Adenoid ameloblastoma revisited: A discursive exploration of its histological dualism, molecular aberrations, and clinical recurrence.

IF 2.9 3区 医学 Q2 MEDICAL LABORATORY TECHNOLOGY Seminars in Diagnostic Pathology Pub Date : 2024-10-08 DOI:10.1053/j.semdp.2024.10.001
Dr Sakshi Deorah, Dr Shalini Gupta
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Abstract

Adenoid ameloblastoma (AA) is a rare benign but locally aggressive odontogenic tumor originating from the remnants of the dental lamina or enamel organ. It was newly incorporated into the 2022 WHO classification of odontogenic lesions, standing as the sole novel entity in this update. AA is also regarded as a hybrid tumor because of the combination of histological characteristics observed in both adenomatoid odontogenic tumors and ameloblastoma. Clinically, it presents similarly to other ameloblastoma variants, with patients typically exhibiting a painless, slow-growing jaw swelling. However, this subtype is noted for its more aggressive behavior, including a higher recurrence rate and greater local invasiveness. Histopathologically, AA is distinguished by an intricate arrangement of epithelial islands, cords, and strands, generating a cribriform architectural pattern, with peripheral palisading and central stellate reticulum-like formations. Immunohistochemical profiling reveals the expression of epithelial differentiation markers, including cytokeratins, and proliferative markers such as Ki-67, further corroborating its aggressive phenotype. While its precise etiopathogenesis remains obscure, the unique histological characteristics imply a potentially distinct underlying molecular pathway. Due to its aggressive nature, AA necessitates meticulous clinical and histopathological evaluation and tailored therapeutic strategies to mitigate recurrence risks and optimize patient prognoses. Furthermore, this review integrates histological and molecular insights from recent studies conducted after its inclusion in the updated WHO classification.

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腺样绒毛膜母细胞瘤再探:对其组织学二元论、分子畸变和临床复发的辨证探索。
腺样釉母细胞瘤(AA)是一种罕见的良性但具有局部侵袭性的牙源性肿瘤,起源于牙层或釉质器官的残余部分。它被新纳入 2022 年世界卫生组织牙源性病变分类,是此次更新中唯一的新实体。AA 也被认为是一种混合瘤,因为它结合了在牙源性腺瘤和釉母细胞瘤中观察到的组织学特征。在临床上,它的表现与其他釉母细胞瘤变体相似,患者通常表现为无痛、生长缓慢的下颌肿胀。不过,这种亚型的侵袭性更强,包括复发率更高、局部侵袭性更强。从组织病理学角度看,AA 的特征是上皮岛、索和股的复杂排列,形成楔形的建筑模式,外围有苍白化,中央有星状网状结构。免疫组化分析显示,包括细胞角蛋白在内的上皮分化标志物和 Ki-67 等增殖标志物均有表达,进一步证实了其侵袭性表型。虽然其确切的发病机制仍不明确,但其独特的组织学特征意味着其潜在的分子途径可能与众不同。由于其侵袭性,AA 需要细致的临床和组织病理学评估以及量身定制的治疗策略,以降低复发风险并优化患者预后。此外,本综述还整合了AA被纳入最新WHO分类后最新研究中的组织学和分子学观点。
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来源期刊
CiteScore
4.80
自引率
0.00%
发文量
69
审稿时长
71 days
期刊介绍: Each issue of Seminars in Diagnostic Pathology offers current, authoritative reviews of topics in diagnostic anatomic pathology. The Seminars is of interest to pathologists, clinical investigators and physicians in practice.
期刊最新文献
Current challenges in breast pathology. Adenoid ameloblastoma revisited: A discursive exploration of its histological dualism, molecular aberrations, and clinical recurrence. Salivary gland-like tumors of the breast: Histopathologic and genetic features with clinical implications. Calcifying cystic odontogenic tumour: Dilemma and pitfalls. Spectrum of atypical ductal hyperplasia (ADH) and ductal carcinoma in-situ (DCIS): Diagnostic challenges.
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