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Actinomycosis of the jaws—histopathological study of 45 patients shows significant involvement in bisphosphonate-associated osteonecrosis and infected osteoradionecrosis

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Abstract

Actinomycosis of the jaws is a rare disease, which has been recently described in patients with infected osteoradionecrosis (IORN) and bisphosphonate-associated osteonecrosis (BON). We investigated our archive material for Actinomycosis of the jaws with special regard to underlying disease. Out of a total number of 45 patients with Actinomycosis, 43 (93.5%) suffered from BON (58.7%) or IORN (35.6%), while there were only 3 patients (6.7%) without anti-tumor treatment. In all cases, we found direct association of Actinomyces colonies with bone; in the surrounding medullary space, mixed inflammatory infiltrates with variable amounts of osteoclasts were a typical finding. Pseudoepitheliomatous hyperplasia occurred in 60.9% of patients. Cell-rich vessel obliteration was seen in less than 25.9% of BON patients, while hyalinized vessel obliteration was obtained in 37.5% of IORN patients. Additionally performed polymerase chain reaction (PCR) on paraffin-embedded and ethylene diamine tetracetic acid (EDTA)-decalcified tissue specimens confirmed the presence of Actinomyces israelii in seven of seven cases analyzed. We conclude that Actinomycosis of the jaws is a particular complication in patients with BON and/or IORN. Patients with Actinomycosis of the jaws during or after these forms of anti-cancer therapy are suggested to represent a distinct patient cohort with a relevant impairment of their general condition.

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Acknowledgement

The authors wish to thank Ute Hildebrand, Institute of Pathology, University of Mainz for her excellent technical assistance in molecular testing. Moreover, we are grateful to Marianne Müller, Institute of Pathology, Mainz, for performing the scanning electron microscopy.

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Authors and Affiliations

  1. Institute of Pathology, University of Mainz, Langenbeckstr. 1, 55101, Mainz, Germany

    Torsten Hansen, Erik Springer & C. James Kirkpatrick

  2. Clinic for Maxillofacial Surgery, University of Mainz, Mainz, Germany

    Martin Kunkel & Christian Walter

  3. Department of Pathology, Institute of Surgical Pathology, University Hospital Zurich, Zurich, Switzerland

    Achim Weber

  4. Institute of Microbiology, University of Mainz, Mainz, Germany

    Ekkehard Siegel

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  1. Torsten Hansen
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  2. Martin Kunkel
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  7. C. James Kirkpatrick
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Correspondence to Torsten Hansen.

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Hansen, T., Kunkel, M., Springer, E. et al. Actinomycosis of the jaws—histopathological study of 45 patients shows significant involvement in bisphosphonate-associated osteonecrosis and infected osteoradionecrosis. Virchows Arch 451, 1009–1017 (2007). https://doi.org/10.1007/s00428-007-0516-2

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