Cutaneous angiosarcomas may express programmed death ligand-1 (PD-L1) and PD-L1 expression, and the presence of tumor-infiltrating lymphocytes (TILs) correlates with outcome. These observations provide a basis for PD-1/PD-L1 inhibitor therapy. Lymphocyte activation gene 3 (LAG-3) is an inhibitory receptor that interacts with the PD-L1 axis and is considered to be a marker of immune exhaustion. The presence of LAG-3positive lymphocytes in cutaneous angiosarcoma has not been established. We reviewed 10 cases of treatment naive angiosarcoma of skin and superficial soft tissue and assessed for PD-L1 (ZR3) expression, presence of TILs, and expression of CD8, PD1, and LAG-3 by tumor-associated inflammatory cells by immunohistochemistry. All 10 angiosarcomas were positive for PD-L1: 7 with high expression and 3 with low expression. TILs were present in all tumors: brisk in 7 and nonbrisk in 3. CD8 lymphocytes were present in all tumors with a range of 212-1274 cells per square millimeter (mean 557 CD8 cells/mm 2 ). LAG-3-positive lymphocytes were present in 9 of 10 angiosarcomas with a range of 0-728 cells/mm 2 (mean 146 LAG-3 cells cells/mm 2 ). The ratio of LAG-3 lymphocytes to CD8 lymphocytes was 0%-59% (mean 27%). The PD1 cell counts were intermediate between CD8 and LAG3 counts. Cutaneous angiosarcomas frequently express PD-L1, have prominent numbers of CD8 positive, and have smaller numbers of LAG-3-positive and PD-1-positive TILs. Our findings provide further evidence of PD-L1 expression in cutaneous angiosarcoma and the promise for immune checkpoint inhibitor therapy.
La fenestración apical es una condición patológica caracterizada por la perforación de la tabla ósea y mucosa labial por el ápice de un diente temporal de etiología multifactorial. La mayoría de los casos de fenestración apical que aparecen en la literatura se refieren a dientes destruidos por caries, traumatismos o atrición. Afecta aproximadamente un 20% de los dientes, especialmente a incisivos maxilares, caninos y en un menor número a molares dañando con más frecuencia el hueso bucal que el lingual. Se reporta el caso clínico de un paciente de 5 años 3 meses con inflamación de la parte interna del labio, pérdida de la continuidad de la mucosa labial y perforación de la tabla ósea bucal en el órgano dentario 51, debido a un traumatismo en la zona.
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