Gunawardhana Kuda Singappulige Niluka Darshani, Jayasooriya Primali Rukmal, Tilakaratne Wanninayake Mudiyanselage
Department of Oral Pathology, Faculty of Dental Sciences, University of Peradeniya, Kandy, Sri Lanka.
J Investig Clin Dent. 2014 Aug;5(3):220-5. doi: 10.1111/jicd.12071. Epub 2013 Dec 20.
Diagnostic criteria that have been specified for unicystic ameloblastomas (UAs) are not always helpful to differentiate these cystic tumors from common odontogenic cysts. The aim of this study therefore was to identify additional histopathological features (other than the features considered for the diagnosis of UA at present) that would be helpful to differentiate UA from odontogenic cysts.
One hundred histopathologically confirmed unicystic ameloblastomas and 20 cases each of radicular, inflamed dentigerous and non-inflamed dentigerous cysts were selected. Histopathological features of the UAs that are not used as diagnostic criteria at present were identified.
Hyperplastic arcading epithelial proliferations with stellate-reticulum-like and vacuolated cells were always seen associated with inflammation in odontogenic cysts, while in UA plexiform-like areas were also seen without inflammation (P < 0.001). In addition, a spiky rete pattern was observed in non-inflamed UA while this pattern was observed only in inflamed odontogenic cysts. Furthermore, spiky retes together with subepithelial hyalinization were usually observed in UAs while only subepithelial hyalinization was observed in non-inflamed dentigerous cysts.
Combinations of histopathological features were identified to differentiate non-inflamed UA from common odontogenic cysts. However, presence of inflammatory changes in UA precludes the use of features identified in the present study for diagnostic purposes.
已明确的单囊性成釉细胞瘤（UAs）诊断标准并非总能有助于将这些囊性肿瘤与常见牙源性囊肿区分开来。因此，本研究的目的是确定其他组织病理学特征（目前诊断UA时未考虑的特征），这些特征有助于将UA与牙源性囊肿区分开来。
选择100例经组织病理学确诊的单囊性成釉细胞瘤以及各20例根端囊肿、含牙囊肿伴炎症和含牙囊肿不伴炎症的病例。确定目前未用作诊断标准的UAs的组织病理学特征。
增生的拱形上皮增生伴有星网状样和空泡状细胞总是见于牙源性囊肿伴炎症时，而在UAs中，即使无炎症也可见到丛状样区域（P<0.001）。此外，在不伴炎症的UAs中观察到棘状 rete 图案，而仅在伴炎症的牙源性囊肿中观察到这种图案。此外，在UAs中通常观察到棘状 rete 与上皮下玻璃样变，而在不伴炎症的含牙囊肿中仅观察到上皮下玻璃样变。
确定了组织病理学特征的组合以区分不伴炎症的UA与常见牙源性囊肿。然而，UA中存在炎症改变排除了将本研究中确定的特征用于诊断目的。
