Idiopathic bone cavity: a clinical, radiographic, and histological study

The aim of the present study was to evaluate the clinical, radiographic and histological characteristics of idiopathic bone cavities from the Oral Pathology archives at Universidade Federal de Minas Gerais. Forty-three cases were retrieved. Age, sex, some radiographic variables and morphological variables measured of the connective tissue, were studied. The results showed the men who developed cavities tended to be younger than women (median 16 years (range 11-48) compared with 18 (12-64)). Radiographically rounded lesions that were single, unilocular, and small were more common in younger patients. While rounded cavities occurred mainly in the anterior region, cavities with interdental scalloping occurred in the posterior area. The median age of the patients with thin connective tissue on the wall of the bony cavity was lower than that of those with a thicker lining. In conclusion, the present study shows that there is a significant relation between age and sex, radiographic and histological variables. These findings may contribute to the diagnosis of idiopathic bone cavities.     

A comparative study of epithelial cell proliferation between the odontogenic keratocyst, orthokeratinized odontogenic cyst, dentigerous cyst, and ameloblastoma

OBJECTIVES: The aim of the present study was to compare the proliferation index of the epithelial cells between odontogenic keratocysts (OKC), orthokeratinized odontogenic cysts (OOC), dentigerous cysts (DC), and ameloblastomas. MATERIALS AND METHODS: The proliferation index, employing a novel cell proliferation marker IPO-38, was studied by the immunohistochemical technique in 10 OKC, seven OOC, eight DC and 10 ameloblastomas. RESULTS: The ameloblastoma had no higher labeling index (LI) of IPO-38 than the OKC (P = 0.910) but had higher LI than the OOC (P = 0.001) and DC (P = 0.000); the OKC had higher LI than the OOC (P = 0.002) and DC (P = 0.000); and the OOC had higher LI than the DC (P = 0.011). IPO-38-positive cells in the OKC and OOC were located principally in the suprabasal cell layers while the ameloblastoma were found in the peripheral portion in particularly, the follicular and plexiform types. CONCLUSION: These findings support previous studies that the proliferation indices are useful in predicting the different biological behavior of the odontogenic lesions and the OKC should be regarded as a benign tumor rather than simply an odontogenic cyst.     

“True” Versus “Bay” Apical Cysts: Clinical,Radiographic, Histopathologic,and Histobacteriologic Features

IntroductionThis study compared the main clinical, radiographic, and histologic features of true and bay apical cysts.MethodsThe study material comprised 95 biopsy specimens of apical periodontitis lesions obtained attached to the root tip of both untreated and root canal–treated teeth. Clinical and radiographic data were recorded. Specimens were obtained by extraction or periradicular surgery and were meticulously processed for histopathologic and histobacteriologic methods. All cases diagnosed as apical cysts (n = 23) were divided into the true and bay types, which were then compared for tooth location, patient’s sex, lesion size, severity of clinical symptoms, presence of a sinus tract, previous abscess episodes, and prevalence of bacteria in the main root canal lumen and ramifications, on the outer root surface, and within the cyst cavity.ResultsEleven specimens were classified as true (48%) and 12 (52%) as bay cysts. Bacteria were found in all specimens, regardless of the histopathologic diagnosis. Planktonic bacteria were observed in the main root canal in all true cysts and in 11 of 12 (92%) bay cyst cases. Biofilms were detected in the main canal in 10 cases from each diagnostic group and were frequently observed in ramifications. Extraradicular biofilms occurred in a few specimens only. Bacteria were visualized within the cavity of both true (4/11, 36%) and bay (6/12, 50%) cyst specimens. The severity of histologic inflammation was always high. There were no significant differences between true and bay cysts for all the clinical, radiographic, histopathologic, and histobacteriologic parameters assessed.ConclusionsExcept for the morphologic relationship of the cyst cavity with the root canal space, true and bay cysts exhibited no other significant differences in the various parameters evaluated. The 2 cyst types were always associated with an intraradicular infection and sometimes with an extraradicular infection. Findings question the need to differentiate true and bay cysts and do not support the assumption that true cysts are self-sustainable entities not maintained by infection.     

Gingival cyst of the adult,lateral periodontal cyst,and botryoid odontogenic cyst: An updated systematic review

The aim of the present review was to integrate the available data published on gingival cyst of the adult (GCA), lateral periodontal cyst (LPC), and botryoid odontogenic cyst (BOC) into a comprehensive analysis of their clinical/radiological features. An electronic search was undertaken in July/2017. Eligibility criteria included publications having enough clinical/radiological/histological information to confirm the diagnosis. A total of 146 publications (157 GCAs, 213 LPCs, 96 BOCs) were included. GCA and LPC presented highest prevalence in the sixth/fifth decades; BOC in the sixth/seventh decades. LPCs were larger lesions than GCAs and GCAs appeared at an older age than LPC. There was no statistically significant difference between them for other factors (location, symptoms, recurrence, follow‐up time). In comparison with LPC, BOC lesions were larger, appeared more often in mandible and in older subjects, had more often a multilocular appearance, and presented a higher recurrence rate. Recurrence rates: GCA (3.2%), LPC (2.4%), BOC (21.7%). No factor seems to influence the recurrence rate of GCA or LPC. Multilocular radiological appearance seems to affect the recurrence rate of BOCs. Conservative surgical approaches seem to be enough for GCA/LPC. BOC presents a more aggressive behavior than GCA/LPC. Therefore, treatment of this lesion might involve some kind of adjunctive therapy after enucleation.     

Comparative Expression of CD34, Intercellular Adhesion Molecule-1, and Podoplanin and the Presence of Mast Cells in Periapical Granulomas,Cysts, and Residual Cysts

Introduction

The aim of the present study was to compare the immunoexpression of CD34, intercellular adhesion molecule-1 (ICAM-1), and podoplanin and the presence of mast cells with clinical, demographic, radiologic, and histologic features from periapical granulomas, periapical cysts, and residual cysts.

The inflammatory paradental cyst: a critical review of 342 cases from a literature survey, including 17 new cases from the author''s files

BACKGROUND: A total of 325 cases of inflammatory paradental cysts (IPCs) and 17 own cases were reviewed. Although known since 1930, the IPC is still unrecognized by many clinicians. The IPCs show a relative frequency of 0.9-4.7%. The majority of cysts occur distally or distobuccally to vital, permanent mandibular molars with a history of pericoronitis (IPC/3rd mandibular molar alone accounts for 64.9%). Radiologically, the cyst appears as a well-defined, semilunar unilocular radiolucency. MATERIALS AND METHODS: Cases of inflammatory paradental cysts and related lesions were retrieved from a worldwide literature survey. In addition, 17 new cases from the files of the authors have been added. RESULTS: The mean ages for patients with IPC/1st, 2nd and 3rd mandibular molars are 8.7, 17.4 and 27.6 years, respectively. The male:female ratio was 1 : 0.9 for IPC/1st and 2nd mandibular molars, and 1 : 0.4 for 3rd mandibular molar. CONCLUSION: Reduced enamel epithelium, cell rests of Malassez and remnants of the dental lamina stimulated by inflammation are thought to play a role in the pathogenesis of IPC. Histological features are indistinguishable from those of the inflammatory, periapical (radicular) cyst.     

Immunohistochemical study of bcl-2 protein, Ki-67 antigen and p53 protein in epithelium of glandular odontogenic cysts and dentigerous cysts

The aim of the present study was the evaluation of the immunohistochemical expression of the apoptosis-inhibiting protein bcl-2, the cell-cycle-related antigen Ki-67 and the p53 protein, which is involved both in cell cycle and apoptosis regulation, in the lining epithelium of glandular odontogenic cysts of the jaws. Formalin-fixed and paraffin-embedded tissue sections of three glandular odontogenic cysts and six dentigerous cysts were immunostained with a standard avidin-biotin peroxidase procedure, after microwave antigen retrieval. The glandular odontogenic cysts showed immunoreactivity for bcl-2 protein in the basal and suprabasal layers, while staining in dentigerous cysts was basal or focal. Most mucous cells and superficial cuboidal cells were negative. The percentage of Ki-67- or p53-positive cells was lower in glandular odontogenic cysts compared with dentigerous cysts. The findings suggest that the biological behavior of glandular odontogenic cysts may be associated with deregulation of cell death in the lining epithelium, while cell proliferation and p53 status do not seem to play a significant role.     

Effects of the patient's age and the size of the primary lesion on the speed of shrinkage after marsupialisation of keratocystic odontogenic tumours,dentigerous cysts,and radicular cysts

Marsupialisation, by which a surgical window is created in the cavity of a cystic lesion, has been recommended to avoid the formation of a bony defect in the jaw and a reduction in a patient's quality of life. However, information about the factors that affect the reduction in the size of a cyst after marsupialisation is limited. We have studied the effects of the patient's age and the size of the primary lesion on the speed of shrinkage after marsupialisation of keratocystic odontogenic tumours (KCOTs), dentigerous cysts, and radicular cysts. The speed of shrinkage (mm²/month) was evaluated by measuring the radiolucent area on panoramic radiographs taken before and after marsupialisation for KCOT (n = 28), dentigerous cysts (n = 26), and radicular cysts (n = 18) in the mandibular molar regions. The mean duration of marsupialisation for each type of cyst was 11 (5), 8 (5), and 5 (2) months, respectively. The radiolucent area decreased linearly in the 3 types depending on the time after marsupialisation: r = −0.86 (p < 0.01), r = −0.73 (p < 0.01), and r = −0.72 (p < 0.01), respectively. The relative speed of shrinkage did not correlate with the age of the patients, though it did correlate with the size of the radiolucent area before marsupialisation in KCOT (r = 0.69, p < 0.01) and radicular cysts (r = 0.73, p < 0.01). These results suggest that the size of a cyst before marsupialisation may affect the speed of shrinkage in KCOT and radicular cysts, while the age of the patient does not.     

Review on 209 Congenital Cysts of the Floor of the Mouth

目的：比较1980—2005年在武汉大学口腔医院治疗的89位中国病人和在约旦医院治疗的120位病人三型口底囊肿的临床特点。方法：回顾性分析皮样囊肿、表皮样囊肿和畸胎样囊肿患者的年龄、性别、种族，以及比较两组患者的囊肿位置、大小、就诊时间、手术治疗方法和复发率等方面的差别。结果：209例口底囊肿中，93例（44．5％）男性，116例（55．5％）女性。皮样囊肿66例（31．6％）、表皮样囊肿115例（55％）、畸胎样囊肿28例（13．4％）。皮样囊肿、表皮样囊肿多见于头3个10岁年龄组，20-29岁高发，而畸胎样囊肿高好发于10岁以前。约90％的患者无自觉症状。发病后6个月以内就诊者，第1组（43．8％）明显少于第2组（80％）。这些先天性囊肿常发生在口底中部。就诊时第1组中囊肿直径大于3cm者达48．3％，而第2组中囊肿直径大于3cm者仅11．7％。第1组中经口外进路切除病变占58．4％，而第2组为41．7％。141例随访病例的术后复发25例，复发率是17．7％。结论：两组口底囊肿有类似的临床特点，其中表皮样囊肿较常见，畸胎样囊肿的发病年龄较小。手术切除不彻底可导致病变复发。     

Comparative immunohistochemical expression of RANK, RANKL and OPG in radicular and dentigerous cysts

Objective

Receptor activator of nuclear factor-κB (RANK), RANK ligand (RANKL) and osteoprotegerin (OPG) are members of the superfamily of ligands and receptors of tumour necrosis factor family involved in bone metabolism. The formation, differentiation and activity of osteoclasts are regulated by these proteins. To clarify the roles of osteoclast regulatory factors in cystic expansion of odontogenic cysts, expression of these proteins were analysed in radicular and dentigerous cysts.

Design

The immunohistochemistry expression of these biomarkers were evaluated and measured in lining epithelium and fibrous capsule of the radicular (n = 20) and dentigerous cysts (n = 20).

Results

A similar expression in lining epithelium was observed in the lesions. The fibrous capsule of dentigerous cyst showed a higher content of RANK-positive and RANKL-positive cells than fibrous capsule of radicular cyst. In the lining epithelium the RANKL/OPG ratio showed higher numbers of OPG-positive than RANKL-positive cells, whereas fibrous capsule of the cysts had a tendency to present a similar expression (OPG = RANKL).

Conclusion

Ours findings indicate the presence of RANK, RANKL and OPG in cysts. Moreover, increased expression of OPG compared to RANKL in the lining epithelium could contribute to the differential bone resorption activity in theses lesions.     

Syndecan‐1 (CD 138) surface expression marks cell type and differentiation in ameloblastoma,keratocystic odontogenic tumor,and dentigerous cyst

J Oral Pathol Med (2013) 42 : 186–193 Background: The altered expression of syndecan‐1 (SD‐1), a transmembrane heparan sulfate proteoglycan, in ameloblastomas and cysts of odontogenic origin suggests that this molecule could have prognostic value in assessing the clinical outcome of those lesions. The purpose of this study was to analyze SD‐1 expression profile immunohistochemically in archival, paraffin‐embedded tissue sections of ameloblastomas and in common odontogenic cysts arising from the same locale. Methods: SD‐1 expression was investigated in 32 ameloblastomas, 26 keratocystic odontogenic tumors (KCOT), and 21 dentigerous cysts from the archives of the histopathology laboratory which were routinely processed. The cases were reviewed and assessed according to the established criteria. Sections were immunostained with monoclonal antibody against SD‐1 (CD138). Sections of normal oral mucosa, site matched, were stained in parallel as positive controls. The plasma cells in sections served as internal positive controls. Results: SD‐1 expression was observed in the epithelial and stromal elements of the sections, and the expression was significantly associated with the lesion’s extension and involvement of adjacent structures (P = 0.025). Stellate‐reticulum cells showed higher expression than the ameloblasts, which was at a significant level (P < 0.0001). Highly significant difference was reported among the three groups of lesion for the epithelial staining (P < 0.0001). The mean rank scores (Kruskal–Wallis test) of ameloblastomas were significantly lower than those of KCOT and dentigerous cysts. Non‐significant comparison was made between KCOT and dentigerous cyst groups. Conclusions: The present study revealed SD‐1 immunoreactivity in the stromal cells of ameloblastoma, KCOT, and dentigerous cysts rather uniformly. This reported SD‐1 expression by the tumor stroma is considered to be associated with poor prognosis of the lesions.     

颈上部支气管源性囊肿1例报告及文献复习

报告1例颈上部支气管源性囊肿,结合文献资料分析其临床表现、影像学、细胞学及病理学特征,为临床诊断及鉴别诊断提供参考。支气管源性囊肿发生在颈上部者非常少见,其症状和体征与常见的颈部肿物相似,鉴别较为困难,术前易误诊为鳃裂囊肿、淋巴管畸形、舌下腺囊肿等。临床上需完善检查、综合判断、妥善处理。     

Nasolabial Cyst: Review of Literature and a Case Report

The nasolabial cyst is a rare non-odontogenic cyst that develops within the skin adjacent to the ala of nose around the uppermost portion of the nasolabial crease; its pathogenesis is uncertain. This lesion grows slowly and measures between 1.5 to 3.0 cm; it is characterized clinically by a floating tumefaction in the nasolabial sulcus, which elevates the upper lip. The diagnosis is essentially based on the clinical findings. Bi—digital palpation revealed fluctulance between the floor of nasal vestibule and the gingivobuccal sulcus, which helps to confirm the diagnosis. This paper reports a case of a 35-year-old female patient that presented a soft swelling in the right ala of the nose; the clinical features suggested a nasolabial cyst. Complete surgical excision of the cyst was done under local anesthesia and the diagnosis was confirmed by histopathology. In spite of the low occurrence of nasolabial cysts, it is important to recognize the clinical characteristics of this lesion. The purpose of this paper is to review the literature and discuss the histopathology, etiology and different treatment options of this condition.     

牙源性颌骨囊肿患者血清钙、磷、镁及ALP变化的临床意义

目的 :研究血清钙、磷、镁及ALP在牙源性颌骨囊肿患者中的变化及其作用。方法 :对 138例颌骨囊肿患者进行血清钙、磷、镁及ALP含量的测定与分析。结果 :颌骨囊肿组的钠、钾、氯、钙含量与正常对照组无明显差异 (p >0.05 )。磷、镁、ALP含量明显高于对照组 (p <0.05)。发育性与炎症性颌骨囊肿患者的磷、镁、ALP无明显差异 (p >0.05)。直径大于 5cm的颌骨囊肿或手术后颌骨囊肿患者的磷、镁、ALP明显高于小于 5cm或手术前颌骨囊肿患者的含量 (p <0.05)。结论 :牙源性颌骨囊肿患者的磷、镁、ALP含量是相对增高的 ,它受囊肿的大小、手术的刺激而变化 ,它们在颌骨囊肿破骨与成骨之间起主要的调节作用。     

Eruption cyst in the adult--a case report

A case of eruption cyst in the right maxilla of a 40-year-old female is reported.     

Glandular odontogenic cyst (sialo-odontogenic cyst): A case report

A case of a rare cyst of the jaw bones is reported. This lesion appears to be a new entity and has been named glandular odontogenic cyst (GOC) or sialo-odontogenic cyst. The clinical and histological features and the differential diagnosis are discussed.     

Cytokine and chemokine levels in radicular and residual cyst fluids

Background:  Cytokines were thought to play an important role for the expansion of odontogenic cysts. The purpose of this study was to evaluate the cytokine and chemokine levels of radicular and residual cyst fluids.
Methods:  Cyst fluids were aspirated from 21 patients (11 radicular and 10 residual cysts) and the levels of interleukin-1 alpha (IL-1α), tumor necrosis factor-alpha (TNF-α), monocyte chemotactic protein-1 (MCP-1), and regulated upon activation normal T cell expressed and secreted (RANTES) were determined by ELISA using commercially available kits.
Results:  Both radicular and residual cyst fluids contained IL-1α, TNF-α, MCP-1, and RANTES, concentrations of which were significantly higher in the radicular cyst fluids than those in the residual cysts ( P  < 0.001 for IL-1α, TNF-α, and RANTES; P  < 0.01 for MCP-1). Compared to the other mediators, the concentration of IL-1α was found to be highest in both of the cyst fluids. In addition, positive correlations were found between IL-1α, TNF-α, MCP-1, and RANTES in radicular and residual cyst fluids.
Conclusion:  If the radicular cyst is inadvertently left behind following tooth extraction, some degree of inflammation may carry on. Residual cysts, although to a lesser extend than radicular cysts, have the potential to expand.     

牙源性角化囊肿与正角化牙源性囊肿CK10、Bcl-2免疫组化表达

目的 :比较牙源性角化囊肿 (odontogenickeratocyst,OKC)与正角化牙源性囊肿 (orthokeratinizedodonto geniccyst,OOC)中CK10及Bcl- 2的表达情况。方法 :OKC及OOC各 10例 ,分别行CK10、Bcl- 2免疫组化染色 ,并利用SPSS10 .0统计软件对免疫组化染色结果进行统计学处理。结果 :CK10在OKC中的阳性表达率为 80 % (8/10 ) ,而在OOC中为 10 0 % (10 / 10 ) (P >0 .0 5 )。OOC上皮中CK10阳性着色于除基底细胞层外的上皮全层 ,而OKC中CK10阳性着色仅见于上皮表层的不全角化层。Bcl- 2在OKC中的阳性表达率为 6 0 % (6 / 10 ) ,而在OOC中为 10 % (1/ 10 ) (P <0 .0 5 )。结论 :OKC与OOC的衬里上皮中免疫组化表达存在显著差别 ,OOC可能为有别于OKC的一种独立病损。     

The lateral periodontal cyst: an update

Lateral periodontal cysts account for 0.8% of all jaw cysts seen in our department. Published reports have indicated that they occur most frequently in the 5th to 7th decades, that there is a male preponderance and that they are located mainly in the mandibular canine-premolar region. In our own series of 20 cases, 10 were found in the anterior maxilla. We have distinguished unicystic and multicystic (including botryoid) varieties. They were lined predominantly or exclusively by thin reduced enamel epithelium-like tissue which contained many clear cells and epithelial thickenings referred to as plaques. Glycogen was present in the epithelium of two-thirds of our cases although not exclusively in the clear cells, many of which showed no positivity. Two of our examples of the botryoid variety were different histologically, being lined predominantly by non-keratinizing stratified squamous epithelium with crowded and pyknotic nuclei and no clear cells. One case contained melanin while another showed epithelial crypt formation and superficial palisaded low columnar cells as seen in the glandular odontogenic cyst. This raised the question of whether the latter may form part of the clinicopathologic spectrum of lateral periodontal cyst. The histogenesis of lateral periodontal cysts is uncertain but we favour origin from reduced enamel epithelium.     

Coexistence of lymphoepithelial and epidermoid cysts on the floor of the mouth: report of a case

Lymphoepithelial and epidermoid cysts in the oral cavity are uncommon. The coexistence of lymphoepithelial and epidermoid cysts in the oral cavity is extremely rare. Only one case of lymphoepithelial cyst associated with two epidermoid cysts on the floor of the mouth has been reported in the literature and the present report describes a second case where a lymphoepithelial cyst coexisted with an epidermoid cyst on the floor of the mouth. It is likely an accidental trauma that was accompanied by inflammation produced the development of implantation-keratinizing epidermoid and lymphoepithelial cysts.