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Torre-Castro J, Ríos-Viñuela E, Balaguer-Franch I, Díaz de Lezcano I, Aguado-García Á, Nájera L, Suárez D, Requena L. Perineural Infiltration: A Comprehensive Review of Diagnostic, Prognostic, and Therapeutic Implications. Am J Dermatopathol 2024; 46:271-286. [PMID: 38457673 DOI: 10.1097/dad.0000000000002667] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/10/2024]
Abstract
ABSTRACT Perineural infiltration refers to a neoplastic cell involvement in, around, and through the nerves. It is considered as one of the neoplastic dissemination pathways. Thus, its identification is crucial to establish the prognosis of some malignant skin neoplasms, such as squamous cell carcinoma, and explains the locally aggressive behavior of cutaneous neoplasms, such as microcystic adnexal carcinoma. We have conducted a review of malignant and benign skin tumors in which perineural infiltration has been described, and we also discuss some histopathological findings that may simulate perineural infiltration.
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Affiliation(s)
- Juan Torre-Castro
- Department of Dermatology, Fundación Jiménez Díaz, Universidad Autónoma, Madrid, Spain
| | - Elisa Ríos-Viñuela
- Department of Dermatology, Instituto Valenciano de Oncología, Escuela de Doctorado Universidad Católica de Valencia, Valencia, Spain
| | | | | | | | - Laura Nájera
- Department of Pathology, Puerta de Hierro University Hospital, Universidad Autónoma, Majadahonda, Madrid, Spain
| | - Dolores Suárez
- Department of Pathology, Puerta de Hierro University Hospital, Universidad Autónoma, Majadahonda, Madrid, Spain
| | - Luis Requena
- Department of Dermatology, Fundación Jiménez Díaz, Universidad Autónoma, Madrid, Spain
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Favero G, Rezzani R, Rodella LF. The Juxtaoral Organ: From Anatomy to Clinical Relevance. Diagnostics (Basel) 2022; 12:diagnostics12020552. [PMID: 35204641 PMCID: PMC8871279 DOI: 10.3390/diagnostics12020552] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2022] [Accepted: 02/18/2022] [Indexed: 11/16/2022] Open
Abstract
The juxtaoral organ was first described 1885 as a rudimentary structure that developed and disappeared in the embryonic period. Since then, it has been studied further and is now known to be a permanent anatomical structure of considerable importance in clinical, surgical and pathological fields. However, there are no precise and uniform descriptions about its anatomical localization and functional significance. Precise and in-depth anatomical knowledge is crucial to reducing the risk of incorrect identification of the juxtaoral organ, due to fact that this anatomical structure can be misinterpreted as a carcinoma, leading to unnecessary treatments. Therefore, the purpose of this review is to summarize the actual knowledge on the gross and microscopic anatomy of the juxtaoral organ and outline its clinical relevance in order to prevent unnecessary investigations/treatments of this anatomical pitfall. We believe that further studies are still needed to add new perspectives in relation to the juxtaoral organ.
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Affiliation(s)
- Gaia Favero
- Anatomy and Physiopathology Division, Department of Clinical and Experimental Sciences, University of Brescia, 25123 Brescia, Italy; (R.R.); (L.F.R.)
- Interdipartimental University Center of Research “Adaptation and Regeneration of Tissues and Organs (ARTO)”, University of Brescia, 25123 Brescia, Italy
- Correspondence: ; Tel.: +39-03-0371-7479; Fax: +39-03-0371-7486
| | - Rita Rezzani
- Anatomy and Physiopathology Division, Department of Clinical and Experimental Sciences, University of Brescia, 25123 Brescia, Italy; (R.R.); (L.F.R.)
- Interdipartimental University Center of Research “Adaptation and Regeneration of Tissues and Organs (ARTO)”, University of Brescia, 25123 Brescia, Italy
| | - Luigi Fabrizio Rodella
- Anatomy and Physiopathology Division, Department of Clinical and Experimental Sciences, University of Brescia, 25123 Brescia, Italy; (R.R.); (L.F.R.)
- Interdipartimental University Center of Research “Adaptation and Regeneration of Tissues and Organs (ARTO)”, University of Brescia, 25123 Brescia, Italy
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Val-Bernal JF, Garijo MF, Fontanil N. Subgemmal neurogenous plaques of the tongue: a systematic autopsy study. ROMANIAN JOURNAL OF MORPHOLOGY AND EMBRYOLOGY = REVUE ROUMAINE DE MORPHOLOGIE ET EMBRYOLOGIE 2022; 63:545-553. [PMID: 36588493 PMCID: PMC9926142 DOI: 10.47162/rjme.63.3.09] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
Subgemmal neurogenous plaque (SNP) is a subepithelial nerve plexus associated with taste buds, occasionally observed in tongue biopsies. There is no evaluation of the prevalence of this structure in the general population. We present a systematic study of samples obtained at random from the dorsal portion of the oral tongue in 205 consecutive complete autopsies. Each sample was about 15 mm long and 10 mm thick. Four hundred fifty-eight samples were routinely obtained and an average of 2.23±0.88 samples per case (range 1-7) was collected. The total number of SNPs observed was 556, with a mean of 2.71±2.68 per case (range 0-16). This means that for every 15 linear mm of the oral tongue, approximately 2.7 SNPs can be present. SNPs display several ages, and they do not show sex differences. The mean size of these structures was 2.1±0.94 mm (range 0.6-3.6 mm). SNP is characterized by its unique neural, zonal pattern with a superficial neurofibroma-like area and a deeper neuroma-like area. Special features of the SNPs include the presence of taste buds (49.1%), ganglion cells (26.3%), dilated thin-walled vessels (11.3%), salivary gland excretory ducts emptying on the surface of the papillae (6.1%), moderate-severe inflammatory infiltrate (6.8%), presence of lymphoid tissue in the vicinity (7.0%), and hyperplasia of the epithelial cover with pseudoepitheliomatous appearance (7.0%). The differential diagnoses include schwannoma, neurofibroma, ganglioneuroma, traumatic neuroma, mucosal neuroma, and squamous cell carcinoma. SNPs are small, normal structures that may undergo hyperplasia and are usually seen incidentally.
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Affiliation(s)
- José-Fernando Val-Bernal
- Pathology Unit, Department of Medical and Surgical Sciences, University of Cantabria–IDIVAL, Santander, Spain
| | | | - Natalia Fontanil
- Service of Anatomical Pathology, Marqués de Valdecilla University Hospital and IDIVAL Research Institute, Santander, Spain
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Pastor JF, Muchlinski MN, Potau JM, Casado A, García-Mesa Y, Vega JA, Cabo R. The Tongue in Three Species of Lemurs: Flower and Nectar Feeding Adaptations. Animals (Basel) 2021; 11:2811. [PMID: 34679832 PMCID: PMC8532830 DOI: 10.3390/ani11102811] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2021] [Revised: 09/19/2021] [Accepted: 09/20/2021] [Indexed: 11/17/2022] Open
Abstract
The mobility of the primate tongue allows for the manipulation of food, but, in addition, houses both general sensory afferents and special sensory end organs. Taste buds can be found across the tongue, but the ones found within the fungiform papillae on the anterior two thirds of the tongue are the first gustatory structures to come into contact with food, and are critical in making food ingestion decisions. Comparative studies of both the macro and micro anatomy in primates are sparse and incomplete, yet there is evidence that gustatory adaptation exists in several primate taxa. One is the distally feathered tongues observed in non-destructive nectar feeders, such as Eulemur rubriventer. We compare both the macro and micro anatomy of three lemurid species who died of natural causes in captivity. We included the following two non-destructive nectar feeders: Varecia variegata and Eulemur macaco, and the following destructive flower feeder: Lemur catta. Strepsirrhines and tarsiers are unique among primates, because they possess a sublingua, which is an anatomical structure that is located below the tongue. We include a microanatomical description of both the tongue and sublingua, which were accomplished using hematoxylin-eosin and Masson trichrome stains, and scanning electron microscopy. We found differences in the size, shape, and distribution of fungiform papillae, and differences in the morphology of conical papillae surrounding the circumvallate ones in all three species. Most notably, large distinct papillae were present at the tip of the tongue in nectar-feeding species. In addition, histological images of the ventro-apical portion of the tongue displayed that it houses an encapsulated structure, but only in Lemur catta case such structure presents cartilage inside. The presence of an encapsulated structure, coupled with the shared morphological traits associated with the sublingua and the tongue tip in Varecia variegata and Eulemur macaco, point to possible feeding adaptations that facilitate non-destructive flower feeding in these two lemurids.
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Affiliation(s)
- Juan Francisco Pastor
- “Osteology and Compared Anatomy” Research Group, Departament of Anatomy and Radiology, University of Valladolid, 47005 Valladolid, Spain;
| | | | - Josep Maria Potau
- Unit of Human Anatomy and Embryology, University of Barcelona, 08036 Barcelona, Spain; (J.M.P.); (A.C.)
| | - Aroa Casado
- Unit of Human Anatomy and Embryology, University of Barcelona, 08036 Barcelona, Spain; (J.M.P.); (A.C.)
| | - Yolanda García-Mesa
- SINPOS Research Group, Departament of Morphology and Cell Biology, University of Oviedo, 33006 Oviedo, Spain; (Y.G.-M.); (J.A.V.)
| | - Jose Antonio Vega
- SINPOS Research Group, Departament of Morphology and Cell Biology, University of Oviedo, 33006 Oviedo, Spain; (Y.G.-M.); (J.A.V.)
- Faculty of Health Sciences, Autonomous University of Chile, Santiago 8380447, Chile
| | - Roberto Cabo
- “Osteology and Compared Anatomy” Research Group, Departament of Anatomy and Radiology, University of Valladolid, 47005 Valladolid, Spain;
- SINPOS Research Group, Departament of Morphology and Cell Biology, University of Oviedo, 33006 Oviedo, Spain; (Y.G.-M.); (J.A.V.)
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Suárez-Quintanilla J, Martín-Cruces J, Martín-Biedma B, Cobo JL, Mérida-García AJ, de Vicente JC, Junquera LM, Mérida-Velasco JR, Vega JA. The juxta-oral organ of Chievitz (organum yuxtaorale) updated: Embryology, anatomy, function and pathology. Ann Anat 2020; 232:151582. [PMID: 32810612 DOI: 10.1016/j.aanat.2020.151582] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2020] [Revised: 07/05/2020] [Accepted: 07/26/2020] [Indexed: 10/23/2022]
Abstract
BACKGROUND The Chievitz's organ or juxta-oral organ is a mysterious bilateral structure, phylogenetically preserved, which develops from the mouth epithelium as an invagination that loses connection to it in the prenatal period. It is located laterally to the walls of the oral cavity in an imprecise anatomical location and receives abundant innervation from the buccal nerve. Structurally it consists of non-keratinizing squamous-like neuroepithelial cells surrounded by two layers of connective tissue with nerve fibers and different morphotypes of sensory corpuscles. Its function is completely unknown although based on its rich innervation it is assumed that works as a mechanoreceptor. METHODS We have performed immunohistochemistry for axonal and Schwann cells, and the putative mechanoproteins ASIC2, TRPV4 and Piezo2 in sections of fetal juxta-oral organ. RESULTS Intraparenchymatous nerve fibers and sensory corpuscles were observed as well as immunoreactivity for Piezo2 in both nerve fibers and epithelial parenchymatous cells. CONCLUSIONS We add indirect evidence that the juxtaoral organ is a mechanoreceptor because in addition to its dense innervation, the epithelial cells and sensory nerve fibers display immunoreactivity for the mechanogated ion channel Piezo2. Based on current knowledge, the functional and clinical importance of the juxta-oral organ should be further investigated.
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Affiliation(s)
- J Suárez-Quintanilla
- Departamento Ciencias Morfológicas, Universidad de Santiago de Compostela, Spain
| | - J Martín-Cruces
- Departamento de Morfología y Biología Celular, Grupo SINPOS, Universidad de Oviedo, Spain
| | - B Martín-Biedma
- Departamento de Cirugía y Especialidades Médico-Quirúrgicas, Universidad de Santiago de Compostela, Spain
| | - J L Cobo
- Departamento de Morfología y Biología Celular, Grupo SINPOS, Universidad de Oviedo, Spain; Servicio de Cirugía Máxilofacial, Hospital Universitario Central de Asturias, Oviedo, Spain
| | | | - J C de Vicente
- Servicio de Cirugía Máxilofacial, Hospital Universitario Central de Asturias, Oviedo, Spain; Departamento de Cirugía y Especialidades Médico-Quirúrgicas, Universidad de Oviedo, Spain
| | - L M Junquera
- Servicio de Cirugía Máxilofacial, Hospital Universitario Central de Asturias, Oviedo, Spain; Departamento de Cirugía y Especialidades Médico-Quirúrgicas, Universidad de Oviedo, Spain
| | - J R Mérida-Velasco
- Departamento de Anatomía y Embriología, Instituto de Embriología, Universidad Complutense de Madrid, Madrid, Spain
| | - J A Vega
- Departamento de Morfología y Biología Celular, Grupo SINPOS, Universidad de Oviedo, Spain; Facultad de Ciencias de la Salud, Universidad Autónoma de Chile, Santiago de Chile, Chile.
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Moriyama H, Amano K, Matsumura G. Study of morphological structure in human fetus Wharton's duct opening area. Int J Pediatr Otorhinolaryngol 2019; 124:18-21. [PMID: 31154118 DOI: 10.1016/j.ijporl.2019.05.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2019] [Revised: 05/10/2019] [Accepted: 05/10/2019] [Indexed: 11/24/2022]
Abstract
OBJECTIVES Not many morphological studies have been reported regarding the human salivary main duct, especially those based on observations of the fetal salivary main duct at various developmental stages. The relationships between fetal structural development and its function, functional disorders and diseases certainly have clinical significance. METHODS In this study, we conducted a morphological observation of seven 5-9 month old human fetal sublingual caruncula, the common opening between the submandibular (Wharton's) duct and the sublingual (Bartholin's) duct. After seven specimens were removed and paraffin sections were prepared, HE and EVG staining were used for histological study of structural differences in the various developmental stages. Furthermore, anti-α-SMA staining was used to observe the distribution of the smooth muscle inside of the Wharton's duct wall. RESULTS An abundance of elastic fibers were observed in the duct walls of both five and nine month old specimens with EVG staining. The smooth muscle fibers of five month old fetus were immature and were starting to distribute throughout the duct wall, whereas nine month old fetus' smooth muscle fibers were further developed and composed in layers. CONCLUSION In this study, we confirmed that the Wharton's duct wall structure of nine month old fetuses was close to its adult structural formation, while the inner structure consisted of an ample distribution of elastic fibers and smooth muscle fibers. Based on the distribution pattern of the smooth muscle, we speculate that the Wharton's duct's opening area does not possess a sphincter-like function in the regulation of salivary flow.
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Affiliation(s)
- Hiroshi Moriyama
- Department of Anatomy, Showa University School of Medicine, 5-8, Hatanodai1, Shinagawa-city, Tokyo, 142-8555, Japan
| | - Kaori Amano
- Department of Oral Anatomy, Kanagawa Dental University, 82 Inaoka-cho, Yokosuka, Kanagawa, 238-8580, Japan.
| | - George Matsumura
- Department of Anatomy, Kyorin University School of Medicine, 6-20-2 Shinkawa, Mitaka-city, Tokyo, Japan
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Bommanavar SB, Hema KN, Baad R. Juxtaoral organ of Chievitz: An innocuous organ to be known. J Oral Maxillofac Pathol 2017; 21:162-164. [PMID: 28479708 PMCID: PMC5406801 DOI: 10.4103/jomfp.jomfp_22_17] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
The Juxtaoral Organ of Chievitz is a normal anatomical structure located within the soft tissue in the buccotemporal fascia on the medial surface of the ascending ramus. This enigmatic vestigial structure is considered to be of neuroepithelial origin with no known function. As a matter of fact, JOOC is one of the most treacherous pitfalls in surgical pathology with respect to lesions in the head and neck area. Hence the basic aim of this short communication is to reveal the importance about this organ and enlighten the oral pathologist about this histopathological structure, thus preventing extensive and unnecessary investigations.
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Affiliation(s)
- Sushma Basavaraj Bommanavar
- Department of Oral Pathology and Microbiology and Forensic Odontology, School of Dental Sciences, Krishna Institute of Dental College and Hospital, Karad, Maharashtra, India
| | - K N Hema
- Department of Oral and Maxillofacial Pathology, V.S. Dental College and Hospital, Bengaluru, Karnataka, India
| | - Rajendra Baad
- Department of Oral Pathology and Microbiology and Forensic Odontology, School of Dental Sciences, Krishna Institute of Dental College and Hospital, Karad, Maharashtra, India
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Kobayashi Y, Nakashima M, Wakakuri T, Imaki J, Ito M. Histology and immunohistochemistry of the developing juxta-oral organ in mice. Ann Anat 2015; 198:49-57. [DOI: 10.1016/j.aanat.2014.11.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2014] [Revised: 11/16/2014] [Accepted: 11/18/2014] [Indexed: 11/24/2022]
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Sancheti SM, Sawaimoon S, Zameer MAL. Juxtaoral Organ of Chievitz, an Obscure Anatomical Structure Masquerading as Perineural Invasion of Mucoepidermoid Carcinoma. Int J Surg Pathol 2015; 23:461-3. [DOI: 10.1177/1066896915568991] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The juxtaoral organ was first described by Chievitz in 1885. This is typically located deep to the medial pterygoid muscle (unilaterally or bilaterally) in the pterygomandibular space. Juxtaoral organ of Chievitz (JOOC) is usually incidentally detected in biopsies or resection specimen of other tumors but exceptionally, it can present as mass lesions. Awareness of this normal anatomic structure is important, because the epithelial islands in this area could be misinterpreted as an invasive carcinoma, mucoepidermoid carcinoma, an odontogenic tumor such as ameloblastoma or adenomatoid odontogenic tumor, or a perineural invasion by carcinoma. When a portion of the juxtaoral organ of Chievitz is accidentally exposed by frozen biopsy, there is an even higher risk of mistaking these cells for an invasive cancer or a perineural invasion of carcinoma. We report this to create awareness about this obscure structure and to draw attention to its differential diagnosis
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Velasco JRM, De La Cuadra Blanco C, Velasco JAM. Development of the juxta-oral organ in rat embryo. Anat Rec (Hoboken) 2012; 295:769-75. [PMID: 22431151 DOI: 10.1002/ar.22444] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2011] [Revised: 11/17/2011] [Accepted: 11/21/2011] [Indexed: 01/20/2023]
Abstract
The aim of this work is to clarify the development and morphology of the juxta-oral organ (JOO) in rat embryos from Day (E)14 to 19. Furthermore, in the region of the JOO, an analysis was made of the expression of the monoclonal antibody HNK-1, which recognizes cranial neural-crest cells. In this study, we report that JOO develops from an epithelial condensation at the end of the transverse groove of the primitive mouth at E14. During E15, it invaginates and is disconnected from the oral epithelium. At E16, the JOO forms an solid epithelial cord with three parts (anterior, middle, and posterior) and is related to the masseter, temporal, medial pterygoid, and tensor veli palatini muscles. During E17-19, no significant changes were detected in their position. Both the mesenchyme caudal to the anlage of the JOO at E14, as well as the mesenchyme that surrounds the bud of the JOO at E15, expressed positivity for HNK-1. Our results suggest that the mesenchyme surrounding the JOO at E15 could emit some inductive signal for the JOO to reach its position at E16. This work shows for the first time that the cranial neural-crest-derived mesenchyme participates in the development of the JOO.
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Affiliation(s)
- J R Mérida Velasco
- Departamento de Anatomía y Embriología Humana II, Facultad de Medicina, Universidad Complutense de Madrid, Spain.
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Abstract
The juxta-oral organ is a bilateral organ in the mammalian bucca. It consists of epithelial cords with surrounding mesenchyme. It develops from embryonic oral epithelium, but its macroscopic morphology in mice is less studied and seems to be very different from that of humans. The juxta-oral organ in mice extends more widely from the subcutaneous tissue of the mandible near the lateral fascia of the masseter to the submucosa of the soft palate. In this paper, we report that the mutant mouse allele Bmp7(lacZ) presented intense lacZ expression in the epithelial component of the juxta-oral organ in its homo- and heterozygous states. The main aims of this study were to show that this mutant mouse allele is suitable for observing macroscopic structure of the juxta-oral organ and to describe the development of this organ during embryonic and postnatal stages. Whole-mount beta-gal staining of this strain of mouse showed that the juxta-oral organ in mice appeared at E12.0 from oral epithelium and lost connection with it before E12.5. Then, the juxta-oral organ extended anteriorly to the lateral fascia of the masseter and posteriorly to the submucosal layer of the soft palate via the orbit. The mature juxta-oral organ had no connection to other epithelia such as those of the bucca and parotid duct. It persisted until adulthood and there seemed to be no tendency to regress. Transmission electron microscopy showed that each part of the juxta-oral organ was an epithelial cord surrounded by a basement membrane and mesenchymal tissue.
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Affiliation(s)
- Masataka Ito
- Department of Developmental Anatomy and Regenerative Biology, National Defense Medical College, Tokorozawa 359-8513, Japan.
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