonates damaged osteoclasts whereas IP1 and Pi did not. This suggests that IP1 may inhibit resorption by a different mechanism perhaps related only to prevention of crystal dissolution.

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An unusual gingivitis noted as a discrete lesion involving the facial attached gingiva in a focal and confined area has been described in two adolescent females. A unique histopathologic appearance includes a striking intraepithelial edema associated with a focal area of acute and chronic inflammation. Inconclusive immunologic study of one patient indicated an epithelial-connective tissue immune complex deposition suggestive of but not typical of that seen in pemphigoid.

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Epithelia from skin, palate, buccal mucosa and dorsal tongue were studied in normal and zinc deficient guinea pigs by transmission electron microscopy. Gap junctions (nexuses) were observed primarily in the basal and prickle cell layers. They were also seen to form bulging and looping configurations which appeared to pinch off into the cytoplasm forming what are recognized as annular gap junctions. These may be attached to the surface or represent separate, intracytoplasmic, nexus-bound inclusions. Their contents varied, but most often they contained glycogen and ribosomal-like particles. Various cell organelles were also seen entrapped, most common of which were membrane coating granules. The development of these annular gap junctions is a prominent feature of many epithelia. It has been suggested that they probably serve to maintain a synchronized differentiation throughout the various epithelial layers.

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"Keratin pools," previously characterized clinically and histochemically in the superficial epithelium of chronic hyperplastic oral mucosa, were studied by light and electron microscopy. These occured as small beaded and larger coalescent masses which varied in metachromasia. Ultrastructurally, the "keratin pools" consisted of electron-dense, amorphous or finely-granular material developing and coalescing, chiefly as extracellular deposits. The "pools" frequently possessed a layered arrangement alternating with cells having distinct tonofilaments, desmosomes, and definite cell membranes. Occasional bands of filamentous-like material, possibly representing tonofilament bundles, were observed in some "pools."

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Electron microscopic study of oral mucosa from a patient with Anderson-Fabry disease (glycosphingolipid lipidosis) revealed lamellar and membranous osmiophilic intracytoplasmic inclusions having a periodicity of 4.5 nanometers. These were observed chiefly in reticulo-endothelial cells as membrane bound and occasionally unbound bodies. They could also be observed within the cytoplasm of squamous epithelial cells, particularly of the stratum germinativum. Morphologic features in endothelial and epithelial cells are described.

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A case of Fabry's disease is reported. The patient had multiple supernumerary, impacted, and unerupted teeth and other developmental abnormalities of the facial skeleton. The patient tolerated surgical removal of impacted and unerupted teeth without complications. However, this did not relieve the facial pain. The expected prognosis of this patient will be a continued vascular and renal degeneration with death probable before the age of 50 years if the disease is untreated. Currently, the patient is being considered as a possible candidate for renal transplantation.

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Clinical, roentgenographic and morphologic features of teeth from patients with vitamin D-resistant rickets are described based on a study of 28 teeth from 5 patients. Clinically normal teeth become symptomatic and develop roentgenographic evidence of periapical infection. The exposed dentin is vulnerable to microbial invasion because of a defective globular-type calcification as seen in both ground and decalcified sections. The changes are distinctive and pathognomonic, but the effects of therapy (vitamin D) have not yet been ascertained.

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