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Dareh MTB, Andisheh‐Tadbir A, Aghakouchakzadeh A. Evaluation of the relationship between the expression of AgNOR and Ki67 with the recurrence rate in central granulomatous giant cell lesions: A case-control. Clin Exp Dent Res 2024; 10:e870. [PMID: 38506305 PMCID: PMC10952119 DOI: 10.1002/cre2.870] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Revised: 02/16/2024] [Accepted: 02/19/2024] [Indexed: 03/21/2024] Open
Abstract
OBJECTIVES Giant cell granuloma is a local nonneoplastic lesion that is divided into two categories, based on its site of occurrence: Central and peripheral giant cell granuloma. Central giant cell granuloma is an intraosseous lesion that has a tendency to recure even in surgically treated cases. Several studies have proven that there is an association between different lesions clinical behavior and their histological features. The aim of this study was to evaluate the expression of AgNOR and Ki67 in lesions with and without recurrency. MATERIAL AND METHODS Files and records of 35 patients who had been histologically diagnosed with central giant cell granuloma were investigated. Histological features were studied after performing AgNOR staining and Ki67 marker. The data were analyzed by chi-square, Fisher, and T-test. RESULTS Acquired data indicated that the count of AgNOR staining and Ki67 marker was significantly higher in lesions with recurrency than the lesions with no recurrency. The same results were attained from Ki67 intensity. CONCLUSION The current study indicated that AgNOR staining and Ki67 marker have prognostic value in predicting recurrency of central giant cell granuloma lesions.
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Affiliation(s)
- Mina T. B. Dareh
- Student Research Committee, School of DentistryAlborz University of Medical SciencesKarajIran
| | - Azadeh Andisheh‐Tadbir
- Department of Oral and Maxillofacial Pathology, School of Dentistry, Oral and Dental Disease Research CenterShiraz University of Medical SciencesShirazIran
| | - Arezoo Aghakouchakzadeh
- Department of oral and maxillofacial pathology, School of DentistryAlborz University of Medical ScienceKarajIran
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Angiogenesis pattern and H3.3 histone mutation in aggressive and non-aggressive central giant cell lesions. Arch Oral Biol 2021; 130:105218. [PMID: 34364170 DOI: 10.1016/j.archoralbio.2021.105218] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2021] [Revised: 07/23/2021] [Accepted: 07/26/2021] [Indexed: 11/22/2022]
Abstract
OBJECTIVE The aim of this study was to evaluate angiogenesis in central giant cell lesions (CGCL) and its association with biological behavior. In addition, investigation of the histone H3.3 mutation was performed. DESIGN Thirty-eight cases of CGCL were classified as aggressive (n = 9) or nonaggressive (n = 29). Cases were submitted to immunohistochemistry to compare angiogenesis using Wilms' tumor protein 1 (WT1), platelet endothelial cell adhesion molecule (CD31) and endoglin (CD105) between groups. To verify the presence of genic mutation, histone H3.3 was investigated. RESULTS WT1 was expressed in mononuclear and giant cells of all cases. CD31 and CD105 were expressed in CGCL microvessels, with a higher CD105 microvascular density than CD31. No statistically significant difference was observed between groups. None of the cases studied showed the histone mutation. CONCLUSIONS There was no difference between aggressive and nonaggressive lesions regarding the angiogenic markers. The expression of WT1 and CD105 suggests that CGCL presents a tumoral vascular pattern with high neoangiogenic activity. The absence of histone mutation may indicate that CGCL is not a true giant cell tumor.
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Can Vitamin D Therapy Contribute to the Conservative Resolution of Osteolytic Lesions of the Jaws? Case Rep Dent 2021; 2021:5510724. [PMID: 34336304 PMCID: PMC8313313 DOI: 10.1155/2021/5510724] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2021] [Accepted: 06/17/2021] [Indexed: 11/17/2022] Open
Abstract
Osteolytic lesions of the jaw are not uncommon. Such lesions usually arise from local pathologies, but some have systemic backgrounds. We describe a 12-year-old girl who presented with an asymptomatic left mandibular swelling. The bony swelling was corresponding to a radiolucent lesion in the left premolar/molar region. This lesion could have represented an inflammatory and developmental odontogenic jaw cyst, giant cell lesion, and odontogenic tumor. However, the workup investigations revealed secondary hyperparathyroidism due to vitamin D deficiency. A vitamin D replacement was initiated with a single I.M. injection of 300,000 I.U followed by 10,000 I.U orally, weekly. Six weeks later, her Vitamin D and parathyroid hormone were normalized, and she showed significant clinical and radiological improvement of the jaw lesion. At 18 months, follow-up the panoramic image revealed complete resolution of the radiolucency and stable normal parathyroid hormone and vitamin D levels. In conclusion, Jaw bone lesions can develop secondary to hyperparathyroidism due to vitamin D deficiency, and this should be ruled out before any surgical intervention. Treatment of such lesions lies in the correction of parathyroid excess with a careful and systematic approach. This may prevent unnecessary surgical intervention in such patients.
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Ahmed A, Naidu A. Towards better understanding of giant cell granulomas of the oral cavity. J Clin Pathol 2021; 74:483-490. [PMID: 33858937 DOI: 10.1136/jclinpath-2020-206858] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2020] [Revised: 12/08/2020] [Accepted: 12/22/2020] [Indexed: 12/20/2022]
Abstract
Giant cell granulomas are enigmatic lesions of the oral cavity characterised by a peculiar combined proliferation of mononuclear and multinucleated giant cells in a mesenchymal stromal background. Central and peripheral giant cell granulomas may have similar pathogenesis and histology but differ in their location and biological behaviour. It is important to differentiate them from other giant cell lesions that can occur in the oral cavity, such as giant cell tumour of the bone, aneurysmal bone cyst, brown tumour of hyperparathyroidism, and giant cell lesions of Ramon syndrome, Noonan syndrome, neurofibromatosis and Jaffe-Campanacci syndrome. A recent insight into their molecular genetics and pathogenesis, with identification of KRAS, FGFR1 and TRPV4 mutations, allows for better diagnostic differentiation and opens the door to the use of pathway inhibitors in the treatment of recurrent or dysmorphic lesions. In this review, we provide an updated summary of the clinical and pathological features of oral cavity giant cell granulomas that help with their precise diagnosis and management.
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Affiliation(s)
- Atif Ahmed
- Pathology and Laboratory Medicine, University of Missouri Kansas City, Kansas City, Missouri, USA .,Children's Mercy Hospital, Kansas City, Missouri, USA
| | - Aparna Naidu
- Oral Pathology, University of Missouri Kansas City, Kansas City, Missouri, USA
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Melo-Muniz VRV, Nunes FD, Cangussu MCT, Cury PR, Xavier FCA, de Azevedo RA, Leitão ÁCGH, de Faro Valverde L, Carneiro Júnior B, Dos Santos JN. Central giant cell granuloma: A clinicopathological and immunohistochemical study of macrophages, blood vessels, lymphatic vessels and regulatory proteins. Ann Diagn Pathol 2020; 46:151526. [PMID: 32339965 DOI: 10.1016/j.anndiagpath.2020.151526] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2020] [Revised: 04/06/2020] [Accepted: 04/08/2020] [Indexed: 01/09/2023]
Abstract
OBJECTIVE This study seeks to investigate immunohistochemical parameters that could distinguish non-aggressive Central giant cell granuloma (CGCG) from aggressive CGCG, two groups of lesions which differ in their clinical and radiographic features and prognosis. MATERIAL AND METHODS 12 cases of non-aggressive CGCG and 11 cases of aggressive CGCG were investigated and associated the immunohistochemical expression of macrophages (CD68 and CD163), blood vessels (CD34 and CD105), lymphatic vessels (D2-40) and regulator proteins (p63 and Ki-67). Clinical and radiographic features were also studied. RESULTS Associations between all proteins in non-aggressive and aggressive CGCG were not significant (p > 0.05). With respect to non-aggressive CGCG, there were no significant correlations, while in aggressive CGCG there was a significant positive correlation between CD68 and CD163 (p = 0.031), between CD34 and D2-40 proteins (p = 0.04), whereas a significant negative correlation was observed between CD105 and CD68 (p = 0.040). However, regardless of aggressiveness of CGCG, there was a significant positive correlation between CD68 and CD163 (p = 0,04). Among the clinical and immunohistochemical aspects, only the symptomatology was a significant risk factor for the occurrence of aggressive CGCG (OR = 12.00/p = 0.016). CONCLUSION Macrophages and angiogenesis contribute to their maintenance and development of CGCG. In addition, immunohistochemistry used here was not able to differentiate their aggressiveness. However, symptomatology was proved to be a risk factor for the occurrence of aggressive CGCG. It is possible that clinical features, particularly symptomatology, represent the most appropriate parameter to attempt to distinguish GCCG.
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Affiliation(s)
- Vinicius Rio Verde Melo-Muniz
- Dentistry and Health Postgraduate Program, School of Dentistry, Federal University of Bahia, Salvador, Bahia, Brazil
| | - Fábio Daumas Nunes
- Laboratory of Oral and Maxillofacial Pathology, School of Dentistry, University of São Paulo, São Paulo, São Paulo, Brazil
| | | | - Patrícia Ramos Cury
- Dentistry and Health Postgraduate Program, School of Dentistry, Federal University of Bahia, Salvador, Bahia, Brazil
| | - Flávia Caló Aquino Xavier
- Dentistry and Health Postgraduate Program, School of Dentistry, Federal University of Bahia, Salvador, Bahia, Brazil; Laboratory of Oral and Maxillofacial Pathology, School of Dentistry, Federal University of Bahia, Salvador, Bahia, Brazil
| | - Roberto Almeida de Azevedo
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Federal University of Bahia, Salvador, Bahia, Brazil
| | - Águida Cristina Gomes Henriques Leitão
- Dentistry and Health Postgraduate Program, School of Dentistry, Federal University of Bahia, Salvador, Bahia, Brazil; Laboratory of Oral and Maxillofacial Pathology, School of Dentistry, Federal University of Bahia, Salvador, Bahia, Brazil
| | | | - Bráulio Carneiro Júnior
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Southwest University of Bahia, Jequié, Bahia, Brazil
| | - Jean Nunes Dos Santos
- Dentistry and Health Postgraduate Program, School of Dentistry, Federal University of Bahia, Salvador, Bahia, Brazil; Laboratory of Oral and Maxillofacial Pathology, School of Dentistry, Federal University of Bahia, Salvador, Bahia, Brazil.
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Melo Muniz VRV, Nunes FD, Xavier FCDA, Cangussu MCT, Almeida Freitas R, Cury PR, Gurgel CA, Santos JN. Potential role of Hedgehog signaling pathway and myofibroblastic differentiation in central giant cell granuloma—A preliminary study. J Oral Pathol Med 2019; 48:855-860. [DOI: 10.1111/jop.12949] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2019] [Revised: 08/07/2019] [Accepted: 08/09/2019] [Indexed: 12/14/2022]
Affiliation(s)
| | - Fábio Daumas Nunes
- Laboratory of Oral and Maxillofacial Pathology School of Dentistry University of São Paulo São Paulo SP Brazil
| | - Flávia Caló de Aquino Xavier
- Dentistry and Health Postgraduation Program School of Dentistry Federal University of Bahia Salvador BA Brazil
- Laboratory of Oral and Maxillofacial Pathology School of Dentistry Federal University of Bahia Salvador BA Brazil
| | | | - Roseana Almeida Freitas
- Laboratory of Oral and Maxillofacial Pathology School of Dentistry Federal University of Rio Grande do Norte Natal RN Brazil
| | - Patrícia Ramos Cury
- Dentistry and Health Postgraduation Program School of Dentistry Federal University of Bahia Salvador BA Brazil
| | - Clarissa Araújo Gurgel
- Dentistry and Health Postgraduation Program School of Dentistry Federal University of Bahia Salvador BA Brazil
| | - Jean Nunes Santos
- Dentistry and Health Postgraduation Program School of Dentistry Federal University of Bahia Salvador BA Brazil
- Laboratory of Oral and Maxillofacial Pathology School of Dentistry Federal University of Bahia Salvador BA Brazil
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Mohtasham N, Saghravanian N, Fatemi B, Vahedi M, Afzal-Aghaee M, Kadeh H. A comparative study of osteopontin and MMP-2 protein expression in peripheral and central giant cell granuloma of the jaw. Braz J Otorhinolaryngol 2017; 85:150-156. [PMID: 29339027 PMCID: PMC9452220 DOI: 10.1016/j.bjorl.2017.11.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2017] [Accepted: 11/08/2017] [Indexed: 11/09/2022] Open
Abstract
Introduction Oral peripheral and central giant cell granulomas are lesions with little-known etiology and pathogenesis. Objective The aim of this study was to compare matrix metalloproteinases-2 and osteopontin protein expression in the multinucleated giant cells and mononuclear cells of the peripheral and central giant cell granuloma lesions. Methods In this retrospective study, the presence of matrix metalloproteinases-2 and osteopontin in 37 cases of central giant cell granuloma and 37 cases of peripheral giant cell granuloma paraffin blocks were assessed by streptavidin-biotin immunohistochemistry. Independent sample t-test, Chi-square, Mann–Whitney tests and Spearman's rank correlation coefficient were used. Results The osteopontin was expressed in both multinucleated giant cells and mononuclear cells in all cases of peripheral and central giant cells granulomas. However, the matrix metalloproteinases-2 expression was positive in 86.5% of giant cells and it was positive in all of mononuclear cells in peripheral giant cells granuloma. In central giant cells granulomas, 91.8% of giant cells and all mononuclear cells were positive for matrix metalloproteinases-2 marker. Percentage and Intensity of staining were significantly higher in central than peripheral giant cells lesions, for both markers (p ˂ 0.05). Conclusion This study showed that the expression of osteopontin in giant cells supports the theory of osteolcastic nature of these cells. Also, the presence of osteopontin and matrix metalloproteinases-2 in mononuclear cells may indicate the monocyte-macrophage origin of these cells, as the differentiation of the precursors of the mononuclear stromal monocyte/macrophage to osteoclasts is possibly affected by the expression of osteolytic factors. Also, may be differences in biological behaviors of these lesions are associated with the level of osteopontin and matrix metalloproteinases-2 expression.
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Affiliation(s)
- Nooshin Mohtasham
- Oral and Maxillofacial Disease Research Center, Mashhad University of Medical Sciences, School of Dentistry, Department of Oral and Maxillofacial Pathology, Mashhad, Iran
| | - Nasrollah Saghravanian
- Oral and Maxillofacial Disease Research Center, Mashhad University of Medical Sciences, School of Dentistry, Department of Oral and Maxillofacial Pathology, Mashhad, Iran
| | - Bahareh Fatemi
- Kerman University of Medical Sciences, School of Dentistry, Department of Endodontics, Kerman, Iran
| | - Mehdi Vahedi
- Kerman University of Medical Sciences, School of Dentistry, Department of Periodontology, Kerman, Iran
| | - Monavar Afzal-Aghaee
- Mashhad University of Medical Sciences, Social Medicine Specialist, Mashhad, Iran
| | - Hamideh Kadeh
- Oral and Dental Disease Research Center, Zahedan University of Medical Science, School of Dentistry, Department of Oral & Maxillofacial Pathology, Zahedan, Iran.
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Noya Maiz N, de la Rosa-García E, Irigoyen Camacho ME. Immunohistochemical expression of alpha-smooth muscle actin and glucocorticoid and calcitonin receptors in central giant-cell lesions. J Oral Pathol Med 2015; 45:289-94. [DOI: 10.1111/jop.12377] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/25/2015] [Indexed: 11/28/2022]
Affiliation(s)
- Nancy Noya Maiz
- Department of Health Care; Universidad Autónoma Metropolitana; Xochimilco México City México
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