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Abstract：
Background Central giant cell granuloma (CGCG) presents as a locally invasive, intraosseous lesion characterized by the accumulation of multinucleated giant cells amidst a matrix of hemorrhage and reactive fibrous tissue that infiltrates bone trabeculae. This idiopathic non-neoplastic proliferative lesion primarily affects the mandible, typically presenting as either unilocular or multilocular radiolucencies on X-rays. Although trauma or intraosseous hemorrhages are potential triggers, the precise histogenesis and etiology remain unclear. CGCG predominantly occurs in children and young adults, with a slight female predilection. Methods and materials A retrospective analysis of 21 cases of CGCG diagnosed at the Oral Pathology/Pathology department of Temple University Hospital between 2015 and 2022 was conducted. Each case was evaluated based on various parameters, including age, gender, presenting symptoms, radiographic findings, clinical differential diagnosis, and histological confirmation. The primary radiographic technique employed for diagnosis was X-ray imaging of the mandible and maxilla. The histological examination involved cutting paraffin-embedded tissue into 5-micrometer-thick sections, which were then stained using routine hematoxylin and eosin (H&E) stain. Notably, no specialized histochemical or immunohistochemical stains were utilized in the evaluation process. Results In our study, we reviewed 21 cases; 9 were male, 11 were female, and one had no available gender data. The age range was 15-76 years, with a mean of 50 years. The mandible was the most commonly affected location (17 cases; 81%) while the maxilla was less commonly involved (4 cases; 19%). Many CGCG lesions were asymptomatic (13 cases; 62%); eight cases (38%) were symptomatic, with pain and fullness of the affected dental region being the main manifestations. In a few cases, conditions such as brown tumor (severe hyperparathyroidism) and odontogenic neoplasms, such as ameloblastoma, were suspected clinically and radiographically. The diagnosis of CGCG with associated acute and chronic inflammation was confirmed in all the cases. Histological evaluation of routinely stained slides was the main diagnostic tool utilized. No special stains or molecular studies were required to establish the final diagnosis. Conclusions Our investigation has determined that CGCG exhibits a non-neoplastic nature, displaying a spectrum of behaviors ranging from non-aggressive to aggressive tendencies. While CGCG is predominantly observed in the mandible, rare instances of involvement in the maxilla have also been documented. Importantly, no confirmed association with neoplastic lesions was identified during our analysis. The clinical course of CGCG tends to be indolent, with some cases presenting in association with impacted teeth. It\'s noteworthy that CGCG can present features mimicking neoplastic conditions, such as ameloblastoma, or localized lesions linked to systemic disorders such as hyperparathyroidism (brown tumor).
摘要：
背景：中心性巨细胞肉芽肿（CGCG）表现为局部侵袭性，骨内病变的特征是多核巨细胞在渗入骨小梁的出血基质和反应性纤维组织中积累。这种特发性非肿瘤性增生性病变主要影响下颌骨，通常在X射线上表现为单眼或多房性放射像。虽然创伤或骨内出血是潜在的诱因，确切的组织发生和病因仍不清楚。CGCG主要发生在儿童和年轻人中。有轻微的女性偏爱。方法和材料回顾性分析2015-2022年天普大学医院口腔病理/病理科21例CGCG患者的临床资料。每个案例都根据各种参数进行评估，包括年龄,性别,出现症状，射线照相结果，临床鉴别诊断,和组织学确认。用于诊断的主要放射学技术是下颌骨和上颌骨的X射线成像。组织学检查包括将石蜡包埋的组织切成5微米厚的切片，然后使用常规苏木精和伊红(H&E)染色。值得注意的是,在评估过程中没有使用专门的组织化学或免疫组织化学染色.结果在我们的研究中,我们回顾了21例；9例为男性，11是女性，其中一人没有可用的性别数据。年龄范围是15-76岁,平均50年。下颌骨是最常见的受影响位置（17例；81％），而上颌骨较不常见（4例；19％）。许多CGCG病变无症状（13例；62％）；8例（38％）有症状，以受影响的牙齿区域的疼痛和丰满为主要表现。在少数情况下,如棕色肿瘤（严重的甲状旁腺功能亢进）和牙源性肿瘤，例如成釉细胞瘤，在临床和影像学上怀疑。所有病例均确诊CGCG伴急性和慢性炎症。常规染色载玻片的组织学评估是使用的主要诊断工具。不需要特殊的染色或分子研究来建立最终诊断。结论我们的调查确定CGCG表现出非肿瘤性，表现出从非攻击性到攻击性倾向的一系列行为。虽然CGCG主要在下颌骨中观察到，上颌骨受累的罕见情况也有记录。重要的是,在我们的分析中,未发现与肿瘤性病变的明确关联.CGCG的临床过程趋于惰性，有些病例与牙齿受累有关。值得注意的是CGCG可以呈现模仿肿瘤状况的特征，例如成釉细胞瘤，或与全身性疾病有关的局部病变，如甲状旁腺功能亢进（棕色肿瘤）。
