Odontogenic fibroma

牙源性纤维瘤
  • 文章类型: Journal Article
    这个病例系列描述了临床,成像,和27个被诊断为良性纤维团的病变的组织学特征,以前在兽医文献中没有描述。作者提出名称牙龈粘膜骨膜纤维瘤(GMPF)来描述在狗中发现的这些纤维性病变。组织学上,GMPF的特征在于缺乏牙源性组织和不同程度的骨化。GMPF影响平均年龄为95个月(范围24-156个月)的成年犬,并表现为具有表面外观与周围牙龈匹配的扩张性生长。下颌切角区域是最常见的受影响区域(n=13),大多数病例在影像学上有一定程度的骨增生(n=14)。肿块的组织学检查显示,细胞纤维组织较差,胶原纤维交织在一起。没有注意到群众的Bony入侵,尽管在17个病变中可见骨的组织学增生。手术切除在所有情况下都是治愈的,随访时未见复发。狗口腔的纤维病变的定义和分类不明确,尽管在人类和兽医文献中都描述了许多病变。
    This case series describes the clinical, imaging, and histological features of 27 lesions diagnosed as a benign fibrous mass not previously described in veterinary literature. The authors propose the name gingival mucoperiosteal fibroma (GMPF) to describe these fibrous lesions found in dogs. Histologically, GMPF is characterized by a lack of odontogenic tissue and various degrees of ossification. GMPFs affect adult dogs with an average age of 95 months (range 24-156 months) and appear as expansile growths with superficial appearance matching the surrounding gingiva. The mandibular incisive region is the most commonly affected region (n = 13) and most cases have some level of bone proliferation radiographically (n = 14). Histological examination of the masses shows poorly cellular fibrous tissue with thick interwoven collagen fibers. Bony invasion by the mass was not noted, though histological proliferation of bone was seen in 17 lesions. Surgical resection was curative in all cases when performed, and no recurrence was seen at time of follow-up. Fibrous lesions of the oral cavity in dogs are poorly defined and categorized, though numerous lesions have been described in both human and veterinary literature.
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  • 文章类型: Journal Article
    四只骆驼(Camelusdromedarius)被送往费萨尔国王大学的兽医教学医院,上颌肿块。在射线照片上,肿块为多囊性,上颌骨扩张。肿瘤经组织病理学检查诊断为常规成釉细胞瘤,骨内鳞状细胞癌2例,和伴有骨化的中央牙源性纤维瘤。就作者所知,这是骆驼成釉细胞瘤的第一份报告,骆驼上颌鳞状细胞癌的第一次详细描述,以及任何动物物种的中央牙源性纤维瘤的第一份报告。
    Four camels (Camelus dromedarius) presented to the Veterinary Teaching Hospital at King Faisal University with maxillary masses. On radiographs, the masses were multicystic and expanded the maxillary bone. The tumors were diagnosed by histopathologic examination as conventional ameloblastoma, two cases as intraosseous squamous cell carcinoma, and central odontogenic fibroma with ossification. To the authors\' knowledge, this is the first report of ameloblastoma in a camel, the first detailed description of maxillary squamous cell carcinoma in camels, and the first report of central odontogenic fibroma in any animal species.
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  • 文章类型: Review
    背景:世界卫生组织(WHO)关于牙源性和颌面骨肿瘤的章节为这些肿瘤的诊断提供了全球参考。在第五版中,纳入共识定义和制定必要和理想的诊断标准有助于提高对不同实体的认识.这些是关键的增强,因为牙源性肿瘤的诊断主要基于组织形态学,并结合临床和影像学表现。
    方法:审查。
    结果:尽管有成釉细胞瘤的诊断标准,腺样成釉细胞瘤,和牙本质鬼细胞瘤,这些肿瘤的一部分继续显示重叠的组织学特征,这可能导致误诊.准确的分类可能是具有挑战性的小活检,但可能通过完善现有的诊断标准和在特定病例中使用免疫组织化学和/或分子技术来增强。很明显,钙化上皮牙源性肿瘤的非钙化朗格汉斯细胞丰富亚型和牙源性纤维瘤的淀粉样蛋白丰富变体的临床和组织学特征融合为单个肿瘤描述。此外,这个肿瘤显示出显著的临床,组织学上与位于上颌骨的硬化性牙源性癌的子集重叠。良性神经周受累与神经周受累是牙源性肿瘤中一个未充分开发的概念,需要澄清以减少与硬化性牙源性癌的诊断混淆。
    结论:虽然在WHO章节中讨论了围绕分类和离散肿瘤实体的有争议的问题,歧义不可避免地仍然存在。这篇综述将研究几组牙源性肿瘤,以突出持续的知识差距,未满足的需求和未解决的争议。
    BACKGROUND: The World Health Organization\'s (WHO) chapter on odontogenic and maxillofacial bone tumors provides a global reference for diagnosis of these tumors. In the fifth edition, the inclusion of consensus definitions and development of essential and desirable diagnostic criteria help improve recognition of distinct entities. These are key enhancements since the diagnosis of odontogenic tumors is largely based on histomorphology which is taken in combination with clinical and radiographic appearances.
    METHODS: Review.
    RESULTS: Despite delineation of diagnostic criteria for ameloblastoma, adenoid ameloblastoma, and dentinogenic ghost cell tumor, a subset of these tumors continues to show overlapping histological features that can potentially lead to misdiagnosis. Accurate classification may be challenging on small biopsies, but potentially enhanced by refining existing diagnostic criteria and utilization of immunohistochemistry and/or molecular techniques in a specific cases. It has become clear that the clinical and histologic features of the non-calcifying Langerhans cell-rich subtype of calcifying epithelial odontogenic tumor and the amyloid-rich variant of odontogenic fibroma converge into a single tumor description. In addition, this tumor shows remarkable clinical, histological overlap with a subset of sclerosing odontogenic carcinoma located in the maxilla. Benign perineural involvement vs perineural invasion is an underexplored concept in odontogenic neoplasia and warrants clarification to reduce diagnostic confusion with sclerosing odontogenic carcinoma.
    CONCLUSIONS: While controversial issues surrounding classification and discrete tumor entities are addressed in the WHO chapter, ambiguities inevitably remain. This review will examine several groups of odontogenic tumors to highlight persistent knowledge gaps, unmet needs and unresolved controversies.
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  • 文章类型: Journal Article
    背景:颗粒细胞牙源性纤维瘤(GCOF)是一种罕见的牙源性肿瘤,随着时间的推移有不同的名称。这项研究的目的是回顾科学文献中有关GCOF的所有可用数据,所有报告病例的摘要和新病例的报告。
    方法:本综述遵循PRISMA指南进行。截至2022年11月,进行了电子搜索。
    结果:纳入报告53例病例的39项研究。GCOF是牙源性肿瘤中的一种罕见肿瘤,在中年和白人女性中患病率较高。这种病变主要发生在下颌骨的后部。此外,基于临床,射线照相,和组织病理学特征,保守治疗是报告最多的选择,2例报告复发.
    结论:由于尚未解决的组织发生,GCOF仍然存在争议。
    BACKGROUND: Granular Cell Odontogenic Fibroma (GCOF) is a rare odontogenic neoplasm reported over time with different names. The purpose of this study is to review all available data on the GCOF in the scientific literature, with a summary of all reported cases and a report of a new case.
    METHODS: This review was conducted following the PRISMA guidelines. An electronic search was performed up to November 2022.
    RESULTS: Thirty-nine studies reporting fifty-three cases were included. GCOF is a rare neoplasm among the odontogenic tumors, with a higher prevalence in women of the middle-aged and white population. This lesion occurs mostly on the posterior region of the mandible. Furthermore, based on clinical, radiographic, and histopathologic features, conservative treatment was the most reported choice with recurrence reported in two cases.
    CONCLUSIONS: GCOF remains controversial due to the still unsolved histogenesis.
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  • 文章类型: Case Reports
    结节性硬化症(TSC)是一种常染色体显性遗传性疾病,其特征是系统性错构瘤和多种系统性特征。TSC1和TSC2是致病基因,和智力低下,癫痫发作,面部血管纤维瘤在许多患有该疾病的患者中发展。本文报道了一例TSC患者发展为下颌骨中央牙源性纤维瘤的病例。该患者是一名21岁的妇女,她在右下侧切牙和犬齿区域的唇牙龈肿胀。牙科X线照相显示具有清晰边界的多房射线可透过区域。右下侧切牙和犬齿与病变连续,因此全部切除。病变被包裹并容易解剖。免疫组织学染色诊断为无上皮成分的牙源性纤维瘤。TSC1/2基因突变导致PI3K-AKT通路下游哺乳动物雷帕霉素靶蛋白(mTOR)的异常激活。该患者的牙源性纤维瘤mTOR阳性,提示牙源性纤维瘤的发展是mTOR异常激活的结果,如血管纤维瘤。介绍了该患者的临床过程,并讨论了中央牙源性纤维瘤的发展机制。
    Tuberous sclerosis complex (TSC) is an autosomal dominant inherited disease characterized by systemic hamartoma and diverse systemic features. TSC1 and TSC2 are the causative genes, and mental retardation, epileptic seizures, and facial angiofibroma develop in many patients with the disease. The case of a patient with TSC who developed a central odontogenic fibroma of the mandible is reported here. The patient was a 21-year-old woman who was referred with a swelling of the labial gingiva in the region of the right lower lateral incisor and canine. Dental radiography revealed a multilocular radiolucent region with a clear boundary. The right lower lateral incisor and canine were continuous with the lesion and thus were excised en bloc. The lesion was encapsulated and easily dissected. The diagnosis on immunohistological staining was odontogenic fibroma without an epithelial component. TSC1/2 gene mutation causes abnormal activation of mammalian target of rapamycin (mTOR) downstream of the PI3K-AKT pathway. The odontogenic fibroma in this patient was positive for mTOR, suggesting that the development of the odontogenic fibroma was the result of abnormal activation of mTOR, as in angiofibroma. The clinical course of this patient is presented and the developmental mechanism of central odontogenic fibroma is discussed.
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  • 文章类型: Case Reports
    Cherubism是一种罕见的常染色体显性疾病,影响颌骨,并由编码定位到染色体4p16.3的衔接蛋白SH3BP2的基因突变引起。Cherubism的特征是上颌骨和下颌骨中对称发展的骨病变。病变已在影像学和组织病理学上得到充分描述。这里,我们介绍了一个患有胆碱病的家庭,其两个成员具有牙源性肿瘤增殖,并伴有持续性中央巨细胞病变(CGCL)。具体来说,先证者,一个25岁的男性,出现了一种放射状的病变,其组织学特征是与CGCL成分相关的中央牙源性纤维瘤样增殖,而他的母亲,在57岁时,被诊断为原发性骨内牙源性癌,伴有良性纤维骨性病变。在两名患者中,病变均发生在下颌骨前部,并伴有临床肿大。儿子接受了切开活检,没有接受其他治疗。由于广泛的肿瘤,他的母亲接受了广泛的下颌骨切除术。儿子有两个患有经典天使症的受影响儿童,而第三个5岁的孩子则没有表现出这种疾病的任何特征。三个受影响成员的突变分析导致SH3BP2中杂合突变的鉴定(c.1244G>C;p.Arg415Pro)。据我们所知,到目前为止,在文献中还没有报道过与牙源性肿瘤病变的联系,因此表明了小天使症与牙齿发育紊乱之间的关系。
    Cherubism is a rare autosomal dominant condition affecting the jaws and caused by mutations in the gene encoding for the adapter protein SH3BP2 that maps to chromosome 4p16.3. Cherubism is characterized by symmetrically developing bone lesions in the maxilla and mandible. The lesions have been radiographically and histopathologically well-described. Here, we present a family with cherubism with two of its members featuring odontogenic tumorous proliferations in association with persistent central giant cell lesions (CGCL). Specifically, the proband, a 25-year-old male, developed a radiolucent lesion characterized histologically by central odontogenic fibroma-like proliferation in association with a CGCL component, while his mother, at age 57, was diagnosed with primary intraosseous odontogenic carcinoma with areas of benign fibro-osseous lesions. In both patients the lesions occurred in the anterior mandible and presented with clinical enlargement. The son underwent incisional biopsy and did not have additional treatment. His mother underwent extensive mandibulectomy due to widespread tumor. The son has two affected children with classic cherubism while a third child at age 5, had not shown any features of the disease. Mutation analysis of three affected members resulted in the identification of a heterozygous mutation in SH3BP2 (c.1244G>C; p.Arg415Pro). To the best of our knowledge, association of cherubism with odontogenic neoplastic lesions has hitherto not been reported in the literature, thus suggesting a relationship between cherubism with disturbed odontogenesis.
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  • 文章类型: Journal Article
    Amelogenesis Imperfecta (AI) is a hereditary enamel defect which is characterized by developmental abnormalities in the quantity and/ or quality of enamel. This condition has been associated with dental anomalies, including taurodontism, congenitally missing teeth, delayed eruption, crown resorption, pulpal calcifications and odontogenic fibromas. This paper presents two cases of AI which were associated with multiple impacted permanent teeth in both the cases; and pulpal calcifications and pericoronal odontogenic fibromas of W.H.O type additionally, in one of the cases.
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  • 文章类型: Journal Article
    OBJECTIVE: Langerhans cell (LC) is an antigen-presenting cell that is very important for T-cell-mediated immune reactions. Our previous studies have shown the presence of LCs in some odontogenic tumors and cysts. In this study, we further examined the presence of LCs in odontogenic epithelia of 16 odontogenic fibromas (OFs).
    METHODS: Anti-CD1a and anti-S-100 immunostains were used to detect the presence of LCs in nests or strands of odontogenic epithelia of 16 OFs.
    RESULTS: These 16 OFs included 10 peripheral OFs excised from seven male and three female patients (mean age, 38 years) and six central OFs (including one recurrent OF) removed from five male patients (mean age, 28 years). Of the 10 peripheral OFs, six were found on the mandibular gingiva and four on the maxillary gingiva. Four central OFs were located in the maxilla and two in the mandible. We found that both anti-CD1a and anti-S-100 immunostains had an equal ability to identify LCs in OFs. Positively stained dendritic LCs could be detected in nests and strands of odontogenic epithelia in nine (six peripheral and three central OFs) of the 16 OFs. In five peripheral OFs, dendritic LCs were found in occasional nests or strands of odontogenic epithelia. In one peripheral and three central OFs, dendritic LCs could be detected in at least half of the nests or strands of odontogenic epithelium in the tissue section.
    CONCLUSIONS: LCs can be detected in the nests or strands of odontogenic epithelia in approximately 60% of the 10 peripheral OFs and approximately 50% of the six central OFs detected.
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