Santoro Angela, Pannone Giuseppe, Ramaglia Luca, Bufo Pantaleo, Lo Muzio Lorenzo, Saviano Raffaele
Department of Services and Laboratories, Institute of Histopathology and Diagnostic Cytopathology, Fondazione di Ricerca e Cura 'Giovanni Paolo II'-UCSC, Campobasso, Italy.
Department of Clinical and Experimental Medicine, Institute of Pathological Anatomy, University of Foggia, Foggia, Italy.
Ann Med Surg (Lond). 2015 Dec 1;5:14-8. doi: 10.1016/j.amsu.2015.11.004. eCollection 2016 Feb.
Odontogenic fibroma (OF), a rare odontogenic tumor of mesodermal origin, has been thought to originate from either dental follicle, periodontal ligament, or dental papilla [1]. Different studies reported high variability in the incidence rate as being between 3 and 23% of all odontogenic tumors [2,3]. OF manifests a dual character at the histopathological examination showing odontogenic epithelial structures mimicking those observed in biopsy of ameloblastoma and, in addition, peculiar fragments of cellular stroma. The clinical and radiological features of OF are similar to other odontogenic and/or non-odontogenic tumours and the differential diagnosis may first occur at fine-needle aspiration biopsy.
In the case reported, a young patient showed a localized gingival enlargement involving radiologically the superior margin of the right angle of the mandible and associated with an un-erupted tooth. The morphological characteristics together with clinical and radiologic findings confirmed the tumor to be a central odontogenic fibroma (COF) with secondary gingival involvement.
Benign odontogenic tumors may be distinguished from other odontogenic/non-odontogenic neoplasias and from malignant tumours through a cytologic differential diagnosis as treatment differs accordingly.
牙源性纤维瘤(OF)是一种罕见的中胚层来源的牙源性肿瘤,被认为起源于牙囊、牙周膜或牙乳头[1]。不同研究报告其发病率差异很大,占所有牙源性肿瘤的3%至23%[2,3]。OF在组织病理学检查中表现出双重特征,显示出牙源性上皮结构,类似于成釉细胞瘤活检中观察到的结构,此外还有特殊的细胞间质碎片。OF的临床和放射学特征与其他牙源性和/或非牙源性肿瘤相似,鉴别诊断可能首先在细针穿刺活检时出现。
在报告的病例中,一名年轻患者出现局限性牙龈肿大,放射学检查显示累及下颌骨右角上缘,且与一颗未萌出的牙齿有关。形态学特征以及临床和放射学检查结果证实该肿瘤为伴有继发性牙龈受累的中央性牙源性纤维瘤(COF)。
良性牙源性肿瘤可通过细胞鉴别诊断与其他牙源性/非牙源性肿瘤以及恶性肿瘤区分开来,因为治疗方法会因此而有所不同。