Vera Sempere Francisco José, Artes Martínez María Jose, Vera Sirera Beatriz, Bonet Marco Jaime
Department of Pathology, Hospital Universitario La Fe, Universidad de Valencia.
Med Oral Patol Oral Cir Bucal. 2006 Jul 1;11(4):E305-8.
Adenomatoid odontogenic tumor (AOT) is an uncommon benign odontogenic lesion that affects young patients, with female predominance, mainly in second decade, showing a radiolucent unilocular image associated with an unerupted tooth, usually a canine. In spite of previous and confusing denominations, such as adenoameloblastoma or adenomatoid ameloblastic tumor, AOT is a benign tumor with a very low rate of recurrence, that show a peculiar morphological picture (basaloid appearance with glandular-like structures, calcifying areas, and amiloid-like material) that allow its histopathological recognition. We present a clinicopathological analysis of a case of follicular AOT affecting the mandible in a 9 years-old female patient associated with unerupted lower left canine. Immunohistochemical study showed some data previously unrecognised. All cellular types that composed AOT showed nuclear positivity for p63 indicating a basal characterization in the different cellular components. According to its benign character and low potential for recurrence, AOT revealed a scant proliferative activity (2-3% nuclei showed Ki-67 positivity) limited to some epithelial nodules (AE1-3 +) of fusiform appearance. Absence of reactivity for hormonal receptors (RE and RPg) excluded a possible hormonodependence in AOT that could explain the observed female predominance.
腺样牙源性肿瘤(AOT)是一种罕见的良性牙源性病变,主要影响年轻患者,女性居多,发病年龄多在第二个十年,表现为与未萌出牙(通常为尖牙)相关的透射性单房影像。尽管之前有诸如腺成釉细胞瘤或腺样成釉细胞瘤等混淆的命名,但AOT是一种复发率极低的良性肿瘤,具有独特的形态学表现(基底样外观伴腺管样结构、钙化区域和淀粉样物质),这使其能够通过组织病理学识别。我们报告了一例9岁女性患者下颌骨滤泡型AOT的临床病理分析,该病变与左下未萌出尖牙相关。免疫组织化学研究显示了一些之前未被认识到的数据。构成AOT的所有细胞类型均显示p63核阳性,表明不同细胞成分具有基底样特征。鉴于其良性特征和低复发潜能,AOT显示出有限的增殖活性(2 - 3%的细胞核显示Ki-67阳性),仅限于一些梭形外观的上皮结节(AE1-3 +)。激素受体(RE和RPg)无反应性排除了AOT可能存在激素依赖性的情况,而激素依赖性本可解释所观察到的女性优势现象。