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目的探讨牙源性腺样瘤的临床表现、病理形态特点和鉴别诊断要点。方法收集本院口腔科2000年1月至2010年6月牙源性腺样瘤住院患者8例,对其临床、影像学、病理形态及免疫组织化学资料进行分析及文献复习。结果本组病例女性5例,男性3例,年龄14～27岁,平均20岁。发生上颌骨5例,下颌骨3例。临床主要表现为局部无痛性膨隆肿胀及其引起的面部不对称畸形,X射线表现病变呈单房性透明阴影且常见不透光的钙化颗粒,有似牙形态的密度增高团块。主要病理学改变:肿瘤平均直径4.0 cm,包膜完整,以囊性病变为主,囊壁上有砂粒状小结,囊内含胶冻样的液体和未萌出的牙齿;肿瘤主要由上皮细胞和少量间质成分组成,增生瘤细胞可形成实性细胞巢、腺管状结构、梁状或筛状结构,细胞间有多少不等、形状不规则的嗜伊红均质物伴灶性钙化。免疫组织化学染色上皮性瘤细胞CK、p63阳性,间质成分Vimentin阳性。结论牙源性腺样瘤为一种特殊类型牙源性良性肿瘤,好发于上颌骨,临床易误诊为造釉细胞瘤或含牙囊肿,术前活检和术中冰冻可明确诊断,有助于临床手术方案选择。
Objective To investigate the clinical manifestations, pathological features and differential diagnosis of odontogenic adenoid. Methods Eight patients with odontogenic adenoid inpatients from January 2000 to June 2010 in our hospital were collected and their clinical, radiological, pathological and immunohistochemical data were analyzed and reviewed. Results The group of female patients in 5 cases, 3 males, aged 14 to 27 years, mean 20 years. 5 cases occurred in the maxilla, mandible in 3 cases. The main clinical manifestations of local painless swelling and swelling of the face caused by asymmetric facial deformities, X-ray lesions showed single-chamber transparent shadows and common opacity of calcified particles, like the density of the tooth-like clumps. The main pathological changes: the average diameter of the tumor 4.0 cm, complete capsule to cystic lesions, wall-gritty nodules, cystic jelly-like liquid and did not erupt teeth; tumor mainly by the epithelial cells and A small amount of interstitial components, the proliferation of neoplastic cells can form solid cell nests, glandular tubular structure, beam or sieve-like structure, how many cells between the irregular shape of eosinophil homogenate with focal calcification. Immunohistochemical staining epithelial tumor cells CK, p63 positive, interstitial component Vimentin positive. Conclusions Odontogenic adenoid adenoidoma is a special type of odontogenic benign tumor, which occurs in the maxilla. It is often misdiagnosed as ameloblastoma or dental cyst in clinic. Preoperative biopsy and intraoperative frozen can confirm the diagnosis. Clinical surgical options.