Department of Oral Pathology, Maulana Azad Institute of Dental Sciences, New Delhi 110002, India.
Head of Department of Oral Pathology, Maulana Azad Institute of Dental Sciences, New Delhi 110002, India.
J Oral Biosci. 2022 Jun;64(2):202-209. doi: 10.1016/j.job.2022.03.005. Epub 2022 Apr 6.
Ghost cells (GCs) are cells with distinct intracytoplasmic keratinization, which leads to the preservation of the cellular outline with a clear area corresponding to the previous nucleus location. GCs may show various patterns, such as degeneration, tissue granulation, and calcification. Their true nature and the mechanism regulating the conversion of odontogenic epithelial cells into GCs remain unclear. GC keratinization is different from normal keratinization as they are larger than keratotic squames, are frequently vacuolated, and have prominent nuclear membrane remnants. Few cystic lesions, odontogenic tumors, and non-odontogenic tumors, such as calcifying odontogenic cyst, craniopharyngioma, pilomatrixoma, odontoma, dentinogenic ghost cell tumor, and ghost cell odontogenic carcinoma, exhibit GCs as a typical feature. The Wnt and Notch signaling pathways play a role in the histogenesis of the neoplasms.
The review clarifies the various proposed hypotheses of the histogenesis of GCs, including molecular pathogenesis. Diagnostic workup for the identification of GCs, including special staining and immunohistochemistry, has been extensively discussed. A stepwise algorithm for identifying odontogenic and non-odontogenic lesions containing GCs has been proposed. Additionally, the prognostic role of GCs in the lesions has been elucidated.
Among the various hypotheses of the origin of GCs, we suggest that aberrant keratinization is the most accepted based on various immunohistochemical studies and special staining characteristics. GCs are a distinct characteristic entity of many odontogenic and non-odontogenic lesions; however, it remains controversial whether their presence has any pathognomonic role in the biological nature of these lesions.
鬼影细胞（GCs）是一种具有独特细胞质角化的细胞，这导致细胞轮廓得以保存，并且有一个清晰的区域对应之前细胞核的位置。GCs 可能表现出各种形态，如退行性变、组织肉芽形成和钙化。其真实本质以及调节成牙本质上皮细胞向 GCs 转化的机制尚不清楚。GC 角化与正常角化不同，因为它们比角化鳞屑大，经常有空泡，并且有明显的核膜残余物。少数囊性病变、牙源性肿瘤和非牙源性肿瘤，如牙源性钙化囊肿、颅咽管瘤、毛母细胞瘤、牙瘤、牙源性骨化性 ghost 细胞瘤和 ghost 细胞牙源性癌，都表现出 GCs 作为典型特征。Wnt 和 Notch 信号通路在肿瘤的组织发生中起作用。
本综述阐明了 GCs 组织发生的各种假设，包括分子发病机制。已经广泛讨论了用于识别 GCs 的诊断工作，包括特殊染色和免疫组织化学。已经提出了一种用于识别含有 GCs 的牙源性和非牙源性病变的逐步算法。此外，还阐明了 GCs 在病变中的预后作用。
在 GCs 起源的各种假设中，我们建议基于各种免疫组织化学研究和特殊染色特征，异常角化是最被接受的假设。GCs 是许多牙源性和非牙源性病变的一个独特特征实体；然而，它们的存在是否对这些病变的生物学性质具有任何特征性作用仍存在争议。
