oral surgeon in June 2002—ne from the upper lip with a diagnosis of

chronic mucositis and the other from the right buccal mucosa—with

a diagnosis of nonspecific ulcer. The patient’s past medical and family

history was noncontributory. The patient had no known drug allergies

and he was not taking medication. A detailed review of systems was

negative, including symptoms related to the respiratory and gastroin-

testinal systems. Clinical examination revealed a well developed, well

nourished boy in no apparent distress with mild facial edema. The upper

lip was significantly enlarged to 2-3 times normal size, indurate, and

had a firm consistency. Multiple small shallow ulcers were noted over

the inferior lip and buccal mucosa. No lymphadenopathy or salivary

gland enlargement was noted. Cranial nerves II-XII were grossly intact.

The tongue was within normal limits without fissures.

A differential diagnosis was made of orofacial granulomatosis to

rule out a chronic granulomatosous disease such as sarcoidosis,

Crohn’s disease, Wegener’s granulomatosis, or hereditary angioedema.

The following studies were ordered: CBC with differential, sedimen-

tation rate, ANA, ANCA, C1 esterase inhibitor, and chest radiograph.

The patient was scheduled 1 month later for a deep incisional biopsy of

the upper lip. Two specimens were taken and sent to the der-

matopathology laboratory. Biopsy showed intercellular edema with

deep inflammatory infiltrate of predominately lymphocytes and plasma

cells. Treatment started with tetracycline and intralesional steroids.

Progress of the patient will be followed in detail.

A new case of cervical Castleman disease (hyaline vascular type) in

a 6-year-old Chinese girl is reported. She presented with a painless mass

in the right neck region for 2 months, during which time the mass had

not changed in size nor affected movements of the neck. The previous

medical history was noncontributory. The 2.53 3.03 2.0 cm mass was

smooth, soft, mobile, and deep to the sternocleidomastoid muscle. The

size did not change with postural change, no pulsation was obvious, and

there was no bruit on auscultation. A thorough examination of the ear,

nose, and throat was within normal limits. The routine laboratory tests

were within the reference ranges, and the chest radiograph was within

normal limits. She did not react to testing with purified protein

derivative of old tuberculin. The computer tomogram showed a

homogeneous mass compressing the internal carotid artery. Cervical

magnetic resonance angiography showed an abnormal signal region at

the bifurcation of the right common carotid artery. The mass received its

blood supply from the branches of the facial artery, the lingual artery,

and the superior thyroid artery, as well as from the branches of the

thyrocervical trunk. There were no abnormal signs such as vascular

malformation, distortion, or narrowing of the common carotid arteries,

the internal and external carotid arteries, or the subclavian arteries.

At operation we found 4 masses, mainly inferior and exterior to the

bifurcation of the right common carotid artery. They were tightly

adherent to the artery and to the internal jugular vein, but could be

removed by blunt dissection. The vagus nerve was protected carefully,

and the arterial branches to the masses were ligated to minimize

hemorrhage. All 4 masses were fragile with intact envelopes, ranging in

size from 1.0 3 1.0 3 1.0 cm to 3.0 3 4.0 3 3.0 cm. The postoperative

histopathological diagnosis was Castleman disease, hyaline vascular

type. The wound healed well. During the 9-month follow-up there was

no sign of recurrence or metastasis.

CSF-1, RANKL, AND OPG REGULATE OSTEOCLASTO-GENESIS DURING MURINE TOOTH ERUPTION. S.Bsoul, J. Heinrich, G. Terezhalmy, K. Woodruff, S. Abboud,University of Texas Health Science Center at San AntonioSchool of Dentistry.

Background. During tooth eruption, osteoclast-mediated bone

resorption predominates in alveolar bone along the occlusal surface

rather than in bone basal to the tooth. CSF-1, RANKL, and OPG,

regulatory molecules essential for osteoclastogenesis, are expressed

during eruption. However, it is unclear if these cytokines exhibit an

expression pattern that correlates with sites of osteoclastogenesis in

vivo.

Study design. Mouse mandibles, isolated from 1 to 14 days

postnatally, were analyzed for osteoclast activity using tartrate resistant

acid phosphatase staining as well as CSF-1, RANKL, and OPG mRNA

expression using in situ hybridization.

Results. CSF-1, RANKL, and OPG are expressed in a distinct

temporal and spatial manner. In the occlusal region, osteoclast activity

was maximal at day 5 and correlated with a relative high expression of

CSF-1 and RANKL compared to OPG. Despite persistent CSF-1

expression in basal bone at this time point, osteoclast activity decreased

and was associated with increased expression of OPG compared to

RANKL. By day 8, osteoclastogenesis declined and correlated with

upregulation of OPG at the occlusal and basal regions, with this effect

continuing throughout eruption.

Conclusions. These findings suggest that the spatiotemporal

pattern and relative abundance of CSF-1, RANKL, and OPG during

ORAL SURGERY ORAL MEDICINE ORAL PATHOLOGYVolume 97, Number 4

Abstracts 463

CLINICAL SIGNIFICANCE OF TELOMERASE ACTIVITYIN SALIVA FROM ORAL SQUAMOUS CELL CARCI-NOMA PATIENTS. L. Zhong, G. Chen, S. Zhao, SecondAffiliated Hospital, College of Medicine, Zhejiang University,Hangzhou, China.

Tumor markers have been detected in saliva from patients with

oral cancers. In order to investigate the expression of telomerase

activity in saliva and its clinical significance, 62 saliva specimens were

collected from 32 patients with oral squamous cell carcinoma (SCC)

and 30 healthy persons, the telomerase activity was detected by

telomerase PCR-ELISA method. The results were analyzed by the

statistical software of SPSS10.0, when the p value was less than 0.05,

the statistical difference was regarded as significant. All of the thirty-

two patients were confirmed by pathologic diagnosis without other

diseases. There were 23 males and 9 females, the age ranged from 31 to

84 years with the mean age of 58 years. There were 14 SCCs of tongue,

10 SCCs of gingiva, 4 SCCs of buccal mucosa, 3 SCCs of floor of

mouth and 1 SCC of palatine mucosa. According to the UICC-TNM

classification for carcinoma of oral cavity, there were 6 patients at

clinical stage I, 10 at clinical stage II, 10 at clinical stage III and 6 at

clinical stage IV. The telomerase activity was detected positively in

75.0%(24/32) of patients with oral squamous cell carcinoma, while it

was positive only in 6.67%(2/30) of normal persons, the statistical

difference was significant with p \0.001. But the difference of

expression of telomerase activity between the patients in clinical stage

I\II (68.75%, 11/16) and III\IV (81.25%, 13/16)was not significant with

P = .414, the same to that between the patients with and without lymph

nodes metastasis, the expression rates of telomerase activity were

80.0%(8/10) and 72.73%(16/22) respectively with P = .660. The

results suggest that the detection of telomerase activity in saliva

could be used as an assistant marker to diagnose oral squamous cell

carcinoma, but it is useless to judge the clinical stage and lymph nodes

metastasis.

CERVICAL CASTLEMANDISEASE IN CHILDREN: A CASEREPORT. L. Zhong, G. Chen, S. Zhao, Second Affiliated Hos-pital, College of Medicine, Zhejiang University, Hangzhou,China.

eruption are key determinants of site-specific osteoclast activity in bone

surrounding the tooth. Targeting these cytokines to specific regions

in alveolar bone may provide a mechanism for regulating osteo-

clastogenesis in dental disorders associated with altered tooth eruption.

This work was supported by funding from the NIH (AR-42306)

and a Veteran’s Administration Merit Award.