Kamath Kavitha P, Vidya M, Shetty Nandaprasad, Karkera Bhavana V, Jogi Hemanth
Department of Oral Pathology, Yenepoya Dental College, Nithyanand Nagar, Deralakatte, Mangalore, Karnataka 575018, India.
Head Neck Pathol. 2010 Jun;4(2):157-62. doi: 10.1007/s12105-010-0173-7. Epub 2010 Mar 24.
Ameloblastic carcinoma is a rare lesion of odontogenic origin. It is defined as a malignant epithelial odontogenic tumor that histologically has retained the features of ameloblastic differentiation and also exhibits cytologic features of malignancy, like atypia and mitotic activity. Although this lesion represents a separate entity, differentiating it from ameloblastoma has been often challenging to pathologists. In this case study reporting a case of ameloblastic carcinoma, we have attempted to verify the previous findings on the use of Argyrophilic nucleolar organizing regions (AgNORs) and immunohistochemical staining for the alpha-smooth muscle actin (alpha-SMA) in differentiating ameloblastic carcinoma from ameloblastoma. It was observed that AgNORs was found to be almost twice in ameloblastic carcinoma as it was in ameloblastoma. A difference between the two lesions in the pattern of expression of alpha-SMA was also observed, with alpha-SMA being expressed in the odontogenic epithelium and the stroma of ameloblastic carcinoma whereas, in the case of ameloblastoma, it was found only in the stromal part. These findings suggest that AgNORs and alpha-SMA expression may be used as adjuncts to the routine histopathologic examination to differentiate ameloblastic carcinoma and ameloblastoma.
成釉细胞癌是一种罕见的牙源性病变。它被定义为一种恶性上皮性牙源性肿瘤，在组织学上保留了成釉细胞分化的特征，并且还表现出恶性的细胞学特征，如异型性和有丝分裂活性。尽管这种病变是一个独立的实体，但对病理学家来说，将其与成釉细胞瘤区分开来往往具有挑战性。在本病例研究报告了一例成釉细胞癌的病例中，我们试图验证先前关于使用嗜银核仁组织区（AgNORs）和α-平滑肌肌动蛋白（α-SMA）免疫组化染色在区分成釉细胞癌与成釉细胞瘤方面的研究结果。观察到成釉细胞癌中的AgNORs数量几乎是成釉细胞瘤中的两倍。还观察到两种病变在α-SMA表达模式上的差异，α-SMA在成釉细胞癌的牙源性上皮和基质中表达，而成釉细胞瘤中仅在基质部分发现α-SMA表达。这些发现表明，AgNORs和α-SMA表达可作为常规组织病理学检查的辅助手段，用于区分成釉细胞癌和成釉细胞瘤。
