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Jawad SN, Abdullah BH. Ameloblastoma vs basal cell carcinoma: an immunohistochemical comparison. Ann Diagn Pathol 2016; 25:79-84. [PMID: 27806852 DOI: 10.1016/j.anndiagpath.2016.09.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Despite behavioral mimicry of ameloblastoma (AB) and basal cell carcinoma (BCC), they are classified at 2 extremes within pertinent WHO classifications with respect to benign and malignant designation. This study aims to appraise the current allocation of AB in the classification through an immunohistochemical comparison of some aspects of behavior with BCC. Sections from retrospectively retrieved formalin-fixed, paraffin-embedded tissue blocks of AB (n = 37) and BCC (n = 34) were comparatively examined for the immunohistochemical expression for Ki-67, Bcl-2, MMP-2, MMP-9, CD31, and D2-40 monoclonal antibodies. No statistically significant differences between the tumors were found regarding the immunoexpressions of Bcl-2 (P = .252), CD31 microvessel density (P = .895), lymphatic vessel density (P = .642), and MMP-9 stromal expression (P = .083). MMP-2 expression was significantly higher in epithelial and stromal regions of AB (P = .009 and P = .001, respectively), whereas Ki-67 and MMP-9 epithelial expressions were significantly higher in BCC (P < .000 and P = .026, respectively). Within the studied immunohistochemical attributes for tumor behavior, the study accentuated the overall behavioral mimicry of the tumors and indicated that BCCs surmount ABs by the proliferative rate only.
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Affiliation(s)
- Salam N Jawad
- Oral pathology, College of Dentistry, Baghdad University, Baghdad, Iraq.
| | - Bashar H Abdullah
- Professor of Oral pathology, College of Dentistry, Baghdad University, Baghdad, Iraq
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2
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Kim YS, Lee SK. Different Protein Expressions between Peripheral Ameloblastoma and Oral Basal Cell Carcinoma Occurred at the Same Mandibular Molar Area. KOREAN JOURNAL OF PATHOLOGY 2014; 48:151-8. [PMID: 24868229 PMCID: PMC4026807 DOI: 10.4132/koreanjpathol.2014.48.2.151] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/07/2013] [Revised: 03/26/2013] [Accepted: 04/04/2013] [Indexed: 11/17/2022]
Abstract
Peripheral ameloblastoma (PA) in gingiva is rare and often confused with oral basal cell carcinoma (OBCC). The tissues of one case of PA and one case of OBCC with the same mandibular molar area affected were compared via an immunohistochemical examination using 50 antisera. The PA and OBCC showed similar proliferation of basaloid epithelial strands, but toluidine blue staining revealed that the PA had pinkish juxta-epithelial myxoid tissue, whereas the OBCC was infiltrated by many mast cells. Immunohistochemical comparisons showed that the PA was strongly positive for ameloblastin, KL1, p63, carcinoembryonic antigen, focal adhesion kinase, and cathepsin K, and slightly positive for amelogenin, Krox-25, E-cadherin, and PTCH1, whereas the OBCC was not. On the other hand, the OBCC was strongly positive for EpCam, matrix metalloprotease (MMP)-1, α1-antitrypsin, cytokeratin-7, p53, survivin, pAKT1, transforming growth factor-β1, NRAS, TGase-1, and tumor nescrosis factor-α, and consistently positive for β-catenin, MMP-2, cathepsin G, TGase-2, SOS-1, sonic hedgehog, and the β-defensins-1, -2, -3, while the PA was not. These data suggest that the tumorigeneses of PA and OBCC differ, and that PAs undergo odontogenic differentiation and generate oncogenic signals for infiltrative growth and bone resorption, whereas OBCCs undergo basaloid epidermal differentiation as a result of growth factor/cytokine-related oncogenic signals.
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Affiliation(s)
- Yeon Sook Kim
- Department of Dental Hygiene, College of Health Sciences, Cheongju University, Cheongju, Korea
| | - Suk Keun Lee
- Department of Oral Pathology, College of Dentistry, Gangneung-Wonju National University, Gangneung, Korea
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3
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Woods TR, Cohen DM, Islam MN, Kratochvil FJ, Stewart JCB, Reeder SL, Bhattacharyya I. Intraoral basal cell carcinoma, a rare neoplasm: report of three new cases with literature review. Head Neck Pathol 2013; 8:339-48. [PMID: 24202723 PMCID: PMC4126916 DOI: 10.1007/s12105-013-0505-5] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/22/2013] [Accepted: 10/29/2013] [Indexed: 11/26/2022]
Abstract
Intraoral basal cell carcinoma (IOBCC) is an extremely rare entity that bears close microscopic resemblance to and is often confused with the peripheral ameloblastoma (PA). Basal cell carcinomas are thought to arise from pluripotential basal cells present within surface epithelium and adnexal structures, so theoretically they can arise within the oral cavity. Many of the early cases reported as IOBCC actually represent PA. Most of the well documented cases arise from the gingiva. The histologic features of basal cell carcinoma that help separate it from a PA include: tumor arising from surface epithelium, scattered mitotic figures and apoptotic cells, presence of mucoid ground substance and tumor infiltrating widely throughout the connective tissue and often exhibiting a prominent retraction artifact. Clinically IOBCC resemble carcinomas, compared to the benign and innocuous appearance of the PA and typically presents as surface ulcerations varying from rodent ulcer to an ulcerated erythroplakia appearance. This contrasts with the classic "bump on the gum" appearance of PAs with usually intact surface and appearing as small discrete, sessile, exophytic lesions. Importantly, the proliferative basaloid epithelium demonstrates positive immunoreactivity for the anti-epithelial antibody, Ber-EP4, a cell surface glycoprotein. The IOBCC has the potential for local recurrence and aggressive behavior and should be treated with wide surgical excision and close clinical follow up. We present 3 rare cases of IOBCC and discuss the salient histologic, immunohistochemical and clinical features.
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Affiliation(s)
- T. R. Woods
- Department of Oral and Maxillofacial Pathology, University of Florida College of Dentistry, Gainesville, FL USA
| | - D. M. Cohen
- Department of Oral and Maxillofacial Pathology, University of Florida College of Dentistry, Gainesville, FL USA
| | - M. N. Islam
- Department of Oral and Maxillofacial Pathology, University of Florida College of Dentistry, Gainesville, FL USA
| | - F. J. Kratochvil
- Department of Pathology and Radiology, Oregon Health and Science University School of Dentistry, Portland, OR USA
| | - J. C. B. Stewart
- Department of Pathology and Radiology, Oregon Health and Science University School of Dentistry, Portland, OR USA
| | - S. L. Reeder
- Private Practice Limited to Oral and Maxillofacial Surgery, Jacksonville, FL USA
| | - I. Bhattacharyya
- Department of Oral and Maxillofacial Pathology, University of Florida College of Dentistry, Gainesville, FL USA
- Division of Oral Pathology, Department of Oral and Maxillofacial Diagnostic Sciences, University of Florida College of Dentistry, PO Box 100414 JHMHC, Gainesville, FL 32610-0414 USA
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4
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Affiliation(s)
- Alice E Curran
- University of North Carolina School of Dentistry, Department of Diagnostic Sciences, Division of Oral and Maxillofacial Pathology, CB# 7450, Chapel Hill, NC 27599, USA
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5
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Koutlas IG, Koch CA, Vickers RA, Brouwers FM, Vortmeyer AO. An unusual ostensible example of intraoral basal cell carcinoma. J Cutan Pathol 2009; 36:464-70. [PMID: 19278434 DOI: 10.1111/j.1600-0560.2008.01059.x] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
An example of oral basal cell carcinoma is presented originating on the posterior mandibular mucosa and gingiva of a 67-year-old female. Histologically, it featured a multifocal pattern. It recurred eight times in a period of 20 years. Tissue samples of the tumor were evaluated with monoclonal antibody Ber-EP4 and were compared with examples of oral mucosa, skin, oral and cutaneous squamous cell carcinoma, peripheral ameloblastoma, ameloblastoma and cutaneous basal cell carcinoma (BCC). Only neoplastic basal cells showed positive immunohistochemical staining. Additionally, microdissected neoplastic areas were evaluated for loss of heterozygosity (LOH) of the PTCH gene with markers D9S303, D9S252 and D9S287. PTCH gene mutations are reported in patients with Gorlin syndrome and sporadic cutaneous BCCs. Loss of one allele was observed with all three markers. Examples of conventional ameloblastomas did not show evidence of LOH. These observations support the inclusion of BCC in the differential diagnosis of appropriate oral mucosal neoplasms.
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Affiliation(s)
- Ioannis G Koutlas
- Department of Oral and Maxillofacial Pathology, University of Minnesota, Minneapolis, MN 55455, USA.
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Shumway BS, Kalmar JR, Allen CM, Rawal YB. Basal cell carcinoma of the buccal mucosa in a patient with nevoid basal cell carcinoma syndrome. Int J Surg Pathol 2009; 19:348-54. [PMID: 19124449 DOI: 10.1177/1066896908329596] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Basal cell carcinoma (BCC) of the oral cavity is a controversial lesion with clinical and histopathologic features that overlap with those of peripheral ameloblastoma (PA). Ber-EP4, a cell surface glycoprotein preferentially expressed in BCC of the skin, has been suggested as a useful marker to support the diagnosis of oral BCC.This study presents a case of intraoral BCC arising in the anterior buccal mucosa of a patient with nevoid basal cell carcinoma syndrome (NBCCS), which represents a previously unreported clinical finding, to our knowledge. Histopathologic and immunohistochemical features of the case were compared to examples of PA, conventional intraosseous ameloblastoma, sporadic cutaneous BCC and cutaneous BCC from NBCCS patients. Ber-EP4 expression by the oral tumor was distinct from both peripheral and intraosseous forms of ameloblastoma and was identical to cutaneous BCC in both sporadic and syndromic settings.
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Affiliation(s)
- Brian S Shumway
- Department of Surgical and Hospital Dentistry, University of Louisville, Louisville, Kentucky 40292, USA.
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Kishino M, Murakami S, Yuki M, Iida S, Ogawa Y, Kogo M, Toyosawa S. A immunohistochemical study of the peripheral ameloblastoma. Oral Dis 2007; 13:575-80. [PMID: 17944675 DOI: 10.1111/j.1601-0825.2006.01340.x] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- M Kishino
- Department of Oral Pathology, Osaka University Graduate School of Dentistry, Osaka, Japan.
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Pires FR, Chen SY, da Cruz Perez DE, de Almeida OP, Kowalski LP. Cytokeratin expression in central mucoepidermoid carcinoma and glandular odontogenic cyst. Oral Oncol 2004; 40:545-51. [PMID: 15006629 DOI: 10.1016/j.oraloncology.2003.11.007] [Citation(s) in RCA: 65] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2003] [Accepted: 11/21/2003] [Indexed: 12/17/2022]
Abstract
Central mucoepidermoid carcinoma (MEC) is an entity whose origin is still controversial. Glandular odontogenic cyst (GOC) is a recently described lesion whose relationship to low-grade central MEC has been reported in the literature. Our aim was to assess the cytokeratin (CK) profile of central MEC and GOC, and compare the results with CK expression in salivary gland MEC and odontogenic cysts and tumors. Eighty-five cases, including 6 central MECs, 23 salivary gland MECs, 10 GOCs, 34 odontogenic cysts and 12 ameloblastomas, were studied through immunohistochemistry using eleven monoclonal anti-CK antibodies. All central MECs expressed CKs 5, 7, 8, 14, and 18 and all GOCs expressed CKs 5, 7, 8, 13, 14, and 19. Comparing CK expression from GOC and central MEC we found differences in CKs 18 (30% vs 100%) and 19 (100% vs 50%). Central MEC and GOC are probably distinct entities with CK profiles similar to lesions of glandular and odontogenic origins, respectively, and expression of CKs 18 and 19 could be useful in their differential diagnosis.
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Affiliation(s)
- Fábio Ramôa Pires
- Oral Pathology, School of Dentistry, State University of Rio de Janeiro (UERJ), Boulevard 28 de Setembro, 157 Vila Isabel, CEP: 21550-030, Rio de Janeiro/RJ, Brazil.
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Dunsche A, Babendererde O, Lüttges J, Springer ING. Dentigerous cyst versus unicystic ameloblastoma--differential diagnosis in routine histology. J Oral Pathol Med 2003; 32:486-91. [PMID: 12901731 DOI: 10.1034/j.1600-0714.2003.00118.x] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
BACKGROUND Unicystic ameloblastomas (UAs) and dentigerous cysts (DCs) have an identical clinical and radiographic appearance. Some subtypes of UAs have a better prognosis than solid or multicystic ameloblastomas, and simple enucleation is the adequate treatment. The present study was designed to test the hypothesis that UAs with small islands of ameloblastomatous epithelium may be misdiagnosed as a DC or keratocyst if no more than two histologic sections are examined. METHODS A total of 101 resection specimens from 22 women and 73 men (mean age: 46.5 years) were selected, all showing the clinical and radiographic features of a DC. Only cysts with a minimum diameter of 15 mm in the panoramic X-ray were considered for the present investigation. The histopathologic diagnosis had been routinely established by examining two sections. For our study, the specimens were investigated by step sections at 50 microm and by staining of 5 microm thin sections with hematoxylin and eosin (H&E) at 1 mm levels. An average of 15 slides were evaluated per case. RESULTS Microscopic examination of the step sections did not reveal ameloblastomatous epithelium in the cyst lining epithelium of the 101 cases. Thus, every primary diagnosis of a dentigerous cyst was confirmed. In four cases, additional rather large odentogenic cell nests were detected with palisading of basaloid cells, while there was a lack of other signs of ameloblastic differentiation. All lesions were completely resected, and no additional treatment was performed. CONCLUSIONS Step sectioning of larger DCs may reveal associated odontogenic cell nests in some cases but does not lead to the detection of formerly missed ameloblastic cells. Thus, unicystic ameloblastomas are not misdiagnosed if only two slides are prepared for routine diagnosis of DCs.
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Affiliation(s)
- Anton Dunsche
- Department of Oral and Maxillofacial Surgery, University of Kiel, D-24105 Kiel, Germany
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Mesquita RA, Lotufo MA, Sugaya NN, De Araújo NS, De Araújo VC. Peripheral clear cell variant of calcifying epithelial odontogenic tumor: Report of a case and immunohistochemical investigation. ORAL SURGERY, ORAL MEDICINE, ORAL PATHOLOGY, ORAL RADIOLOGY, AND ENDODONTICS 2003; 95:198-204. [PMID: 12582361 DOI: 10.1067/moe.2003.63] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
A case of peripheral calcifying epithelial odontogenic tumor, clear cell variant, located on the right gingival maxilla of a 48-year-old woman, presenting as a 2.0-cm solitary, firm nodule was studied. Microscopically, it was composed of polyhedral and clear epithelial cells associated with amyloid-like deposition. The clear epithelial cells exhibited granules that were positive for periodic acid-Schiff, and the amyloid-like deposit stained with Congo red showed a green birefringence in the polarized light. Polyhedral and clear epithelial cells were immunopositive for AE1/AE3 and cytokeratin 14. Immunoexpression of fibronectin and types I and III collagen were different between the amyloid-like deposits and the connective tissue stroma. Tenascin surrounded epithelial cells located inside the amyloid-like deposits. Laminin and type IV collagen were immunodetectable around the strands, cords, and nests of epithelial cells. This report represents the seventh case of peripheral calcifying epithelial odontogenic tumor, clear cell variant.
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11
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Abstract
Neoplasms and tumours related to the odontogenic apparatus may be composed only of epithelial tissue or epithelial tissue associated with odontogenic ectomesenchyme. The immunohistochemical detection of different cytokeratins (CKs) polypeptides and vimentin has made it easier to explain the histogenesis of many epithelial diseases. The present study aimed to describe the immunohistochemical expression of cytokeratins 7, 8, 10, 13, 14, 18, 19 and vimentin in the epithelial components of the dental germ and of five types of odontogenic tumours. The results were compared and histogenesis discussed. All cells of the dental germ were positive for CK14, except for the preameloblasts and secreting ameloblasts, in which CK14 was gradually replaced by CK19. CK7 was especially expressed in the cells of the Hertwig root sheath and the stellate reticulum. The dental lamina was the only structure to express CK13. The reduced epithelium of the enamel organ contained CK14 and occasionally CK13. Cells similar to the stellate reticulum, present in the ameloblastoma and in the ameloblastic fibroma, were positive for CK13, which indicates a nature other than that of the stellate reticulum of the normal dental germ. The expression of CK14 and the ultrastructural aspects of the adenomatoid odontogenic tumour probably indicated its origin in the reduced dental epithelium. Calcifying odontogenic epithelial tumour is thought to be composed of primordial cells due to the expression of vimentin. Odontomas exhibited an immunohistochemical profile similar to that of the dental germ. In conclusion, the typical IF of odontogenic epithelium was CK14, while CK8, 10 and 18 were absent. Cytokeratins 13 and 19 labelled squamous differentiation or epithelial cells near the surface epithelium, and CK7 had variable expression.
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Affiliation(s)
- M M Crivelini
- Department of Oral Pathology, School of Dentistry, State University, Araçatuba, São Paulo, Brazil.
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12
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Tateyama H, Tada T, Okabe M, Takahashi E, Eimoto T. Different keratin profiles in craniopharyngioma subtypes and ameloblastomas. Pathol Res Pract 2002; 197:735-42. [PMID: 11770017 DOI: 10.1078/0344-0338-00152] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Craniopharyngiomas are generally considered to arise from the remnants of Rathke's pouch or a misplaced enamel organ. We tried to refine these hypotheses, comparing the subtypes of craniopharyngioma with Rathke's cleft cyst, a known Rathke's pouch derivative, and with ameloblastoma, an enamel organ derivative. Nineteen craniopharyngiomas (14 adamantinomatous and 5 papillary type tumors) and 17 ameloblastomas were immunostained for cytokeratin (CK) 7, CK 8, CK 14, and human hair keratin (HHK). All cases of adamantinomatous craniopharyngioma were CK 7+/CK 8+/CK 14+. Two cases (40%) of papillary craniopharyngioma were CK 7+/CK 8+/CK 14+, whereas the remaining three cases (60%) were CK 7+/CK 8-/CK 14+. Fifteen cases (88%) of ameloblastoma were CK 7-/CK 8+/CK 14+. Only the shadow cells present in adamantinomatous craniopharyngiomas were positive for HHK, which may indicate their follicular differentiation. In Rathke's cleft cyst, ciliated cuboidal cells were CK 7+/CK 8+/CK 14- and metaplastic squamous cells were CK 7+/CK 8/CK 14+. These findings suggest that both subtypes of craniopharyngioma may differ from ameloblastoma in histogenesis, although cytokeratin expression patterns may change during tumor development. Adamantinomatous craniopharyngioma may be related to a heterotopic ectodermal tissue which can differentiate into hair follicles, while papillary craniopharyngioma may arise from Rathke's cleft cyst.
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Affiliation(s)
- H Tateyama
- Department of Pathology, Nagoya City University Medical School, Nagoya, Aichi, Japan.
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13
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Abstract
AIMS Calretinin is a 29-kDa calcium-binding protein which is expressed in the central and peripheral nervous systems as well as in many other normal and pathological human tissues. The objective of this study was to determine whether calretinin was expressed in the epithelium of ameloblastomas. METHODS AND RESULTS Twenty-seven cases of unicystic ameloblastoma and 31 cases of solid and multicystic ameloblastoma were studied. Five-micron sections were immunohistochemically stained using either antiserum 7696 from Swant, or antiserum 18-0211 from Zymed with a standard ABC method. The results were identical with the two antisera. Positive staining was seen in 22 cases (81.5%) of unicystic ameloblastomas. This generally consisted of diffuse, intense nuclear and cytoplasmic staining of several cell layers of the more superficial cells both in the characteristic and nondescript areas of the cyst linings. In the solid and multicystic ameloblastomas, staining occurred in 29 (93. 5%) of the cases. The staining was almost always restricted to the stellate reticulum-like epithelium, was generally intense and diffuse in distribution. Areas of squamous metaplasia stained particularly intensely as did the cells surrounding micro- and macro-cysts. In both groups of lesions, most of the cases that did not stain were intensely inflamed. CONCLUSIONS The biological significance of calretinin expression in ameloblastomas is not known and its use as a distinctive, specific immunohistochemical marker for ameloblastic tissues remains to be confirmed. However, the results of this study raise the possibility that calretinin may be an important diagnostic aid in the differential diagnosis of cystic and solid ameloblastic tumours.
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Affiliation(s)
- M Altini
- Division of Oral Pathology, Department of Anatomical Pathology, University of the Witwatersrand, Johannesburg, South Africa.
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Kato N, Endo Y, Tamura G, Motoyama T. Ameloblastoma with basal cell carcinoma-like feature emerging as a nasal polyp. Pathol Int 1999; 49:747-51. [PMID: 10504544 DOI: 10.1046/j.1440-1827.1999.00932.x] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
A case of a 63-year-old man with ameloblastoma with basal cell carcinoma (BCC)-like features clinically emerging as a nasal polyp is reported. The left nasal cavity was filled with a solid mass, which seemed to be a sinusitis-associated nasal polyp. The polyp was covered by parakeratotic squamous epithelium which was directly connected to the BCC-like tumor nest. The BCC-like features gradually changed to adamantinoid features. The polyp was connected with a huge mass filling the maxillary sinus and the molar area, which consisted of conventional ameloblastoma features. Although the tumor was finally diagnosed as an ameloblastoma of the maxilla, the biopsy specimen forced us to face the problem of differential diagnosis, ameloblastoma with BCC-like features or adamantinoid basal cell carcinoma (BCC). Immunohistochemical examination revealed that tumor cells of the ameloblastoma reacted with anticytokeratin antibody KL-1 but not with antiepithelial antibody Ber-EP4, and these reaction patterns were completely contrary to those of BCC. It is emphasized that immunohistochemical examination using anticytokeratin antibody KL-1 and antiepithelial antibody Ber-EP4 is a good tool for distinguishing ameloblastoma with BCC-like features from adamantinoid BCC.
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Affiliation(s)
- N Kato
- Department of Pathology, Yamagata University School of Medicine, Japan.
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15
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Ong'uti MN, Howells GL, Williams DM. An immunohistochemical study of keratin expression in ameloblastoma from a Kenyan population. Oral Dis 1999; 5:111-6. [PMID: 10522206 DOI: 10.1111/j.1601-0825.1999.tb00074.x] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
OBJECTIVES Ameloblastomas appear to exhibit biological heterogeneity and, except in the case of malignancy, histological appearances that do not always allow their behaviour to be predicted. The aim of this study was to assess keratin expression in African ameloblastomas and to correlate this with their clinical and histological features. MATERIALS AND METHODS Expression of simple keratins 7, 8, 18 and 19; cornification keratins 1 and 10; basal and differentiation keratins 5 and 14 and hyperproliferation-related keratins 6 and 16 in 14-39 cases of ameloblastoma was assessed by immunohistochemical methods. RESULTS There was patchy expression of keratin 7 in the suprabasal and stellate reticulum-like cells in some cases. All cases showed similar weak expression for keratins 8 and 18 in suprabasal and stellate reticulum-like cells but none showed keratin 1 or 10 expression. There was intense expression of keratins 5, 14 and 19 by all tumour cells suggesting that they may retain basal cell characteristics with a potential for proliferation. No consistent relationship was seen between histological types and keratin expression pattern. However, keratins 6 and 16, expressed by suprabasal and stellate reticulum-like cells, showed a marked variation within and between cases, with the highest levels of expression in squamous strands. CONCLUSIONS We propose that squamous strands may represent the sites of most active growth within individual tumours and expression of keratins 6, 16 and 19 may be predictors of rapid growth. There is a need for further investigation of this in longitudinal clinical studies.
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Affiliation(s)
- M N Ong'uti
- Oral Diseases Research Centre, St Bartholomew's and the Royal London School of Medicine and Dentistry, Whitechapel, UK
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16
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Basarab T, Orchard G, Russell-Jones R. The use of immunostaining for bcl-2 and CD34 and the lectin peanut agglutinin in differentiating between basal cell carcinomas and trichoepitheliomas. Am J Dermatopathol 1998; 20:448-52. [PMID: 9790103 DOI: 10.1097/00000372-199810000-00003] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Fifteen unequivocal basal cell carcinomas (BCC) and ten unequivocal trichoepitheliomas (TE) were studied using the lectin peanut agglutinin (PNA), and the monoclonal antibodies Q bend 10 and bcl-2 oncoprotein directed against the antigens CD34 and bcl-2, respectively, to see whether these markers could be used to differentiate between the two tumors. Ten percent of TE demonstrated a continuous band-like peritumorous staining with PNA and 80% demonstrated a discontinuous band-like peritumorous staining with PNA, with the comparable figures for BCC being 40% and 20%, respectively. In addition, 40% of BCC showed focal areas of pemphigus-like staining in contrast with only 10% of TE. Using the antibody directed against bcl-2, TE demonstrated weak staining mainly confined to the basal layer of tumor cells in 20% of cases and staining of the cells throughout the tumor in 30% of cases. Similarly, BCC also showed staining of the basal layer of tumor cells in 7% of specimens and staining of cells throughout the tumor mass in 40% of specimens studied. Finally, with the antibody Q bend 10 directed against CD34, staining of the immediate peritumoral spindle-shaped cells was observed in 20% of TE compared with 7% of BCC. Despite reports in the literature, we found that none of these three markers can be reliably used to differentiate between TE and BCC.
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Affiliation(s)
- T Basarab
- St. John's Institute of Dermatology, St. Thomas' Hospital, London, UK
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17
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Hellquist H, Young-Wedenberg C. Reply. Oral Oncol 1998. [DOI: 10.1016/s1368-8375(97)00100-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Badger KV, Gardner DG. The relationship of adamantinomatous craniopharyngioma to ghost cell ameloblastoma of the jaws: a histopathologic and immunohistochemical study. J Oral Pathol Med 1997; 26:349-55. [PMID: 9379423 DOI: 10.1111/j.1600-0714.1997.tb00229.x] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
The objective of this investigation was to study the relationship of the ghost cell ameloblastoma (GCA), which is a form of type II calcifying odontogenic cyst (COC), to the adamantinomatous craniopharyngioma (ACP). H&E sections of 26 examples of ACP were compared to three cases of GCA and to the reported microscopic features of that tumor. Clinical records of the ACPs were studied to determine their biologic behavior compared to that of the ameloblastomas. Immunohistochemical studies of nine examples of ACP were performed for KL1 (high mol.wt cytokeratins), 5D3 (low mol.wt cytokeratins) and involucrin (characteristic of terminally differentiated keratinocytes) using the peroxidase-antiperoxidase method. The results were compared with those reported for COC and ameloblastoma. ACP and GCA exhibited similar microscopic features, including pre-ameloblasts, tissue resembling stellate reticulum, ghost cells and calcifications; both tumors grew slowly and were invasive. ACP and COC, and by interpolation GCA, exhibited similar features with all three antibodies. The ghost cells did not exhibit any immunoreactivity but the adjacent cells stained positively for involucrin. The immunological features of ACP were similar to those reported in ameloblastomas for squamous differentiation. However, because of their rarity, no ameloblastomas exhibiting keratinization, including ghost cells, have yet been studied with these antibodies. We conclude that ACP and GCA are homologous lesions.
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Affiliation(s)
- K V Badger
- Division of Oral Pathology and Oncology, University of Colorado School of Dentistry, Denver 80262, USA
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Todd R, Gallagher GT, Kaban LB. Mass in the infratemporal fossa. ORAL SURGERY, ORAL MEDICINE, ORAL PATHOLOGY, ORAL RADIOLOGY, AND ENDODONTICS 1997; 84:116-8. [PMID: 9269009 DOI: 10.1016/s1079-2104(97)90054-8] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Affiliation(s)
- R Todd
- Department of Oral and Maxillofacial Surgery, Massachusetts General Hospital, USA
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20
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Rosa LE, Jaeger MM, Jaeger RG. Morphometric study of nucleolar organiser regions in ameloblastoma and basal cell carcinoma. Oral Oncol 1997; 33:209-14. [PMID: 9307731 DOI: 10.1016/s0964-1955(96)00070-x] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Ameloblastoma and basal cell carcinoma share histological similarities. Morphometric analysis of nucleolar organiser regions (NORs) from ameloblastoma and basal cell carcinoma (BCC) was carried out by silver (Ag) staining. Mean counts were lower in ameloblastoma (1.652 +/- 0.032) compared to those in BCC (2.354 +/- 0.054). Ameloblastoma presented one or two NORs per nucleus, in a narrow distribution (one to four NORs per nucleus). In contrast, BCC exhibited two or three NORs per nucleus, in a broad distribution (one to six NORs per nucleus). Perimeter and area measurements of AgNOR dots yielded significantly higher mean values for ameloblastoma. Our data suggest that most BCC cells are in mitosis, showing small and numerous NORs in each nucleus, while ameloblastoma cells are in interphase, showing one or two large NORs in each nucleus. Although ameloblastoma and BCC are neoplasms with similar growth patterns, they have cell populations with statistically significant differences in AgNOR patterns.
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Affiliation(s)
- L E Rosa
- Department of Oral Pathology, School of Dentistry, University of São Paulo, Brazil
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21
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Muramatsu T, Hashimoto S, Inoue T, Shimono M, Noma H, Shigematsu T. Clear cell odontogenic carcinoma in the mandible: histochemical and immunohistochemical observations with a review of the literature. J Oral Pathol Med 1996; 25:516-21. [PMID: 8959562 DOI: 10.1111/j.1600-0714.1996.tb00308.x] [Citation(s) in RCA: 37] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
A rare case of clear cell odontogenic carcinoma was investigated using histochemical and immunohistochemical methods. The tumor occurred in the anterior mandible of a 69-year-old Japanese man. Histologically, the tumor was composed mostly of large clear cells and squamous cells. Columnar-shaped cells with basophilic nuclei polarized away from the basement membrane were observed at the periphery of the tumor foci. The tumor cells had aggressively invaded muscle and perineural tissues. The tumor cells were positive for PAS staining. Immunohistochemically, tumor cells reacted positively to keratin, cytokeratin19, epithelial membrane antigen, and S-100 protein. The tumor was diagnosed as a clear cell odontogenic carcinoma. Its characteristics are discussed in term of its histopathological, histochemical and immunohistochemical features.
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Affiliation(s)
- T Muramatsu
- Department of Pathology, Tokyo Dental College, Chiba, Japan
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22
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Califano L, Maremonti P, Boscaino A, De Rosa G, Giardino C. Peripheral ameloblastoma: report of a case with malignant aspect. Br J Oral Maxillofac Surg 1996; 34:240-2. [PMID: 8818258 DOI: 10.1016/s0266-4356(96)90277-6] [Citation(s) in RCA: 20] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
Peripheral ameloblastoma is a very rare tumour with histological characteristics similar to those of the centrally located ameloblastoma. It appears in the gum and in the alveolar process of the jaws. We report a case of tumour of the left maxillary region, near the canine area. Histologically it presented itself with follicles and nests of cells with a trabecular architectural pattern. High mitotic index and clear images of perineural infiltration were present. The diagnosis was peripheral ameloblastoma with malignant aspects. At 12-month follow-up no local recurrence was noted.
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Affiliation(s)
- L Califano
- Department of Maxillo-Facial Surgery, Federico II University of Naples, Italy
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23
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de Aguiar MC, Gomez RS, Silva EC, de Araújo VC. Clear-cell ameloblastoma (clear-cell odontogenic carcinoma): report of a case. ORAL SURGERY, ORAL MEDICINE, ORAL PATHOLOGY, ORAL RADIOLOGY, AND ENDODONTICS 1996; 81:79-83. [PMID: 8850489 DOI: 10.1016/s1079-2104(96)80153-3] [Citation(s) in RCA: 38] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
Clear-cell ameloblastoma (clear-cell odontogenic carcinoma) is an uncommon odontogenic epithelial neoplasm. We report a case of a well-circumscribed 2 cm radiolucent lesion of the anterior mandible in a 30-year-old woman; this tumor was curetted. The first recurrence (at 5-year follow-up) was treated by aggressive curettage, and in the second recurrence a block resection was performed. However, 2 years after the resection was performed, the tumor recurred for a third time as an extraosseous gingival tumor, and 6 months later a recurrence was noted involving only alveolar mucosa.
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Affiliation(s)
- M C de Aguiar
- Department of Oral Pathology, University of São Paulo, Brazil
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24
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Affiliation(s)
- S J Miller
- Dermatology Department, Johns Hopkins University, Baltimore, Maryland 21287-0900, USA
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25
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Cleveland DB, Miller AS. DIAGNOSTIC LABORATORY AIDS IN ORAL AND MAXILLOFACIAL SURGICAL PATHOLOGY. Oral Maxillofac Surg Clin North Am 1994. [DOI: 10.1016/s1042-3699(20)30760-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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