甲状舌管囊肿(瘘)172例临床病理研究

目的：研究甲状舌管囊肿（瘘）的临床病理特点。方法：回顾性总结172例甲状舌管囊肿（瘘）的临床资料，光镜下观察其组织学表现。结果：172例中，10岁以下儿童91例（52．9％），男女之比为1．8：1，发生于舌骨下部位106例（61．2％），复发30例（17．4％）；囊肿衬里上皮为假复层纤毛柱状上皮54例（31．4％）、复层鳞状上皮40例（23．3％）、单层上皮8例（4．7％）、假复层纤毛柱状上皮伴有复层鳞状上皮7例（4．1％）和假复层纤毛柱状上皮伴有单层上皮7例（4．1％）。结论：甲状舌管囊肿（瘘）好发于10岁以下男性，且舌骨下多见，组织学表现具有多样性。     

Clinicopathologic study of odontogenic keratocysts in Singapore and Malaysia

This was a retrospective study of odontogenic keratocysts in people from the Singapore-Malaysian region. The purpose of this study was to present the clinicopathologic features of odontogenic keratocysts in the Oriental population and to compare these data with those from other reported studies. Biopsy records from 1981 to 1992 of 61 cases of odontogenic keratocysts from patients in Malaysia and Singapore showed that 42.6% of patients were female and 57.4% of patients were male. Among patients with cysts, 75.4% were Chinese, 6.6% were Malays, 9.8% were Indians and 8.2% were other ethnic groups. The mean age of these patients was 26.98 +/- 15.38 years with a peak incidence occurring in the second to fourth decades. The location of the lesions was more often in the mandible (65.5%) than the maxilla (31.0%). There was a marked predilection for lesions to occur in the posterior mandible. Histologically, 90.2% of the cysts were lined with a para-keratinized stratified squamous epithelium while only 3.3% of the cysts were lined with orthokeratinized stratified squamous epithelium. Mixed para-keratinized and orthokeratinized epithelial linings were observed in 4 cases (6.5%). The cyst linings were mainly uninflamed (95.1%). Inflammation of the cyst wall was found in 42 cases (68.8%). Twelve (19.7%) cases contained keratin in the lumen. A satellite cyst was observed in only 6 cases (9.8%). In conclusion, most clinical and histological features seen in this study were similar to those found for Caucasians. The only clinical feature that was different was the peak age incidence, that ranged from the second to fourth decades, with an absence of a second peak. Odontogenic keratocysts presenting at the site of the dentigerous cyst were observed in 7 cases (11.5%).     

Prevalence of Ciliated Epithelium in Apical Periodontitis Lesions

Introduction

This article reports on the morphologic features and the frequency of ciliated epithelium in apical cysts and discusses its origin.

Methods

The study material consisted of 167 human apical periodontitis lesions obtained consecutively from patients presenting for treatment during a period of 12 years in a dental practice operated by one of the authors. All of the lesions were obtained still attached to the root apices of teeth with untreated (93 lesions) or treated canals (74 lesions). The former were obtained by extraction and the latter by extraction or apical surgery. Specimens were processed for histopathologic and histobacteriologic analyses. Lesions were classified, and the type of epithelium, if present, was recorded.

Results

Of the lesions analyzed, 49 (29%) were diagnosed as cysts. Of these, 26 (53%) were found in untreated teeth, and 23 (47%) related to root canal–treated teeth. Ciliated columnar epithelium was observed partially or completely lining the cyst wall in 4 cysts, and all of them occurred in untreated maxillary molars. Three of these lesions were categorized as pocket cysts, and the other was a true cyst.

Conclusions

Ciliated columnar epithelium-lined cysts corresponded to approximately 2% of the apical periodontitis lesions and 8% of the cysts of endodontic origin in the population studied. This epithelium is highly likely to have a sinus origin in the majority of cases. However, the possibility of prosoplasia or upgraded differentiation into ciliated epithelium from the typical cystic lining squamous epithelium may also be considered.     

Jaw cysts at children and adolescence: a single-center retrospective study of 152 cases in southern Bulgaria

One hundred fifty two cysts of the upper and lower jaw were examined at patients up to 18 years old treated in the Clinics of Maxillo-Facial Surgery, University Hospital, Plovdiv, Bulgaria for the period 1998 - 2007. Patients were distributed in four age groups (up to 4 years old, from 5 to 9 years old, from 10 to 14 years old, from 15 to 18 years old). Both sexes were constantly affected (52% male, 48% female). The biggest number cystic lesions were found in the third age group (48.7%). The mandible was preferable localization of the lesions (69.7%). Dentigerous cysts predominated (61.8%) - more affected was third age group (31.6%). Radicular cysts were observed two times less (31.6%) - more affected were third (15.8%) and fourth (12.5%) age groups. The most frequently observed clinical symptom was presence of painless swelling (59.9%). The operative interventions were carried out predominantly under general anesthesia (81.6%) by intraoral approach (97.4%). The extraoral surgical approach was preferred in four cases only - three in third and one in fourth age groups.     

Clinicopathologic features of 54 cases of paradental cyst.

OBJECTIVE: The aim of the study was to evaluate the clinicopathologic features of 54 paradental cysts. METHOD AND MATERIALS: The cases were retrieved from the files of the Department of Oral Pathology of the University of S?o Paulo, in Brazil. Only case files that included complete data, radiographs, and clinical history were used for the study. RESULTS: Most of the cysts were adjacent to a partially erupted mandibular third molar; only two cysts were adjacent to mandibular second molars, and one cyst was adjacent to a first molar. Women were affected more often than were men (33:21), and most of the patients were in their second or third decades. In most cases, the affected tooth had a history of one or more episodes of pericoronitis. Histologically, these cysts presented the typical features of an inflammatory cyst, having a lining epithelium, which apparently resulted from a union between reduced enamel epithelium and oral epithelium. CONCLUSION: Development of the paradental cyst could be avoided if episodes of pericoronitis were properly treated, because the cyst is usually related to pericoronitis.     

Retrospective analysis of 31 cases of nasopalatine duct cyst

OBJECTIVE: To perform a retrospective analysis of patients with nasopalatine duct cysts (NPDC) in Brazil and compare with previous analyses. MATERIALS AND METHODS: The files of the Laboratory of Oral Pathology (Minas Gerais Federal University) from 1966 to 1997 were reviewed. Demographic, clinical and histologic data of patients with nasopalatine duct cysts were collected. RESULTS: The mean age of patients with nasopalatine duct cysts at the time of diagnosis was 37.4 years and with a predilection for males. The majority of cases were asymptomatic. Histologically, non-keratinized stratified squamous epithelium alone or in combination with other epithelia was observed in 93% of the cases. Recurrence was not recorded. CONCLUSION: The demographic, histopathological, radiographic, and clinical data of the NPDC in our series are similar to previous studies in other populations.     

Radicular cysts arising from deciduous teeth. Review of the literature and report of 23 cases

Radicular cysts arising from deciduous teeth are rare. 28 such cases have been recorded in the literature since 1898. In this study, we present 23 personally-observed cases of radicular cysts arising from deciduous teeth. The patients' ages ranged from 4 to 12 years with one exceptional case aged 19 years. The M:F ratio was 1.6:1. The mandible was affected more frequently than the maxilla and the deciduous molars were the teeth most commonly involved. 2 of the cysts presented multi-locular radiolucency; in 9 cases, buccal expansion was noticed and in 8 cases, permanent buds were displaced. Caries was the most common etiologic factor in the formation of the cysts. Histologically, cysts in varying stages of development were lined by proliferating non-keratinized stratified squamous epithelium.     

Retrospective analysis of 15 cases of nasolabial cyst.

The nasolabial cyst is classified as a nonodontogenic cyst and is the only nonodontogenic cyst to occur in soft tissue. The aim of this retrospective analysis was to gather demographic, clinical, radiographic, and histopathologic data on the nasolabial cysts described in the files of the Oral Pathology Laboratory of Minas Gerais University School of Dentistry. Fifteen cases were included in the analysis. The mean age of the patients at the time of diagnosis was 42 years, and there was a female predilection. All the cysts were asymptomatic. Pseudostratified columnar (respiratory) epithelium, alone or in combination with other types of epithelium, was present in all cysts. Recurrence was not observed after surgical excision.     

Recurrence of the odontogenic keratocyst in relation to clinical and histological features. A 20-year follow-up study of 72 patients.

Seventy-two patients with 75 primary odontogenic keratocysts have been followed from 6 months to 20 years after the primary treatment. Patients with the nevoid basal cell carcinoma syndrome were not included in the material. Fifty-four patients with 57 primary cysts have been followed for 5 years or more, and 18 patients all having a single primary cyst for less. If the number of primary cysts later recurring was related to the number of primary cysts observed for more than 5 years, a recurrence rate of 51% was found. A diagnosis of recurrence was made in 37 cases within a period of 5 years postoperatively and in 10 cases from 5 to 12 years after the operation. Only two of these patients have been followed with regular intervals for the first 5 years postoperatively. The diagnosis of recurrence was in these two cases made 6 and 8 years after the primary treatment. A postoperative follow-up period of 10 years after the last operation is therefore advocated. The occurrence of microcysts and/or islands of odontogneic epithelium in the cyst membrane of 26 nonrecurring cysts, 25 recurring primary cysts and the last recurrence in 14 patients were compared. There were no statistical differences in occurrence of remnants of odontogenic epithelium in the cyst wall between the three groups.     

The histomorphologic spectrum of the gingival cyst in the adult.

Gingival cysts with clinical manifestations are relatively uncommon lesions. The present study adds thirty-three new cases to the literature and analyzes their clinical and histologic features. The mandibular cuspid and first premolar region was found to be the most common location. The epithelial lining of the cysts was of several types. The most common type was a thin, flattened lining with or without localized thickenings (buds). Other types included nonkeratinized stratified squamous epithelium, keratinized stratified squamous epithelium, and parakeratinized epithelium with palisading basal cells. Gingival cysts should be distinguished from lateral periodontal cysts on the basis of their origin in the gingiva rather than in bone. It appears that most gingival cysts with clinical manifestations are of odontogenic origin.     

The paradental cyst: a clinicopathologic study of 50 cases

The paradental cyst is an odontogenic cyst of inflammatory origin, which occurs on either the buccal, distal, or (rarely) mesial aspects of partially erupted mandibular third molars. In most cases there is an associated history of recurrent pericoronitis. The clinicopathologic features of 50 cases are reviewed. The frequency of the paradental cyst is 3% to 5% of all odontogenic cysts, although we believe its true incidence to be higher. All cases occur in the mandible, and there is a marked preponderance in males. White persons are affected more frequently than blacks. The size of the cysts varies from 1 to 2 cm; they are attached to the cementoenamel junction (CEJ) and the coronal third of the roots. Histologically, they cannot be distinguished from other inflammatory odontogenic cysts. While origin from junctional epithelium or cell rests of Malassez cannot be entirely excluded, we favor an origin from reduced enamel epithelium and suggest that cyst formation occurs as a result of unilateral expansion of the dental follicle secondary to inflammatory destruction of bone and periodontium.     

Clinicopathologic features of nasopalatine duct cysts: A retrospective study in two Brazilian oral and maxillofacial pathology referral centers

Background Nasopalatine duct cyst (NDC) is the most common non-odontogenic cyst in the oral cavity. Clinically it is not difficult to suspect these lesions based on clinical and radiographic appearance. However, the histopathological diagnosis may be difficult due to the broad morphological diversity of these lesions. The objective was to analyze the clinicopathological features of NDCs diagnosed in two oral and maxillofacial pathology services in the Brazilian northeast.Material and Methods A retrospective clinicopathologic study was performed. A total of 18,121 clinical records of oral lesions from two oral and maxillofacial pathology services in Brazil were analyzed (2000-2020). All NDCs cases were revised and demographic, clinical, radiographic, and histopathological data were collected.Results Among 18,121 diagnoses in the oral pathology services, 45 (0.2%) were NDCs. The series comprises 24 males (53.3%) and 21 females (46.7%), with a mean age of 43.2 years-old. Most lesions were asymptomatic (n = 27, 60%) with an mean size of 2.1 cm. Microscopically, the non-keratinized stratified squamous epithelium was the most common (66.7%). However, in 88.9% of cases, the epithelial lining was varied and composed of two or more types of epithelium. There was no significant association between the type of epithelium and the size of the cysts (p = 0.389). Nerve, blood vessels, hemorrhage, and chronic inflammatory infiltrate were commonly observed. In contrast, there was a low frequency of mucous glands, sebaceous glands, cholesterol clefts, and multinucleated giant cells.Conclusions The clinical, radiographic, and microscopic findings observed in this study are similar to those reported in the literature. Due to the morphological diversity of NDC, it is needed to correlate its histopathological features with the clinical and radiographic findings to establish a correct diagnosis. Key words:Oral cavity, oral pathology, nonodontogenic cysts, diagnosis.     

Clinicopathologic study of the postoperative maxillary cyst

Sixty cases of the postoperative maxillary cyst were studied clinicopathologically. The cysts accounted for 19.5% of all oral cystic lesions. Most of the patients were in their 20s and 30s at the time of diagnosis, and the postoperative duration was between 10 and 49 years. Radiographically, most cases revealed a unilocular cystic lesion. In two thirds of the cases, the lesion occupied more than half the volume of the maxillary sinus while the remaining one third of the cases revealed more limited lesions of the sinus. Histopathologically, cuboidal, squamous, and mixed epithelial cyst linings were observed, although the basic epithelial lining was the ciliated columnar type. Epithelial dysplasia was found in two cases. The cysts near the nasal cavity may originate from regenerated nasal mucosa, and the cysts that are located at a distance from the nasal cavity may be lined with epithelium derived from residual mucosa of the sinus entrapped during surgery to relieve sinusitis.     

Odontogenic cysts: a clinical study of 90 cases

The maxillofacial region is affected by a greater number of cysts than any other part of the body. In this study, 90 odontogenic cysts were collected from 90 patients over a five-year period. Patients with radicular cysts, dentigerous cysts and odontogenic keratocysts were further analyzed with regard to age, sex and anatomical distribution. Using the histological classification of the World Health Organization, 53 cases (59%) were classified as radicular cysts, 24 (27%) as keratocysts and 13 (14%) as dentigerous cysts. Radicular cysts occurred most frequently in the anterior region of the maxilla, odontogenic keratocysts in the ramus and angular region of the mandible, and dentigerous cysts in the mandible. No recurrences were observed during the limited follow-up period.     

Pathohistologische Varianten des Befundes Epithel bei 150 Osteotomien unterer Weisheitszähne

Background

The aim of the study was to classify epithelial structures (ES) and to determine the prevalence of cysts associated with mandibular third molars (M₃).

Material and method

Sections of HE-stained soft tissue specimens and panoramic radiographs of 150 consecutive patients undergoing surgical removal of M₃ were evaluated. ES were classified as islands and/or strands of odontogenic epithelium (OE), reduced enamel epithelium (REE), stratified cyst epithelium (SCE), oral mucosa (OM), and pocket epithelium (PE). The diagnostic criteria were defined as a pericoronal translucency >2.5 mm and SCE for dentigerous cysts (DC) and a distal translucency >2.5 mm, SCE, and inflammation for inflammatory paradental cysts (IPC).

Results

Median age was 24.4 years: 23.0 years for 86 (57.3%) female patients and 25.7 years for 64 (42.7%) male patients (p=0.017). ES were found in 95.3%, classified as OE in 53.3%, REE in 34.7%, SCE in 28%, OM in 30.7%, and PE in 10.7%. Both REE and SCE were found in 6%. The total number of cases with REE and/or SCE was 56.7%. Median age of cases with SCE was 28.7 years compared to 20.7 years in cases with REE (p<0.001). Pericoronal translucencies were found in four M₃, of which three were associated with SCE. Distal translucencies were found in 47 M₃, of which 15 were associated with SCE and inflammation. The prevalence was 2% for DC and 10% for IPC.

Conclusions

A differentiated application of histological and radiological criteria enables the prevalence of cystic lesions to be more accurately determined than does the use of one criterion alone.     

Calcifying odontogenic cyst. A review of ninety-two cases with reevaluation of their nature as cysts or neoplasms, the nature of ghost cells, and subclassification.

Ninety-two cases of calcifying odontogenic cyst (COC) were reviewed with special consideration of their nature as cysts or neoplasms, the nature of ghost cells, and classification on the basis of clinicopathologic features. The cases were divided into 79 (85.9%) cysts and 13 (14.1%) neoplasms. The cysts occurred as four variants: (1) nonproliferative COC (35 cases), characterized by a simple unicystic structure; (2) proliferative COC (17 cases), characterized by a cystic structure with multiple daughter cysts, extensive ghost cell formations, and marked tendency for calcification; (3) ameloblastomatous COC (11 cases), characterized by ameloblastoma-like, cyst-lining epithelium with ghost cells and calcifications; and (4) COC associated with odontoma (16 cases), which combined features of COC and odontoma. The neoplasms occurred as three variants: (1) ameloblastoma ex COC (two cases), which showed unifocal and multifocal intraluminal and intramural ameloblastoma proliferating from the COC-lining epithelium; (2) peripheral epithelial odontogenic ghost cell tumor (eight cases), which occurred in the gingiva and resembled peripheral ameloblastoma except for clustered ghost cells in the central portion of epithelial islands and the presence of juxtaepithelial dentinoid; and (3) central epithelial odontogenic ghost cell tumor (three cases). The latter showed ameloblastomatous or adenomatoid odontogenic tumor-like epithelial clusters with ghost cell formation and juxtaepithelial dentinoid. The clinical features of cystic and neoplastic variants were tabulated and described. On the basis of histopathologic features and their immunohistochemical reaction to polyclonal antikeratin antibody, it is suggested that ghost cells might be the result of coagulative necrosis.     

Clinical and histopathological features of nasopalatine duct cyst: A 47-year retrospective study and review of current concepts

Purpose

To evaluate the clinical and histopathological features of nasopalatine duct cysts (NDCs) stored in the archives of a referred Oral Pathology Service over a 47-year-period, and to review current concepts about these cysts.

Immunohistochemical study of jaw cysts: different existence of keratins in odontogenic and non-odontogenic epithelial linings

Keratins and secretory component (SC) were immunohistochemically examined in fresh tissue samples from 45 odontogenic and 35 non-odontogenic cysts. Lining epithelia of almost all cases contained keratins which reacted with polyclonal antibodies (Dako, Bio-Science), and no difference could be found between the two groups of lesions. By staining with two monoclonal antibodies against keratins, i.e., RGE53 (Bio-Science) and RKSE60 (Bio-Science), it was revealed that the epithelia of non-odontogenic cysts, which were columnar epithelium in most cases, had fully and positively reacted with RGE53, while none of the cases was positive for RKSE60. In contrast, the squamous linings of odontogenic cysts except for two cases did not react with RGE53, and few cases possessed RKSE60-reactive keratin. SC was also contradictory. All non-odontogenic cysts exhibited SC. Regarding each pair of non-odontogenic and odontogenic cysts covered with RGE53 and SC-positive, and RKSE60-negative squamous epithelium, it seemed reasonable from the staining results to conclude that the squamous linings were metaplastic from the columnar epithelium. Based on the results, concomitant examinations of SC with keratins will be helpful in deciding the epithelial derivation of jaw cysts.     

Recurrence of keratocysts and decompression treatment. A long-term follow-up of forty-four cases.

Recurrence was found in eight cases (18%) in a group of 44 patients (22 male) with odontogenic keratocysts treated at the Department of Oral Surgery and Oral Medicine, Odense University Hospital, from 1971 to 1983. All these recurrences were found in cysts with parakeratotic, thin, bandlike epithelium with palisade-like basal cells (Forssell group la). In 12 large cysts the use of a polyethylene drainage tube implanted at cystotomy and biopsy some months before primary cystectomy resulted in considerable reduction in the cystic lumen and also in alteration of the thin, fragile cystic epithelium into thick, solid cystic epithelium with no adhesion to the adjoining structures. No recurrence was seen in these 12 patients after an observation period of between 7 and 17 years. The decompression treatment seems to reduce the tendency to recurrence of the odontogenic keratocyst, which is far more important than the advantages to the surgeon of surgical simplicity and safety, and to the patient of less discomfort and pain.