Ackermann G L, Altini M, Shear M
Department of Oral Pathology, South African Institute for Medical Research, Johannesburg.
J Oral Pathol. 1988 Nov;17(9-10):541-6. doi: 10.1111/j.1600-0714.1988.tb01331.x.
A clinicopathological study of 57 unicystic ameloblastomas has been undertaken, which represents 15% of all cases of ameloblastoma accessioned in our department over a 30-yr period. Of the cases where gender was recorded: 30 were male and 23 female. The majority of patients were black (51 cases) and most occurred in the mandible (52). This distribution conforms to that of solid and multicystic ameloblastomas. The mean age at diagnosis was 23.8 years (S.D. 14.9) which is significantly younger than for the conventional counterpart (p less than 0.1%). The lesions were classified histologically into 3 groups: Group 1 (42%) cyst lined by a variable often non-descript epithelium; Group 2 (9%) cyst showing intraluminal plexiform proliferation of epithelium; Group 3 (49%) cyst with invasion of epithelium into the cyst wall in either follicular or plexiform patterns. While Group 1 and 2 lesions may be treated by enucleation, Group 3 lesions should be treated aggressively as for conventional ameloblastomas. The objectives of correct histological diagnosis, subclassification and appropriate therapy are best achieved by enucleation biopsy. There is little evidence to support origin from pre-existing odontogenic cysts.
对57例单囊性成釉细胞瘤进行了临床病理研究，这些病例占我们科室30年间收治的所有成釉细胞瘤病例的15%。在记录了性别的病例中：男性30例，女性23例。大多数患者为黑人（51例），且大多数发生在下颌骨（52例）。这种分布与实性和多囊性成釉细胞瘤的分布一致。诊断时的平均年龄为23.8岁（标准差14.9），明显低于传统型成釉细胞瘤（p小于0.1%）。病变在组织学上分为3组：第1组（42%）囊肿内衬一层形态多样、常难以描述的上皮；第2组（9%）囊肿显示腔内上皮呈丛状增生；第3组（49%）囊肿上皮以滤泡状或丛状模式侵入囊壁。第1组和第2组病变可通过摘除术治疗，而第3组病变应像传统成釉细胞瘤一样积极治疗。通过摘除活检能最好地实现正确的组织学诊断、亚分类及适当治疗的目标。几乎没有证据支持其起源于先前存在的牙源性囊肿。
