Vered Marilena, Buchner Amos, Dayan Dan, Shteif Moshe, Laurian Adi
Department of Oral Pathology and Medicine, School of Dental Medicine, Tel Aviv University, Tel Aviv, Israel.
J Oral Pathol Med. 2004 Feb;33(2):125-8. doi: 10.1111/j.1600-0714.2004.00014.x.
A case of an unusual lesion from the maxilla is presented. Macroscopically, the lesion was solid and histologically consisted of 'multiple separate keratocysts' of varying size that infiltrated into the surrounding bone and soft tissues. Panoramic image and CT scans showed a multilocular honeycomb ill-defined radiolucency with infiltration into the maxillary sinus and floor of orbit. This lesion should be differentiated from similar odontogenic lesions, such as keratoameloblastoma and papilliferous keratoameloblastoma. As there was no evidence of follicles, islands of ameloblastoma, or papilliferous structures in the entire specimen, the lesion could not be diagnosed as either a keratoameloblastoma or a papilliferous keratoameloblastoma. The invasive and destructive growth behavior, the histopathological features, and the histochemical pattern of the collagen stroma imply that this solid lesion is a neoplasia. It is suggested that the proper term for this lesion is solid variant of odontogenic keratocyst.
本文报告一例来自上颌骨的罕见病变。大体上，该病变质地坚实，组织学检查显示由多个大小不一的“独立角化囊肿”组成，这些囊肿浸润至周围骨组织和软组织。全景片和CT扫描显示为多房性蜂窝状边界不清的透射区，累及上颌窦和眶底。该病变应与类似的牙源性病变相鉴别，如角化成釉细胞瘤和乳头状角化成釉细胞瘤。由于整个标本中未发现滤泡、成釉细胞瘤岛或乳头状结构，因此该病变不能诊断为角化成釉细胞瘤或乳头状角化成釉细胞瘤。其侵袭性和破坏性生长行为、组织病理学特征以及胶原基质的组织化学模式提示该实性病变为肿瘤。建议将该病变恰当命名为牙源性角化囊肿实性型。
