口腔淋巴上皮囊肿3例报道

对3例口腔淋巴上皮囊肿进行临床病理分析,该囊肿的好发部位为口底,临床上常诊断为黏液腺囊肿等囊性疾病。镜下观察淋巴上皮囊肿以囊壁内衬复层鳞状上皮及纤维囊壁存在大量淋巴样组织为其特点。目前认为。口腔淋巴上皮囊肿可能来源于舌下腺或小唾液腺分泌管。由于慢性刺激,分泌管上皮发生鳞状化生,化生上皮的腔面细胞脱落后引起周围淋巴细胞浸润,表现为淋巴上皮囊肿。本文结合文献进行讨论,为类似病例的预防和诊断提供参考,为临床诊断和治疗提供借鉴。     

Recurring anterior facial swelling

The nasolabial cyst was first reported in 1882. The most common clinical finding of the nasolabial cyst is that of an asymptomatic soft tissue swelling involving the canine fossa/nasal alar base region. The pathogenesis is controversial, but this cystic lesion most likely develops from the nasolacrimal duct. Microscopically, this cystic structure is composed of a fibrous capsule with an unremarkable layer of pseudostratified columnar epithelium. The treatment of choice is surgical excision, after which recurrence is rare.     

CT analysis of a complicated nasopalatine duct cyst

A study was conducted to evaluate CT imaging in differentiating nonodontogenic nasopalatine duct cysts from odontogenic radicular cysts. The patient's palatine cystic lesion was analyzed by CT and excised with postoperative microscopic identification. CT findings of a nasopalatine cyst are midline location, smooth expansion with sclerotic margins and displacement of teeth apices. Radicular cysts differ in that the teeth apices are within the cyst rather than being displaced. We concluded that differentiation is clearly demonstrated by CT images.     

How to name it: a rare case of odontogenic cyst

Odontogenic cysts and tumors are well-recognized entities to the specialist oral pathologist and they seldom pose problems in differential diagnosis. This paper deals with an aggressive cystic lesion in the maxilla of a 65-year-old male that was characterized by a large radiographically multilocular lesion and a multicystic pattern microscopically. The categorization of this lesion was complicated by the presence of features suggestive of both glandular odontogenic cyst and cystic ameloblastoma with aggressive histologic phenotypes.     

Cystic lesion of the parotid following drug-induced toxic epidermal necrolysis (Lyell''s syndrome)

A 32-year-old woman developed a unilateral cyst of the duct of parotid gland 4 months after severe oral involvement of drug-induced toxic epidermal necrolysis (TEN). The pathomechanism leading to the TEN epidermal destruction had presumably involved the salivary epithelium as well, leading to the development of the cystic lesion. The patient had low serum lipase levels, but high serum amylase levels at the time of TEN. These serological markers could represent a clue for the risk of developing cystic lesions of the large salivary glands following TEN.     

Adenoid cystic carcinoma associated with salivary duct cyst in the sublingual gland

We described an extremely rare case of adenoid cystic carcinoma associated with salivary duct cyst in the sublingual gland of a 40-year-old Japanese woman. The tumor was growing from the cyst wall and almost occluded the cyst lumen. The epithelium lining the cyst lumen contained both keratin 19-positive cells and alpha-smooth muscle actin-positive cells, indicating the cyst being derived from the acinus/intercalated duct of the sublingual gland. Therefore, our case has presented for the first time a direct evidence that adenoid cystic carcinoma arises from acinus/intercalated duct.     

Extensive nasopalatine duct cyst causing nasolabial protrusion

In this report, we show a case of the extensive nasopalatine duct cyst showing remarkable nasolabial protrusion. CT and MR examinations showed remarkable expansion of the extraosseous part of the lesion toward anterior and lateral sides, and this finding is considered to show the rather aggressive nature of this common cystic lesion after penetration of the maxillary cortex.     

Immediate dental implant failure associated with nasopalatine duct cyst

This case report presents an analysis of the clinical, radiographic, and histological features of a peri-implant lesion around an implant placed immediately after extraction of a tooth with a periapical lesion. A 52-year-old man received an immediate implant (3.75 x 11.5 mm2) placed in the anterior region of the maxilla. Three years after implant placement, the patient presented with swelling in the anterior portion of the maxilla. Radiographic examination showed a well-circumscribed radiolucency around the implant. The implant and the lesion were removed and fixed in 10% buffered formalin and processed. Histological analysis showed 3 types of epithelium: respiratory, cuboidal, and non-keratinized stratified squamous. In the cyst wall peripheral nerves, arteries, veins, and chronic inflammation were present. The diagnosis was nasopalatine duct cyst. We concluded that the nasopalatine duct cyst can develop in association with dental implants. Clinically, the lesion is similar to the classical nasopalatine duct cyst. Histological analysis should be mandatory in all cases of peri-implant lesions and in all dental periapical lesions before immediate implant placement.     

Microcystic lateral parodontal cyst. Report of a case

The lateral periodontal cyst (LPC) is an odontogenetic lesion of the maxillary bone representing about 0.8% of maxillary cystic lesions. It starts in the lateral periodontal area of a vital erupted tooth. Clinical symptoms are generally absent. Its diagnosis usually can be made on the basis of an occasional radiographic examination which shows an osteolytic monoloculate lesion with defined outlines. The botryoid cyst is a variation of LPC and is radiographically different and more aggressive than the common LPC. A clinical case of LPC which allows to make histopathological and clinical considerations on these cystic lesions is described.     

Calcifying odontogenic cyst

Summary The calcifying odontogenic cyst designated by Gorlin et al. in 1962 is a cystic lesion of the odontogenic origin which is characterized histologically by keratinizing ghost cell and its calcification. Recently, neoplastic potential of this lesion has been pointed out by several investigators and this lesion has been considered to be a borderline lesion between cyst and tumor. From the view point of neoplastic potential of this lesion, we evaluated 8 cases of calcifying odontogenic cyst encountered in our hospital within 12 years from 1972 to 1984. Our cases were divided into two types, cystic and proliferative. Clinical differential diagnoses of the cystic type were globulomaxillary cyst, primordial cyst and cystic odontoma, while those of the proliferative type were ameloblastoma and calcifying epithelial odontogenic tumor. There wre 2 cases of the proliferative type among all the cases. One of them was recurrent lesion with 20 years' duration. We agreed to the designation of “calcifying ghost cell odontogenic tumor”, proposed by Fejerscov and Krogh, rather than calcifying odontogenic cyst. Furthermore, we propose to sub-classify it into cystic type and proliferative type.     

Cystic degeneration in fibrous dysplasia of the jaws: a case report.

A case of nonspecific cystic degeneration complicating fibrous dysplasia of the mandible is presented. This condition is extremely rare in the jaw bones. The patient had a painless swelling of the right face measuring 10 cm in diameter, and there was no history of trauma. Radiographs showed a poorly defined, "ground glass" radiopaque lesion; a central well-defined cyst was confirmed by means of computed tomography. During surgery, a large cystic cavity with surrounding, soft fibrous bone that merged with the cortex was observed. Histologic examination showed a large non-epithelial-lined cystic cavity with a surrounding fibro-osseous lesion, which was consistent with a diagnosis of fibrous dysplasia.     

Echographic evaluation of bone lesions of endodontic origin: report of two cases in the same patient

We report on two periapical lesions of endodontic origin detected in the maxillary bone of the same patient, whose echographic examination was used to address a tentative differential diagnosis between a granuloma and a cystic lesion. The patient on whom two periapical lesions were diagnosed with clinical and conventional radiographic findings and scheduled for endodontic surgery, was also examined using echography and color power doppler at the site of the lesions. The lesions were echographically described in each case according to a scheme from a previous work. A tentative differential diagnosis between a cystic lesion and a granuloma was made. One lesion was described as a cyst, the other as a granuloma. After surgical excision, the lesions were examined under light microscopy. In both cases the two echographic diagnoses were confirmed by the histopathologic examination.     

Early unicystic ameloblastoma: report of case.

The occurrence of an atypical cystic lesion of the mandible in a 13-year-old boy is described. At first, a diagnosis could not be made. The biopsy specimen showed features resembling an ordinary follicular cyst, together with areas in which distinct alterations in the epithelium were noticed. These alterations seemed to be in accordance with findings of Vickers and Gorlin in cases of early or unicystic ameloblastoma. The lesion was treated by enucleation. After almost three years, no recurrence has been noticed. Long-term follow-up care is necessary. The case illustrates the obvious need for meticulous histologic examination of every cystic lesion of the jaw.     

Well-defined radiolucent area involving the anterior maxilla

An example of a large and symptomatic nasopalatine duct cyst is presented. This cyst is the most common type of developmental or fissural cyst occurring in the maxilla. Treatment for most patients is conservative surgical excision. The excised tissue should be submitted for histopathologic examination to establish a definitive diagnosis and to rule out the possibility of a more serious lesion.     

A unique location of branchial cleft cyst: case report and review of the literature

Branchial cleft cysts (BCC) are benign lesions caused by anomalous development of the branchial apparatus. This case report describes a 63-year-old woman with a 12 cm × 12 cm sized cystic mass located anterior to the manubrium sternum and sternum. MRI revealed a cystic lesion with a sinus tracking to the piriform sinus. Postoperative histopathological examination confirmed the diagnosis of branchial cleft cyst. Because of the course of the sinus track, it is believed that this was a fourth branchial cleft cyst. These are the rarest of the branchial anomalies, and extension below the peri-thyroid region is very infrequently described. When this extension occurs, it is always post-sternal into the mediastinum, and the pre-sternal presentation here appears to be unique. A review of the relevant literature was performed to summarize the clinical features of fourth branchial cleft cyst and to identify the best options for diagnosis and treatment.     

A huge midline premaxillary cyst as a late complication of maxillary surgery

A median palatal cyst is an uncommon nonodontogenic cyst, and patients usually present with a painless swelling or the sensation of a mass. The mass is typically a well-defined fixed swelling along the midline. The mass can cause slight elevation of the nasal floor or swelling and drainage from the hard palate. Surgical resection is usually recommended as a definite treatment.We treated a 30-year-old man with a premaxillary mass with nasal obstruction. He had undergone surgery on both the maxilla and the mandible to correct malocclusion 10 years earlier. A physical examination revealed elevated mucosa of the nasal floor, resulting in near-total obstruction of the nasal cavity, and the gingival mucosa over the upper incisors was also swollen. Preoperative computed tomographic scan demonstrated a midline nonenhancing round cystic lesion in the premaxillary area. Surgical excision was performed via a sublabial approach under general anesthesia, and his recovery after surgery was uneventful.     

Periapical cyst repair after nonsurgical endodontic therapy--case report

This article presents the procedures that must be considered for periapical cyst repair after nonsurgical endodontic treatment. The case of a periapical cyst associated to the left maxillary lateral incisor is reported. Nonsurgical root canal therapy was performed and lesion healing was confirmed radiographically after 24 months. Differential diagnosis, endodontic infection control, apical foramen enlargement and filling of the cystic cavity with a calcium hydroxide paste were important procedures for case resolution.     

Malignant cyst of the lateral aspect of the neck: branchial cleft carcinoma or metastasis?

A 58-year-old man had a left jugulodigastric mass, which was found to be cystic by computed tomography, and no evidence of other lesions. Grossly and histologically, the surgical specimen consisted of a thin-walled, fluid-filled cyst lined by squamous epithelium that varied in appearance from benign to invasive squamous cell carcinoma. The findings supported a differential diagnosis of branchial cleft carcinoma (BCCA) versus cystic growth of a lymph node metastasis from an occult malignancy. On this basis, guided biopsies of the upper aerodigestive tract were performed, with strong suspicion of a tonsillar bed lesion. Microscopic examination revealed the primary tumor within tissue excised from the left tonsillar fossa. Comparison of the current case with cases of BCCA and cystic tonsillar metastases from the literature illustrated the potential pitfalls in rendering a diagnosis of BCCA. Recognition of this lesion as a distinctive clinical variant of oropharyngeal carcinoma is warranted.     

Inflammatory follicular cyst associated with an endodontically treated primary molar: a case report

This is a case study of an inflammatory follicular cyst associated with an endodontically treated deciduous molar with radiographic and microscopic diagnosis. This cystic lesion represents a typical follicular cyst that arose in association with periapical inflammation from a non-vital deciduous molar and involved the follicle of the unerupted successor premolar. This paper describes the case and discusses diagnosis, histogenesis, and controversies regarding terminology.     

Calcifying epithelial odontogenic tumor of the mandible with cyst formation

We encountered a rare case of a calcifying epithelial odontogenic tumor with cyst formation. The patient was a 28-year-old man with swelling in the anterior mandibular region. Panoramic and intraoral imaging showed a clear, unilocular, radiolucent lesion with bony boundaries. Many small radiopacities were apparent in the radiolucent area. Clinically, the lesion was thought to represent an odontogenic tumor involving calcified bodies. Multidetector row computed tomography showed small radiopaque bodies arranged in a regular circular manner on the outer rim of the radiolucent region, which showed an attenuation value of approximately +20 Hounsfield units. This appearance strongly suggested a calcifying cystic odontogenic tumor, and the final diagnosis was a calcifying epithelial odontogenic tumor with cyst formation. According to the 2005 World Health Organization Classification of Tumours, cystic changes are not seen macroscopically in calcifying epithelial odontogenic tumors. We thus consider this to be a very rare and interesting case.