unicystic

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  • 文章类型: Case Reports
    有很多良性病变会导致下颌骨肿胀,这些可以分为牙源性和非牙源性病变。在牙源性病变的类别中,成釉细胞瘤是发生最多的病变,起源于上皮细胞元素和牙齿组织的不同发育阶段。成釉细胞瘤由于其患病率和临床特征而成为最严重的牙源性肿瘤。成釉细胞瘤是一个广泛的类别,包括80%的固体多囊性成釉细胞瘤,其中单囊性成釉细胞瘤(UA)变体作为重要的临床病理形式,其余20%与周围成釉细胞瘤变体一起。UA是指临床上看起来像颌骨囊肿的囊性病变,射线照相,或大致但由典型的成釉细胞上皮排列,有或没有腔和/或壁肿瘤的发展,组织学调查。大约5-15%的成釉细胞病变没有转移倾向,这是UA.单一的壁画形式,虽然总体增长缓慢,局部侵入性强,复发率高。由于UA肿瘤表现出非常接近的特征与牙质囊肿,考虑到临床,需要执行一个非常尖锐的鉴别诊断方案来排除其他单囊性牙源性病变,放射学,和生物学特征以及适当的随访,并观察病变的任何复发。这里,我们报告一例21岁的男性下颌骨UA患者并进行文献复习。
    There are plenty of benign lesions that can result in swelling of the mandible, and these can be classified as odontogenic and non-odontogenic lesions. Among the categories of odontogenic lesion, ameloblastoma is the most occurring lesion that takes origin from the epithelial cellular elements and dental tissues in their different stages of development. Ameloblastoma is the most serious odontogenic neoplasm due to its prevalence and clinical characteristics. Ameloblastoma is a broad class which encompasses 80% of solid multicystic type of ameloblastoma with unicystic ameloblastoma (UA) variant included as vital clinicopathological form claiming the rest 20% along with peripheral ameloblastoma variant. UA refers to cystic lesions that seem like jaw cysts clinically, radiographically, or grossly but are lined by typical ameloblastomatous epithelium, with or without luminal and/or mural tumor development, on histologic investigation. Around 5-15% of all ameloblastic lesions do not have a propensity to metastasis, and this is UA. Unicystic mural form, although slow growing overall, is very invasive locally and has a high recurrence rate. As UA tumors show very close features with dentigerous cyst, a very sharp differential diagnosis protocol need to be executed to exclude the other unicystic odontogenic lesions considering the clinical, radiological, and biological characteristics along with proper follow-up and seeing any recurrence of the lesion taking place. Here, we report the case of a twenty-one year male patient with UA of the mandible and review of the literature.
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  • 文章类型: Case Reports
    成釉细胞瘤(DA)是一种上皮牙源性肿瘤,是成釉细胞瘤的一种罕见变体。它于1984年由Eversole首次描述。在世界卫生组织(WHO)牙源性肿瘤的分类(2005年)中,DA被认为是与常规/多囊性成釉细胞瘤不同的实体。DA在临床上有惊人的不同,放射学,与成釉细胞瘤的其他变体相比,以及组织病理学表现。我们在这里报告了一名50岁女性患者的极为罕见的“混合DA”,该患者无痛性硬肿胀累及右后下颌骨,并有详细的临床病史,不寻常的影像学和组织病理学表现。组织病理学显示毛囊形式的牙源性上皮,成釉细胞瘤与囊性变性,在某些地方和其他地方,鳞状上皮化生被致密的纤维细胞基质压缩,提示增生和骨组织形成。还回顾了文献,并讨论了DA中囊变和骨组织形成的病因的可能解释。
    Desmoplastic ameloblastoma (DA) is an epithelial odontogenic tumor and a rare variant of ameloblastoma. It was first described by Eversole in 1984. In the World Health Organization (WHO) classification of odontogenic tumors (2005), DA has been considered as a distinct entity from conventional/multicystic ameloblastoma. DA differs strikingly in its clinical, radiological, and histopathological presentation when compared to other variants of ameloblastoma. We report here an extremely rare \"Hybrid DA\" in a 50-year-old female patient with painless hard swelling involving right posterior mandible with detailed clinical history, an unusual radiographic and histopathological presentation. Histopathology revealed odontogenic epithelium in the form of follicles, ameloblastoma with cystic degeneration, and squamous metaplasia at places and elsewhere there were odosntogenic islands compressed by dense fibrocellular stroma suggestive of desmoplasia along with osseous tissue formation. Also review of the literature and possible explanation of etiopathogenesis of cystic change and osseous tissue formation in DA are discussed.
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  • 文章类型: Editorial
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  • 文章类型: Case Reports
    囊性部分分化肾母细胞瘤(CPDN)患者的病例迄今已有报道,在所有这些肿瘤中都表现为多囊性肾肿瘤。它是肾母细胞瘤的一种特殊病理类型。这里,我们报告了首例儿童中的单纯性CPDN病例.该患者被诊断为单纯性肾囊肿,并接受了腹腔镜剥脱术。在病理切片中发现了幼稚的肾单位,确诊为CPDN。然后,患者接受了根治性肾切除术和六个周期的术后化疗。随访2年无复发或转移。表现为单囊性肾肿瘤的小儿CPDN对诊断提出了新的挑战,鉴别诊断,和治疗单囊性肾肿瘤。
    Cases of patients with cystic partially differentiated nephroblastoma (CPDN) have been reported to date, which presented as polycystic renal tumor in all of them. It is a special pathological type of nephroblastoma. Here, we report the first case of a unicystic CPDN in a child. The patient was diagnosed with a simple renal cyst and underwent laparoscopic decortication. The naive nephron was found in the pathological section, and the diagnosis of CPDN was confirmed. The patient then underwent a radical nephrectomy and six cycles of postoperative chemotherapy. There was no recurrence or metastasis after 2 years of follow-up. Pediatric CPDN presenting as a unicystic renal tumor poses a new challenge to the diagnosis, differential diagnosis, and treatment of unicystic renal tumor.
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  • 文章类型: Journal Article
    透明化的诱导作用及其对成釉细胞瘤变体的生物学行为的影响代表了口腔病理学的一个几乎没有研究的领域。牙源性设备内诱导效应的复杂性,外胚层和中胚层组织都参与其中,负责不同的组织病理学特征,透明质化是主要特征。本研究旨在首次推断三种单囊性成釉细胞瘤(UA)变种的透明质化(SOH)严重程度与复发之间的相关性。即,腔内(UA-IL),腔(UA-L)和壁(UA-M)。回顾性诊断的UA-IL档案病例(n=08),评估UA-L(n=22)和UA-M(n=30)的SOH及其与复发的相关性。还进行了亚组比较(UA-IL/UA-L和UA-M之间)。还从文件中分析了患者的临床参数与复发的临床病理相关性。结果:上皮下透明化(SEH)与UA-L和UA-M的复发显着相关(p=0.001)。当组织学类型(UA-L和UA-ILvs.对UA-M)进行分组,并检查SOH与复发的相关性,观察到两组(p=0.001)显示出强的统计学相关性.UA-M病变与多房性放射性(p=0.001)也显示出与复发的显着相关性。SOH可以是UA复发和侵袭性生物学行为的可靠组织学预测指标。本研究表明,透明质化与UA的生物学行为存在显着关联。通过免疫组织化学研究的进一步研究可以验证透明质化的存在并确定透明质化产物在UA中的起源。
    The inductive effect of hyalinisation and its influence on the biologic behaviour of ameloblastoma variants represent a scarcely researched domain of oral pathology. The complexity of the induction effects within the odontogenic apparatus, with the involvement of both ectodermal and mesodermal tissues, is responsible for diverse histopathological characteristics, hyalinisation being the major feature. The present study aims to deduce for the first time the correlation between the severity of hyalinisation (SOH) and recurrence in three unicystic ameloblastoma (UA) variants, namely, intra-luminal (UA-IL), luminal (UA-L) and mural (UA-M). Retrospectively diagnosed archival cases of UA-IL (n = 08), UA-L (n = 22) and UA-M (n = 30) were assessed for SOH and its correlation with recurrence. A subgroup comparison (between UA-IL/UA-L and UA-M) was also performed. The clinical parameters of the patients were also analysed from files for clinicopathological correlation with recurrence. Results: sub-epithelial hyalinisation (SEH) significantly correlated with the recurrence of UA-L and UA-M (p = 0.001). When the histologic types (UA-L and UA-IL vs. UA-M) were grouped and the correlation of SOH with recurrence was checked, it was observed that both groups (p = 0.001) showed strong statistical correlation. UA-M lesions with multilocular radiolucency (p = 0.001) also showed significant correlation with recurrence. SOH can be a reliable histological predictor of recurrence and of aggressive biologic behaviour in UA. The present study shows a significant association of hyalinisation with the biologic behaviour of UA. Further studies with immunohistochemical investigations could validate the presence of hyalinisation and identify the origin of the hyalinised product in UAs.
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  • 文章类型: Journal Article
    单囊性成釉细胞瘤(UA)是成釉细胞瘤的一种罕见变体,其行为与成釉细胞瘤(SMA)的固体多囊性变体完全不同;此外,UA的组织学亚组在增殖方面也表现出不同的行为。本多中心研究旨在介绍单囊性成釉细胞瘤(UA)的临床病理特征,并比较两种流行的组织学分类系统。从印度北部的四所牙科教学学校中检索到80例令人满意的UA病例,并对其临床病理参数进行了评估。使用改良的Reichart和Philipsen系统以及Marx和Stern系统对病例进行分类,然后比较观察者之间的变异性。结果采用SPSS软件进行分析。平均发病年龄为30.79±16.49岁。男性人数超过女性(M:F::1.67:1)。大多数病例发生在第三个十年,不分性别。大多数病例发现于下颌骨的体角支区域。修改后的Reichart和Philipsen分类产生了更好的观察者间一致性(kappa值0.845)。修改后的Reichart和Philipsen分类可产生更好的评分者之间的一致性,并且易于在口腔病理学家中复制。更简单,手术外科医生可以很容易地理解它,以获得更好的治疗结果。
    Unicystic ameloblastoma (UA) is an uncommon variant of ameloblastoma and behaves totally different from the solid multicystic variant of ameloblastoma (SMA); furthermore the histological subgroups of UA also show varied behavior regarding proliferation. The present multi-centric study was designed to present the clinicopathological features of unicystic ameloblastoma (UA) and to compare the two popular histological classifications systems. 80 satisfactory cases of UA were retrieved and evaluated for clinicopathological parameters from four teaching dental schools of North India. The cases were classified using modified Reichart and Philipsen system and Marx and Stern system followed by comparison of inter-observer variability. The results were analyzed using SPSS software. The mean age of occurrence was 30.79 ± 16.49 years. Males outnumbered females (M:F::1.67:1). The majority of cases occurred in the third decade irrespective of the gender. Most cases were found in body-angle-ramus region of the mandible. The modified Reichart and Philipsen classification yielded better interobserver agreement (kappa value 0.845). The modified Reichart and Philipsen classification yields better inter-rater agreement and is easy to reproduce amongst oral pathologists. Being simpler it may easily be understood by the operating surgeon for better treatment outcome.
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  • 文章类型: Journal Article
    目的:本研究旨在评估单囊性成釉细胞瘤年轻患者的临床疗效,通过各种保守治疗方式,如袋袋化,骨刮除术和帮助建立合理的治疗指南。
    方法:有15例单囊性成釉细胞瘤患者,在过去的6年(2010-2015年)中,他向我们部门介绍了所有患者中选择的保守治疗方法。此外,增加了一项关于2001年至2015年过去15年中青年年龄组(<20岁)单囊性成釉细胞瘤治疗研究的系统文献综述.
    结果:注意到保守治疗后骨再生更快,由于年轻和成长潜力。平均随访4年,顺利的二次愈合,在任何病例中均未发现复发的临床或影像学证据,也未发现明显的畸形.
    结论:单囊性成釉细胞瘤是良性的,年轻的局部侵袭性牙源性肿瘤可以在牙齿形成阶段发展,因此它的早期开始和大量增殖在这个年龄段并不少见,因此,它可以长成一个巨大的病变,导致显著的发病率。保守性手术治疗可能是降低发病率并增加年轻人群中继发愈合和骨再生的可能性的可行选择。
    OBJECTIVE: The study intends to evaluate the clinical outcome of treating young patients of unicystic ameloblastoma, by various conservative treatment modalities such as marsupialization, enucleation with bone curettage and aid in establishing sound treatment guidelines.
    METHODS: A case series of fifteen patients is presented of unicystic ameloblastoma, who presented to our Department over the past 6 years (2010-2015) and conservative method of treatment elected in all the patients. Also, a methodical literature review of studies discussing treatment of unicystic ameloblastoma in young age group (<20 years) patients over the last 15 years from 2001 to 2015 is added.
    RESULTS: Faster osseous regeneration after conservative treatment was noted, owing to the young age and growth potential. Over a mean follow-up of 4 years, uneventful secondary healing, no clinical or radiographic evidence of recurrence and no apparent deformity were noted in any of the cases.
    CONCLUSIONS: Unicystic ameloblastoma is a benign, locally invasive odontogenic neoplasm of young age which can develop during the stage of tooth formation and hence its early inception and vast proliferation is not uncommon in this age group, due to which it can grow into a huge lesion causing significant morbidity. Conservative surgical management may be a viable option to reduce morbidity and increase the probability of uneventful secondary healing and bone regeneration in the younger population.
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  • 文章类型: Case Reports
    目的:成釉细胞瘤是一种局部侵袭性良性肿瘤,通常发生在下颌骨。虽然已经报道了多囊性或丛状变异的巨大成釉细胞瘤,作者报告了一例罕见的腔内变异的巨大单囊性成釉细胞瘤,通过房室切除术治疗,并计划延迟重建。
    方法:一名46岁的男性患者向口腔外科门诊部报告,左侧下颌骨区域肿胀2年。他接受了阿育吠陀治疗,但没有改善。出现时病变的大小约为9×12cm。
    方法:房室切除并计划进行二次重建,经过适当的随访期。
    结论:虽然正在探索保守治疗作为单囊性成釉细胞瘤的治疗选择,无论巨大病变的组织病理学亚型如何,切除仍是治疗标准.
    OBJECTIVE: Ameloblastoma is a locally aggressive benign tumor, commonly occurring in the mandible. While giant ameloblastoma of multicystic or plexiform variant have been reported, the authors report a rare case of giant unicystic ameloblastoma of luminal variant, which was treated by compartmental resection and planned for delayed reconstruction.
    METHODS: A 46 year old male patient reported to the oral surgery out-patient department with a swelling of the left side mandible region of 2 years duration. He had undergone ayurvedic treatment for the same with no improvement. The size of the lesion on presenting was approximately 9 × 12 cm.
    METHODS: Compartmental resection with plan for secondary reconstruction, after adequate follow up period.
    CONCLUSIONS: While conservative management is being explored as a treatment option for unicystic ameloblastoma, resection is still the standard of care regardless of the histopathological subtype for giant lesions.
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  • 文章类型: Journal Article
    目的:这项研究的目的是在成釉细胞病变周围引起必要的安全界限,以防止进一步复发。
    方法:本研究包括25例下颌骨成釉细胞瘤。诊断基于临床和放射学分析,并通过组织病理学报告证实。术前进行了切开活检以确认诊断。计划对所有病例进行分段切除。切除后,术后对标本进行全景X线片,然后对其边缘进行组织病理学检查以检测肿瘤细胞浸润。
    结论:在我们所有的案例中,成釉细胞瘤本质上是浸润的。10年的随访期显示既没有复发也没有植入失败。在我们的研究中,我们根据切除标本的组织病理学报告得出我们对于成釉细胞瘤浸润性变异型的安全界限.
    OBJECTIVE: The purpose of this study is to elicit the amount of safety margin necessary around the ameloblastic lesion in view of preventing further recurrence.
    METHODS: The study consisted of 25 cases of mandibular ameloblastoma. Diagnosis was based on clinical and radiological analysis and confirmed by histopathological report. An incisional biopsy was done preoperatively to confirm the diagnosis. Segmental resection was planned for all the cases. After the resection, postoperative panoramic radiograph of the specimen was taken followed by histopathological examination of its margin to detect tumor cell infiltration.
    CONCLUSIONS: In all our cases, the ameloblastoma was infiltrating in nature. A follow-up period of 10 years showed neither recurrence nor implant failure. In our study, we conclude our safe margin for infiltrating variant of ameloblastoma based on histopathological report of the resected specimen.
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  • 文章类型: Case Reports
    成釉细胞瘤是牙源性上皮起源的肿瘤。单囊性成釉细胞瘤用于描述具有类似牙源性囊肿的临床影像学特征的囊性病变。但组织学上显示存在成釉细胞瘤上皮衬里部分的囊肿腔。大部分病变都在下颌骨中发现,通常会导致下巴无痛肿胀。它们可以在射线照相上细分为“牙质”和“非牙质”类型。单囊性成釉细胞瘤被认为比实性/多囊性成釉细胞瘤更具侵袭性。因此对摘除术和刮宫有更有利的反应。该病例报告介绍了一例45岁女性患者的前下颌骨中具有多房性影像学表现的单囊性成釉细胞瘤,以及该主题的文献综述。
    Ameloblastomas are tumors of odontogenic epithelial origin. The term unicystic ameloblastoma is used to describe cystic lesions with clinico-radiographic features resembling an odontogenic cyst, but histologically showing the presence of ameloblastomatous epithelium lining part of the cyst cavity. A large majority of lesions are found in the mandible, and usually cause a painless swelling of the jaws. They can be radiographically subdivided into \'dentigerous\' and \'non-dentigerous\' types. The unicystic ameloblastoma is believed to be less aggressive than a solid/multicystic ameloblastoma, and thus has a more favorable response to enucleation and curettage. This case report presents a case of unicystic ameloblastoma with a multilocular radiographic appearance in the anterior mandible of a 45-year-old female patient, along with a literature review of the topic.
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