Mahdavi Nazanin, Yasaman Kheirandish, Garajei A, Nouri Naeimeh Nikfarjam
Department of Oral and Maxillofacial Pathology, School of Dentistry, Tehran, Iran.
Department Oral and Maxillofacial Radiology, Tehran University of Medical Sciences, Tehran, Iran.
J Oral Maxillofac Pathol. 2020 Jan-Apr;24(1):168-171. doi: 10.4103/jomfp.JOMFP_346_19. Epub 2020 May 8.
A 48-year-old female with a complaint of persistent pain referred to the Imam Khomeini (Tehran, Iran) in 2018. Based on the radiographic findings, radiolucent lesion found in the right mandible and she had alendronate administration approximately for 10 years. Since the past 6 months, the lesion detected in the right mandible. According to the computed tomography scan, a large lytic destructive lesion with a soft-tissue component was seen at the right mandibular ramus. Microscopic examinations revealed the proliferation of anaplastic spindle-shaped cells arranged in interlacing bundles and whorled patterns. Nuclear polymorphism, scattered cells with hyperchromatic nuclei and increased mitotic activity were notable. Immunohistochemistry findings for tissue section composed of spindle cell proliferation revealed Ki67 (20% positive in hotspots), scattered positive right side incisional biopsy was done. The observation revealed hyperplastic and disorganized squamous epithelial lesion, suggestive of spindle squamous cell carcinoma and osteonecrosis in this patient.
一名48岁女性，因持续性疼痛于2018年转诊至伊朗德黑兰伊玛目霍梅尼医院。根据影像学检查结果，在右侧下颌骨发现透光性病变，她服用阿仑膦酸盐约10年。自过去6个月以来，右侧下颌骨发现病变。根据计算机断层扫描，右侧下颌支可见一个伴有软组织成分的大型溶骨性破坏病变。显微镜检查显示，间变的梭形细胞呈交错束状和漩涡状排列增殖。核多形性、散在的核深染细胞和有丝分裂活性增加明显。由梭形细胞增殖组成的组织切片免疫组化结果显示，Ki67（热点区域20%阳性），右侧做了切开活检，结果呈散在阳性。观察结果显示增生且紊乱的鳞状上皮病变，提示该患者为梭形鳞状细胞癌和骨坏死。
