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《头颈部肿瘤第五版世界卫生组织分类更新:牙源性和颌骨肿瘤》。

Update from the 5th Edition of the World Health Organization Classification of Head and Neck Tumors: Odontogenic and Maxillofacial Bone Tumours.

机构信息

Department of Oral Pathology, Oral Medicine and Maxillofacial Imaging, School of Dental Medicine, Tel Aviv University, Tel Aviv-Yafo, Israel.

Institute of Pathology, Sheba Medical Center, Tel Hashomer, Ramat Gan, Israel.

出版信息

Head Neck Pathol. 2022 Mar;16(1):63-75. doi: 10.1007/s12105-021-01404-7. Epub 2022 Mar 21.

Abstract

The 5 edition of the World Health Organization (WHO) Classification of Head and Neck Tumours (2022) comes out only five years after the previous edition, however it presents important updates that run in parallel with the rapid progression involving the increasingly sophisticated molecular investigation and its interpretation, some of which already have therapy-related impact. This manuscript provides an overview of the leading changes introduced in the classification of Odontogenic and Maxillofacial Bone Tumours that encompasses cysts of the jaws, odontogenic tumours, giant cell lesions and bone cysts, and bone and cartilage tumours. This is the first edition that Essential and Desirable Diagnostic Features were added for each entity, so that the most important clinical, microscopic and/or radiologic features were encapsulated and briefly highlighted. Surgical ciliated cyst was added to the group of odontogenic cysts, adenoid ameloblastoma was a newly recognized benign epithelial odontogenic tumour, and segmental odontomaxillary dysplasia was introduced in the group of fibro-osseous tumours and dysplasia. In addition, rhabdomyosarcoma with TFCP2 rearrangement, was introduced into the group of malignant jawbone tumours. The unique genetic aberrations distinguish it from other types of rhabdomyosarcomas. On the other hand, melanotic neuroectodermal tumour of infancy and osteoid osteoma were deleted from the benign bone and cartilageneous tumours, as was the hematolymphoid tumour of solitary plasmacytoma of bone. We systematically reviewed each entity in this chapter and provided important updated findings for selected topics that can further aid in the diagnostic process for challenging cases, broaden insights on the logic of the present classification, and finally, emphasize the potential that some of the molecular results may have in the near future to set new treatment approaches.

摘要

世界卫生组织(WHO)头颈部肿瘤分类第 5 版(2022 年)距上一版仅相隔 5 年,但它提出了一些重要的更新,与日益复杂的分子研究及其解释并行不悖,其中一些已经对治疗产生了影响。本文概述了颌骨和颌面骨肿瘤分类中引入的主要变化,涵盖了颌骨囊肿、牙源性肿瘤、巨细胞病变和骨囊肿、骨和软骨肿瘤。这是第一个为每个实体添加了基本和理想诊断特征的版本,以便将最重要的临床、显微镜下和/或影像学特征进行总结并简要强调。外科纤毛囊肿被添加到牙源性囊肿组中,腺样造釉细胞瘤是一种新认可的良性上皮性牙源性肿瘤,节段性牙颌骨发育不良被引入纤维骨性肿瘤和发育不良组中。此外,TFCP2 重排的横纹肌肉瘤被添加到恶性颌骨肿瘤组中。其独特的遗传学异常将其与其他类型的横纹肌肉瘤区分开来。另一方面,黑色素神经外胚层肿瘤婴儿型和骨样骨瘤从良性骨和软骨肿瘤中删除,骨孤立性浆细胞瘤的血液淋巴肿瘤也是如此。我们系统地回顾了这一章中的每一个实体,并提供了选定主题的重要更新发现,这些发现可以进一步帮助诊断有挑战性的病例,拓宽对当前分类逻辑的认识,并最终强调一些分子结果在不久的将来可能具有设定新治疗方法的潜力。

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