The Korean Journal of Oral and Maxillofacial Pathology (대한구강악안면병리학회지)

Korean Academy of Oral and Maxillofacial Pathology (대한구강악안면병리학회)
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Immunohistochemical Array Analysis of Cemento-Ossifying Fibroma Exhibiting aneurysmal Cystic Changes

백악-골화섬유종에서 보이는 동맥류성 낭종변화의 면역조직화학염색 배열분석

  • Lee, Sang Shin (Department of Pathology, College of Dentistry, Gangneung-Wonju National University, Research Institute of Oral Science) ;
  • Kim, Yeon Sook (Department of Dental Hygiene, College of Health Sciences, Cheongju University) ;
  • Lee, Suk Keun (Department of Pathology, College of Dentistry, Gangneung-Wonju National University, Research Institute of Oral Science)
  • 이상신 (강릉원주대학교 치과대학 병리학교실 및 구강과학연구소) ;
  • 김연숙 (청주대학교 보건의료과학대학 치위생학과) ;
  • 이석근 (강릉원주대학교 치과대학 병리학교실 및 구강과학연구소)
  • Received : 2018.11.29
  • Accepted : 2018.12.14
  • Published : 2018.12.31
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Abstract

A 31 years old female had been suffered from a bony swelling in right premolar region of the mandible for 12 years, recently grown rapidly. A fistula tract developed on the right anterior mandibular border, but the lesion was relatively asymptomatic. In the radiological examination, the tumor mass was irregularly mixed with radiolucent and radiopaque areas, forming multiple cystic spaces. Under the diagnosis of calcifying odontogenic cyst, the mandibular mass was resected and examined pathologically. After decalcification, the dissected tumor mass showed multiple small cystic spaces and calcifying fibrous tissue, mimicking calcifying odontogenic cyst or ameloblastoma. Histological observation showed many calcifying cementoid materials and ossifying trabeculae. The cystic spaces were turned out to be dilated vascular channels lined by endothelial cells, containing plasma fluid. However, the main lesion was diagnosed as cemento-ossifying fibroma (COF), and the atypical vascular channels were greatly dilated and gradually expanded the whole tumor mass. The present COF was examined through immunohistochemical (IHC) array, and investigated for tumor cell characteristics, exhibiting abnormal ossification and aneurysmal cystic changes. IHC array disclosed that the tumor cells grew progressively in the lack of apoptosis, and that they showed lower expression of RUNX2 than BMP-2, RANKL, and OPG, and increases of protein expression in $HIF-1{\alpha}$, VEGF-A, and CMG2. These data suggested that the reduced expression of RUNX2, osteoblast differentiation factor, be relevant to abnormal ossification of COF, and that the consistent expressions of angiogenesis factors be relevant to de novo angiogenesis in COF, subsequently resulted in aneurysmal cystic changes.

Keywords

Acknowledgement

Supported by : Gangneung-Wonju National University

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