Department of Maxillo Facial Surgery, Multiprofile Hospital for Active Medical Treatment "Sv. Panteleimon" Plovdiv, Plovdiv, Bulgaria.
Department of General and Clinical Pathology, Medical Faculty, Medical University of Plovdiv, Plovdiv, Bulgaria.
J Med Case Rep. 2024 May 7;18(1):225. doi: 10.1186/s13256-024-04534-y.
A xanthoma is a rare bone condition consisting of a predominant collection of lipid-rich, foamy histiocytes. The central xanthoma of the jaws is a unique benign tumor.
A 15-year-old Caucasian male has been presented to our department. He had radiological changes in the area of the left mandibular angle, with an area of diffuse osteolysis of 3.0 cm by 2.0 cm. Computed tomography reveals an area of diffuse osteolysis that starts from the distal root of the lower second molar and reaches the ascending process. A bone biopsy was performed, which revealed a benign proliferative process composed of histiocytic cells involving and infiltrating trabecular bone in a background of loose fibrous connective tissue devoid of any other significant inflammatory infiltrate. The size of the formation was 2.9 cm by 2.0 cm. Immunohistochemical staining for CD68 was strongly positive and negative for S-100 and CD1a. From routine blood tests, cholesterol, triglycerides, and blood sugar are within normal values, which excludes systemic metabolic disease. Subsequent to the surgical intervention, the patient underwent postoperative assessments at intervals of 14, 30, 60 days, and a year later, revealing the absence of any discernible complications during the aforementioned observation periods.
The diagnosis of primary xanthoma of the mandible is rare and can often be confused with other histiocytic lesions. A differential diagnosis should be made with nonossifying fibroma and Langerhans cell histiocytosis, as in our case. In these cases, immunohistochemistry with CD 68, S-100, and CD1a, as well as blood parameters, are crucial for the diagnosis.
黄色瘤是一种罕见的骨病，主要由富含脂质的泡沫状组织细胞聚集而成。颌骨中央性黄色瘤是一种独特的良性肿瘤。
一名 15 岁的白人男性被送到我们科室。他的左下颌角处有影像学改变，有一个 3.0cm×2.0cm 的弥漫性溶骨性区域。计算机断层扫描显示一个弥漫性溶骨性区域，从下第二磨牙的远侧根开始，延伸到升支。进行了骨活检，结果显示良性增生性病变，由组织细胞组成，累及并浸润松质骨背景下的小梁骨，无任何其他明显的炎症浸润。病变大小为 2.9cm×2.0cm。CD68 的免疫组织化学染色呈强阳性，而 S-100 和 CD1a 呈阴性。从常规血液检查来看，胆固醇、甘油三酯和血糖值均在正常范围内，排除了全身性代谢性疾病。手术后，患者在术后 14、30、60 天和一年后进行了随访评估，在上述观察期间未发现任何明显的并发症。
下颌骨原发性黄色瘤的诊断较为罕见，常与其他组织细胞病变混淆。鉴别诊断应与非骨化性纤维瘤和朗格汉斯细胞组织细胞增生症相鉴别，就像我们的病例一样。在这些情况下，CD68、S-100 和 CD1a 的免疫组织化学以及血液参数对于诊断至关重要。
