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中央性牙源性纤维瘤的临床病理研究:特别提及淀粉样变亚型

A clinicopathologic study on central odontogenic fibroma: with special reference to amyloid variant.

作者信息

Zhou Chuan-Xiang, Li Tie-Jun

机构信息

Department of Oral Pathology, Peking University School and Hospital of Stomatology, Beijing, PR China.

Department of Oral Pathology, Peking University School and Hospital of Stomatology, Beijing, PR China.

出版信息

Oral Surg Oral Med Oral Pathol Oral Radiol. 2018 Dec;126(6):513-520. doi: 10.1016/j.oooo.2018.08.019. Epub 2018 Sep 6.

Abstract

OBJECTIVE

The aim of this study was to clarify the clinicopathologic features of central odontogenic fibroma (OF), especially the amyloid variant, and to discuss its association with the Langerhans cell variant of calcifying epithelial odontogenic tumor (CEOT).

STUDY DESIGN

The clinicopathologic features and immunophenotypes of 17 OFs, including 6 amyloid variants, were analyzed. The Langerhans cell variant of CEOT is reviewed, and its relationship with OF is discussed.

RESULTS

Most OFs (13 of 17) were located at the anterior region of the jaws, often with root resorption. The amyloid variant exhibited the typical clinicopathologic features of OFs, characterized by dispersed small epithelial nests embedded in a fibrous stroma. Immunohistochemically, the epithelial component in all central OFs, including the amyloid variants, exhibited dispersed staining for CK10/13 but was negative for CK7 and CK8/18. Langerhans cells were positive for S-100 and Langerin in the epithelium of OFs, including the amyloid variants.

CONCLUSIONS

The amyloid variant of OF is a rare benign tumor exhibiting the typical clinicopathologic features of conventional OFs and should not be diagnosed as CEOT even in the presence of amyloid deposits. Previously reported cases described as "Langerhans cell variant of CEOT" should be classified as the "amyloid variant of OF," given that it shares features more in common with OFs than with CEOTs.

摘要

目的

本研究旨在阐明中央型牙源性纤维瘤(OF)的临床病理特征,尤其是淀粉样变亚型,并探讨其与钙化上皮性牙源性肿瘤(CEOT)的朗格汉斯细胞亚型之间的关系。

研究设计

分析了17例OF的临床病理特征和免疫表型,其中包括6例淀粉样变亚型。对CEOT的朗格汉斯细胞亚型进行了回顾,并讨论了其与OF的关系。

结果

大多数OF(17例中的13例)位于颌骨前部,常伴有牙根吸收。淀粉样变亚型表现出OF的典型临床病理特征,其特点是在纤维性间质中散在分布着小上皮巢。免疫组织化学分析显示,所有中央型OF(包括淀粉样变亚型)的上皮成分对CK10/13呈散在染色,但对CK7和CK8/18呈阴性。在OF(包括淀粉样变亚型)的上皮中,朗格汉斯细胞对S-100和朗格蛋白呈阳性。

结论

OF的淀粉样变亚型是一种罕见的良性肿瘤,具有传统OF的典型临床病理特征,即使存在淀粉样沉积物也不应诊断为CEOT。鉴于之前报道的被描述为“CEOT的朗格汉斯细胞亚型”的病例与OF的共同特征多于与CEOT的共同特征,因此应将其归类为“OF的淀粉样变亚型”。

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