顎骨動脈瘤性骨嚢胞：臨床病理学的研究

Aneurysmal Bone Cyst of the Jaws: Clinicopathological Study.

抄録

目的:

本研究の目的は、顎の動脈瘤性骨嚢胞（ABC）の臨床的、X線学的、病理組織学的特徴を解析することである。

AIM: The aim of the present study was to analyze clinical, radiological and histopathological features of aneurysmal bone cysts (ABCs) of jaws.

材料と方法:

口腔病理学教室に保存されている2009年から2012年までのアーカイバルデータを検索し、過去にABCと診断された全症例の臨床病理学的特徴を詳細に分析した。

MATERIALS AND METHODS: Archival data from 2009 to 2012 present in the Oral Pathology Department was retrieved and clinicopathological features of all the cases which had been previously diagnosed as ABC were analyzed in detail.

結果:

10歳から50歳までの7症例が含まれ、そのうち最大（5/7）は20歳未満であった。男女比は3:6、上顎と下顎では1:6であった。腫脹と疼痛が最も一般的な症状であった。レントゲン写真上、病変は多彩であったが、多眼性、境界明瞭、骨膨張、穿孔が最も多く観察された。病理組織学的解析の結果、1例は骨化性線維腫、2例は海綿状の若年性骨化性線維腫であった。また、間質、巨細胞、血管の性質、骨破壊、穿孔、オステオイドや石灰化物質の存在などの特徴も認められた。本研究では、若年性骨化性線維腫の海綿状型が2例認められたが、これはまれな所見である。

RESULTS: Seven cases ranging in age from 10 to 50 years were included, in which maximum (5/7) cases were below 20 years. Ratio of presentation of lesion in male to female and in maxilla to mandible was 3:6 and 1:6 respectively. Swelling and pain were the most common presenting features. Variable presentation of the lesion was observed radiographically; although multilocular, well defined, bone expansion and perforation were the most common observations. Histopathological analysis revealed association of one case with ossifying fibroma and two cases with trabecular variety of juvenile ossifying fibroma. Predominance of solid variety was noted and other features like stroma, giant cells, nature of blood vessels, bone destruction and perforation and presence of any osteoid or calcified material was also accounted for. The current study showed association of two cases with trabecular variety of juvenile ossifying fibroma, which is a rare finding.

結論:

顎のABCは、このように診断の難しい様々なパターンを示す。したがって、患者の治療計画に影響を及ぼす他の病変との関連を確認するためには、切開/切除組織の徹底的な検査が必要である。

CONCLUSION: ABCs of jaws, thus have varying patterns of presentation which are diagnostically challenging. A thorough examination of the incisional/excisional tissue is thus required to confirm the association with any other lesion which will affect the treatment plan for the patient.