Odontogenic myxoma : clinicopathological and immunohistochemical analyse of 67 cases / Mixomas odontogenicos : analise clinicopatologica e imunohistoquimica de 67 casos

AUTOR(ES)
DATA DE PUBLICAÇÃO

2005

RESUMO

The aim of this study was to analyze the immunohistochemical profile and clinical, radiographical and histopathological characteristics of 67 cases of odontogenic myxoma (OM), as well as to report the greatest series related in the world literature. Females were more affected with 48 cases (71,64%) whereas males were in 19 (26.83%), male-female ratio 1:2.5. The patient?s age ranged from 10 to 84 years (mean 32,7 years). The most frequent site affected was mandible with 27 cases (40,29%). Clinically, 29 cases (43,28%) of OM were asymptomatic, 9 cases (13,43%) presented pain and another 9 (13.43%) showed swelling. Radiographically, we disposed of clinical information in 47 cases, of which 29 (43,28%) cases were radioluced lesions and 18 (26,86%) were described as mixed/multilobular lesions of honey/comb or soap/bubble appearance. Microscopically, OM was constituted by a myxomatous background with spindle-shaped and stellate cells. Mitoses and pleomorphism were absent. Epithelium was present in 6 (8,95%) cases and 16 (23.88%) presented dystrophic calcifications. Immunohistochemical analyses revealed that 27 cases (40.29%) were positives for mast cell (clone AA1) and 19 (28,35%) positives for toluidine blue. Thirteen cases (19,47%) were positives for the antibody PAN CK AE1/AE3 and CK 14 respectively. Only 2 cases (2,98%) were positives for CK 19 suggering an possible odontogenic origin. The spindle-shaped and stellate cells showed positivity for vimentin in 67 cases, 27 cases (40,29%) for ?-smooth muscle actin positives and 6 (8,95%) for desmin. All 67 cases were S-100 and CK 8 negatives. Twenty cases (29,85%) were immunopositives for CD-34, demonstring multiples blood vessels. Expression of the marker of cellular proliferation Ki-67 was low, being present only in two cases. Based on these findings, we can suggest that OM probably derives from mesenchymal elements, possibly modified fibroblasts with miofibroblastic diferentation, and that others nomenclatures as mixoma of the jaws could be suggest for this lesion

ASSUNTO(S)

tumors imunohistoquimica immunohistochemistry tumores

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