Kahn M A
Department of Pathology, School of Medicine, Temple University, Philadelphia, Pa.
Oral Surg Oral Med Oral Pathol. 1989 Jun;67(6):706-15. doi: 10.1016/0030-4220(89)90013-3.
Ameloblastoma, an odontogenic tumor of ectodermal origin, has been reported to arise, on rare occasions, in a primordial or dentigerous cyst of a young person. Numerous authors have suggested differing nomenclatures for these ameloblastomas (e.g., mural, unicystic, monocystic, intracystic, cystogenic, cystic, plexiform unicystic) and have sought to describe and classify the clinical and histopathologic features. These tumors have been characterized as a distinct variant exhibiting less aggressive behavior and a lower rate of recurrence than conventional ameloblastoma. Furthermore, various etiologic factors have been proposed for these cystic ameloblastomas, including (1) nonspecific irritational factors such as extraction, caries, trauma, infection, inflammation, or tooth eruption; (2) nutritional deficit disorders, and (3) viral infection. The files of the combined accessioned cases of Emory University's and Temple University's oral pathology laboratories were searched and a review of the literature was performed. Thirty-eight cases of mandibular ameloblastoma (37 intraosseous, 1 peripheral) in persons 19-year-old and younger were found from a combined total of 311 accessioned cases of ameloblastoma (12.2%). The average age at diagnosis was 10.4 years for the 18 males and 20 females. Of the 33 cases in which race was stated, 19 (57.6%) were white and 14 (42.4%) were black. In the 28 cases in which a clinical diagnosis was offered, fifteen (53.6%) were thought to be dentigerous cysts. Ten cases from patients less than 19 years old were investigated by means of an immunohistochemical staining technique for the detection of human papilloma virus (HPV) genus-specific structural antigen in formalin-fixed, paraffin-embedded tissue. Three of the ten cases (cases 31, 37 and 38) were positive for HPV capsid antigen, whereas none of ten randomly selected ameloblastomas in adults was positive. A discussion of the clinical and histopathologic comparative findings, with emphasis on treatment results and possible HPV etiology, is included. The preliminary nature of finding HPV in the tumor cells is stressed, with recommendation for further verification and typing with the more sensitive in situ hybridization technique.
成釉细胞瘤是一种外胚层来源的牙源性肿瘤，据报道，在极少数情况下，它起源于年轻人的原始囊肿或含牙囊肿。许多作者针对这些成釉细胞瘤提出了不同的命名（例如，壁性、单囊性、单房性、囊内性、囊肿源性、囊性、丛状单囊性），并试图描述和分类其临床及组织病理学特征。这些肿瘤被认为是一种独特的变异型，与传统成釉细胞瘤相比，其侵袭性较低，复发率也较低。此外，针对这些囊性成釉细胞瘤还提出了各种病因，包括（1）非特异性刺激因素，如拔牙、龋齿、创伤、感染、炎症或牙齿萌出；（2）营养缺乏性疾病；以及（3）病毒感染。检索了埃默里大学和天普大学口腔病理学实验室合并入档病例的档案，并进行了文献综述。在总共311例入档的成釉细胞瘤病例中（12.2%），发现了38例19岁及以下患者的下颌成釉细胞瘤（37例骨内型，1例外周型）。18例男性和20例女性的诊断平均年龄为10.4岁。在注明种族的33例病例中，19例（57.6%）为白人，14例（42.4%）为黑人。在给出临床诊断的28例病例中，15例（53.6%）被认为是含牙囊肿。对10例19岁以下患者的病例采用免疫组织化学染色技术，检测福尔马林固定、石蜡包埋组织中的人乳头瘤病毒（HPV）属特异性结构抗原。10例病例中的3例（病例31、37和38）HPV衣壳抗原呈阳性，而随机选择的10例成人成釉细胞瘤均无阳性。本文还讨论了临床和组织病理学的比较结果，重点是治疗结果和可能的HPV病因。强调了在肿瘤细胞中发现HPV的初步性质，并建议采用更敏感的原位杂交技术进行进一步验证和分型。
