DigitalCommons@UNMC

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  The Clinical Misdiagnosis of Lichen Planus and its Potential for Untoward Outcome

  Nagamani Narayana

  The diagnosis of "lichen planus" may be incorrectly applied to a solitary white lesion and to lesions with ulceration, referred pain and lack of response to corticosteroid therapy. In two patients, the diagnosis of "lichen planus" lead to the delayed recognition of squamous cell carcinoma requiring extensive surgery.

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  USP6 Translocation in Giant Cell Granulomas of the Jaws

  Nagamani Narayana

  Central giant cell granulomas (CGCG) account for 7% of all benign tumors of the jaw while peripheral giant cell granulomas (PGCG) occur on the gingiva (Table 1). The underlying pathophysiology of CGCG and PGCG is not known. Therefore there are studies attempting to identify biomarkers to increase understanding the pathogenesis of CGCG and PGCG. Some authors consider CGCG in jaw bones similar to giant cell tumors of long bones while others believe them to be reactive or non-neoplastic lesions. Recurrence of these lesions following conservative treatment is attributed to matrix metalloproteinases, namely MMP9. Recent studies have shown an increase in levels of MMP9 in central and peripheral giant cell granulomas as in aneurysmal bone cysts (ABC). De-ubiquitinating enzymes play an important role in cellular processes, though their precise role in normal physiology is not fully understood. USP6 is the first de-ubiquitinating enzyme recognized as an oncogene. Recently studies have described the USP6 translocation in CGCG as transforming this lesion to a neoplasm. This retrospective study analyzed two cases of CGCG and one PGCG for the USP6 translocation.

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  Misdiagnosis of Lateral Periodontal Cysts: A Retrospective Study

  Piper Larson, John Huebner, and Nagamani Narayana

  A total of 239 cases were retrieved from the files of the UNMC College of Dentistry oral biopsy service which had lateral periodontal cyst (LPC) as a clinical or a histological diagnosis. Of these, 178 were submitted with a clinical differential diagnosis that included LPC. Upon histological examination only 26 (11%) of those were in fact LPC. Only 21(9%) of the 51 cases diagnosed histologically met the criteria for LPC. Within those 239 cases, 120(50%) cases were inflammatory cysts, 31(13%) of the samples were determined to be keratocystic odontogenic tumors (odontogenic keratocysts). Conclusion: The LPC is frequently misdiagnosed due to its radiographic similarity to other lateral radiolucencies.