Mosqueda-Taylor Adalberto, Martínez-Mata Guillermo, Carlos-Bregni Roman, Vargas Pablo Agustin, Toral-Rizo Victor, Cano-Valdéz Ana María, Palma-Guzmán José Mario, Carrasco-Daza Daniel, Luna-Ortiz Kuauhyama, Ledesma-Montes Constantino, de Almeida Oslei Paes
Oral Pathology and Medicine, Departamento de Atención la Salud, Universidad Autónoma Metropolitana, Mexico City, Mexico.
Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2011 Sep;112(3):349-58. doi: 10.1016/j.tripleo.2011.03.021.
The aim of this study was to describe the clinicopathologic and immunohistochemical characteristics of 14 cases of central odontogenic fibroma (COF), and the ultrastructural features of 2 of them.
Collaborative retrospective study based on the records of 4 oral pathology diagnostic services in Latin America based on the current World Health Organization classification.
There were 7 male and 7 female patients (mean age 31.8 years). Eight tumors occurred in the maxilla and 6 in the mandible. Thirteen cases were epithelium-rich and 1 epithelium-poor COF. Three were classified as hybrid COF with giant cell lesion. Mean size of the hybrid lesions were larger than pure COF (3.8 vs. 2.4 cm). Odontogenic epithelial islands were immunoreactive for cytokeratin (CK) AE1/AE3, CK5, CK14, CK19, and 34BE12 and negative for CK1 and CK18. Langerhans cells positive for S-100 and CD1a were found within the epithelial islands in 6/6 tested cases. CD68 was expressed in the giant cells of the hybrid lesions and in a few mononuclear cells of 2 cases of COF. Ki-67 index was <1% in all cases. In 6 tumors (42.8%), there were small globular eosinophilic droplets within the epithelial islands, which were positive for collagen type IV, and 9/13 cases (69.2%) were focally positive for smooth muscle actin. In addition to fibroblasts, myofibroblastic differentiation was found in the 2 cases studied ultrastructurally.
Immunohistochemistry was useful to confirm the presence of epithelium and to exclude other central fibrous tumors. COF also contains a variable number of mast cells, Langerhans cells, and myofibroblasts, and further studies are needed to better understand the participation of these cells in COF histogenesis.
本研究旨在描述14例中央性牙源性纤维瘤（COF）的临床病理及免疫组化特征，以及其中2例的超微结构特征。
基于当前世界卫生组织分类，对拉丁美洲4个口腔病理诊断机构的记录进行合作性回顾研究。
患者共7男7女（平均年龄31.8岁）。8例肿瘤发生于上颌骨，6例发生于下颌骨。13例为富含上皮的COF，1例为上皮稀少的COF。3例被归类为伴有巨细胞病变的混合性COF。混合性病变的平均大小大于纯COF（3.8 cm对2.4 cm）。牙源性上皮岛对细胞角蛋白（CK）AE1/AE3、CK5、CK14、CK19和34BE12呈免疫反应性，对CK1和CK18呈阴性。在6/6例检测病例的上皮岛内发现S-100和CD1a阳性的朗格汉斯细胞。CD68在混合性病变的巨细胞及2例COF的少数单核细胞中表达。所有病例的Ki-67指数均<1%。6例肿瘤（42.8%）的上皮岛内有小的球状嗜酸性小滴，对IV型胶原呈阳性，13例中的9例（69.2%）平滑肌肌动蛋白呈局灶性阳性。超微结构研究的2例中除成纤维细胞外，还发现肌成纤维细胞分化。
免疫组化有助于确认上皮的存在并排除其他中央性纤维性肿瘤。COF还含有数量不等的肥大细胞、朗格汉斯细胞和肌成纤维细胞，需要进一步研究以更好地了解这些细胞在COF组织发生中的作用。
