腺性歯原性囊胞の2例−WHO新診断基準の有用性

• Published in: 日本口腔外科学会雑誌 Vol. 66; no. 7; pp. 317 - 323
• Main Authors: 石井, 宏昭, 岡田, 奈穂子, 美島, 健二, 野中, 咲, 水書, 智子, 笠原, 英生
• Format: Journal Article
• Language: Japanese
• Published: 社団法人 日本口腔外科学会 20.07.2020
• Subjects: 歯原性囊胞; 腺性歯原性囊胞
• ISSN: 0021-5163; 2186-1579
• DOI: 10.5794/jjoms.66.317

Glandular odontogenic cysts (GOCs) are rare, accounting for 0.2% of all odontogenic cysts. In 1992, WHO classified a GOC as a developmental odontogenic epithelial cyst. It was classified in the same category in the WHO new classification in 2017, but its histological diagnostic criteria have changed.　We describe two cases of GOC occurring in the mandible and compare the new standards with the old standards using the two cases we experienced.　The new WHO classification has shown that a confident diagnosis of GOC can be made when at least 7 of 10 specific criteria are present. The condition that ‘there is no inflammatory infiltrate present within the connective tissue’ was deleted from the old classification and replaced by three new criteria. Two of the three criteria:‘intraepithelial microcysts’ and ‘multiple cystic compartments, which are sometimes present,’ focus on the assessment of early lesions. And one criterion:‘apocrine metaplasia of the luminal cells,’ is presumed to be an evaluation of differentiated cells. This has led to more accurate discrimination between GOC and other cysts and tumors, because mucous cells can be found in radicular cysts.　Our two cases satisfy all three of the new criteria, which are expected to also be useful in clinical practice.