Department of Dentistry, University of Taubaté, SP, Brazil.
Acta Odontol Scand. 2012 Dec;70(6):577-82. doi: 10.3109/00016357.2011.640286. Epub 2012 Jan 3.
The purposes of this study were to assess clinical, histopathological and immunohistochemical features of 22 oral neurofibromas (NFs) and discuss with previously described literature, addressing the main aspects regarding the differential diagnosis.
Immunohistochemical reactions included S-100, CD34, GLUT-1, EMA, Ki-67, p53 and Collagen IV and histochemical reactions for Alcian blue.
Clinically, the preferential location was the maxillary bones, tongue and buccal mucosa. Microscopically, widely spread spindle-shaped cells with scant cytoplasm and elongated nuclei were observed. Immunostaining revealed that the tumor cells weakly expressed GLUT-1, Collagen IV, Ki-67 and p53. They were variably positive for CD34, S-100 protein and membrane epithelial antigen (EMA).
The different types of nerve sheath cells observed in the present series reinforce the presence of heterogeneous population in NFs. The strong positivity for S-100 suggests that the lesions were more composed by S-100-positive Schwann cells than other cells. Besides, the high number of CD34-positive cells suggests that this marker can be useful for the differential diagnosis of NFs against PEN, traumatic neuromas and Schwannomas. Finally, the low immunostaining for p53 and Ki-67 may indicate that NFs massively composed by S-100-positive Schwann cells present low potential of aggressiveness and malignant transformation.
本研究旨在评估 22 例口腔神经纤维瘤的临床、组织病理学和免疫组织化学特征,并结合已发表的文献进行讨论,主要涉及鉴别诊断的各个方面。
免疫组织化学反应包括 S-100、CD34、GLUT-1、EMA、Ki-67、p53 和 Collagen IV,组织化学反应包括 Alcian blue。
临床上,好发部位为上颌骨、舌和颊黏膜。显微镜下,可见广泛分布的纺锤形细胞,细胞质稀少,细胞核细长。免疫组化染色显示肿瘤细胞弱表达 GLUT-1、Collagen IV、Ki-67 和 p53。CD34、S-100 蛋白和膜上皮抗原(EMA)的表达呈不同程度的阳性。
本系列观察到的不同类型的神经鞘细胞证实了 NF 中存在异质性细胞群体。S-100 的强阳性表达表明病变主要由 S-100 阳性施万细胞组成,而非其他细胞。此外,CD34 阳性细胞数量较多提示该标志物可用于 NF 与 PEN、创伤性神经瘤和神经鞘瘤的鉴别诊断。最后,p53 和 Ki-67 的免疫组化染色较低可能表明,大量由 S-100 阳性施万细胞组成的 NF 具有较低的侵袭性和恶性转化潜能。