Taleb Reda, Koutlas Ioannis G, Argyris Prokopios P
Clinical Assistant Professor, Division of Oral and Maxillofacial Surgery, School of Dentistry, University of Minnesota, Minneapolis, Minnesota, USA.
Associate Professor, Division of Oral and Maxillofacial Pathology, School of Dentistry, University of Minnesota, Minneapolis, Minnesota, USA.
Oral Surg Oral Med Oral Pathol Oral Radiol. 2017 Aug;124(2):165-174. doi: 10.1016/j.oooo.2017.04.008. Epub 2017 Apr 25.
Intraosseous vascular lesions of the craniofacial region are rare and may cause diagnostic and therapeutic challenges. The purpose of this study was to characterize 16 cases of intraosseous arteriovenous malformations (AVMs) affecting the jaws.
Immunohistochemical evaluation was performed using antibodies against α-smooth muscle actin (α-SMA), desmin, CD31, D2-40, and glucose transporter 1 (GLUT-1). Staining with elastic Verhoeff-Van Gieson and Masson trichrome histochemical stains was also performed.
No gender predilection (female:male ratio = 1:1) was observed, with patients' mean age being 50.8 years (SD of ±13.9; range 28-71 years). Predilection for the mandible was observed (12 of 16 [75%]). Immunohistochemically, diffuse endothelial CD31 staining was noted, and α-SMA strongly highlighted smooth muscle cells and pericytes. Desmin-positive vessels were identified in 9 of 16 AVMs (56.3%). D2-40 was uniformly negative in all specimens. AVMs were negative for GLUT-1 (11 of 14 [78.6%]) except for 2 cases (2 of 14 [14.3%]) exhibiting focal limited cytoplasmic GLUT-1 immunoreactivity. One case was equivocal for GLUT-1. Masson trichrome highlighted smooth muscle cells, and elastic fibers were identified in thick-walled arteries.
AVMs of the jaws generally lack expression of GLUT-1, similar to soft tissue vascular malformations. Clinicoradiographic features of intraosseous AVMs in the present study were consistent with the findings of previous studies, although mean age was higher.
颅面部骨内血管病变较为罕见，可能带来诊断和治疗方面的挑战。本研究旨在对16例累及颌骨的骨内动静脉畸形（AVM）进行特征描述。
采用抗α平滑肌肌动蛋白（α-SMA）、结蛋白、CD31、D2-40和葡萄糖转运蛋白1（GLUT-1）的抗体进行免疫组织化学评估。还进行了弹性韦尔霍夫-范吉森染色和马森三色组织化学染色。
未观察到性别偏好（女性与男性比例 = 1:1），患者平均年龄为50.8岁（标准差±13.9；范围28 - 71岁）。观察到下颌骨有偏好（16例中的12例[75%]）。免疫组织化学方面，可见弥漫性内皮CD31染色，α-SMA强烈突出平滑肌细胞和周细胞。16例AVM中有9例（56.3%）鉴定出结蛋白阳性血管。所有标本中D2-40均呈阴性。除2例（14例中的2例[14.3%]）表现出局灶性有限的细胞质GLUT-1免疫反应性外，AVM对GLUT-1呈阴性（14例中的11例[78.6%]）。1例GLUT-1结果不明确。马森三色染色突出了平滑肌细胞，在厚壁动脉中鉴定出弹性纤维。
颌骨AVM通常缺乏GLUT-1表达，类似于软组织血管畸形。尽管本研究中骨内AVM的临床放射学特征与先前研究结果一致，但平均年龄较高。
