title: Actinomycosis of the jaws--histopathological study of 45 patients shows significant involvement in bisphosphonate-associated osteonecrosis and infected osteoradionecrosis.
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.
authors.affiliation: Institute of Pathology, University of Mainz, Langenbeckstr. 1, 55101, Mainz, Germany. hansen@pathologie.klinik.uni-mainz.de
authors.forename: Torsten
authors.initials: T
authors.lastname: Hansen
authors.forename: Martin
authors.initials: M
authors.lastname: Kunkel
authors.forename: Erik
authors.initials: E
authors.lastname: Springer
authors.forename: Christian
authors.initials: C
authors.lastname: Walter
authors.forename: Achim
authors.initials: A
authors.lastname: Weber
authors.forename: Ekkehard
authors.initials: E
authors.lastname: Siegel
authors.forename: C James
authors.initials: CJ
authors.lastname: Kirkpatrick
mesh_terms: D000190:Actinomyces / Q000235:genetics / Q000302:isolation & purification / Q000648:ultrastructure; D000196:Actinomycosis / Q000382:microbiology / Q000473:pathology* / Q000601:surgery; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D050071:Bone Density Conservation Agents / Q000009:adverse effects*; D001850:Bone Diseases, Infectious / Q000382:microbiology / Q000473:pathology*; D004269:DNA, Bacterial / Q000032:analysis; D004164:Diphosphonates / Q000009:adverse effects*; D005260:Female; D006801:Humans; D007568:Jaw; D008297:Male; D008875:Middle Aged; D010020:Osteonecrosis / Q000139:chemically induced / Q000382:microbiology / Q000473:pathology*; D010025:Osteoradionecrosis / Q000382:microbiology / Q000473:pathology*; D016896:Treatment Outcome
chemical_list: D050071:Bone Density Conservation Agents; D004269:DNA, Bacterial; D004164:Diphosphonates