Aggarwal Dipanshu, Jain Anshi, Farnaz Huma, Shetty Devi Charan
Department of Oral Pathology and Microbiology, I.T.S-Centre for Dental Studies and Research, Ghaziabad, Uttar Pradesh, India.
J Microsc Ultrastruct. 2022 Aug 4;12(3):165-168. doi: 10.4103/jmau.jmau_34_22. eCollection 2024 Jul-Sep.
The presence of clear cells is associated with the aggressiveness of the lesion and also poses a diagnostic dilemma. Hence, specific categorization of the lesion is of the utmost importance for therapeutic intervention. A 70-year-old male patient reported with a chief complaint of discomfort and swelling in the left mandibular alveolar region. Biopsy from the lesion was suggestive of ameloblastic carcinoma (AC) with clear-cell differentiation. The differential diagnosis of clear-cell components can be clear-cell odontogenic carcinoma, clear-cell adenocarcinoma of the salivary gland, mucoepidermoid carcinoma, and metastatic neoplasm. In the present case, the pathogenesis of this rare tumor is studied with the help of molecular markers such as p53, proliferating cell nuclear antigen, alpha-smooth muscle actin, vimentin, and p63 along with special stains such as periodic acid-Schiff, mucicarmine, and alcian blue. The clinical and biological behavior of these lesser-known variants has not been established due to the scarcity of meta-analysis and systematic reviews. Thus, this rare case of AC with clear-cell differentiation would highlight the pathogenesis, prognosis, and outcome of the disease with unusual histological presentation than conventional AC.
透明细胞的存在与病变的侵袭性相关，同时也带来了诊断难题。因此，对病变进行准确分类对于治疗干预至关重要。一名70岁男性患者，主诉左下颌牙槽区域不适和肿胀。病变活检提示为具有透明细胞分化的成釉细胞癌（AC）。透明细胞成分的鉴别诊断包括透明细胞牙源性癌、涎腺透明细胞腺癌、黏液表皮样癌和转移性肿瘤。在本病例中，借助p53、增殖细胞核抗原、α-平滑肌肌动蛋白、波形蛋白和p63等分子标志物以及过碘酸希夫染色、黏液卡红染色和阿尔辛蓝染色等特殊染色，对这种罕见肿瘤的发病机制进行了研究。由于缺乏荟萃分析和系统评价，这些鲜为人知的变异型的临床和生物学行为尚未明确。因此，这例罕见的具有透明细胞分化的AC病例将突出该疾病与传统AC不同的组织学表现的发病机制、预后和结局。
