Is maspin immunolocalization a tool to differentiate central low-grade mucoepidermoid carcinoma from glandular odontogenic cyst?

Department of Oral Pathology and Oral Medicine, School of Dental Medicine, Tel Aviv University, Tel Aviv 69978, Israel.
Acta histochemica (Impact Factor: 1.71). 06/2009; 112(2):161-8. DOI: 10.1016/j.acthis.2008.10.006
Source: PubMed


Mucoepidermoid carcinoma (MEC) of the salivary glands has a low-grade variant (LGMEC), which may be found within the jawbones. LGMEC shares a number of histopathological similarities with glandular odontogenic cysts (GOC) of the jawbones. Maspin has been identified in several benign and malignant salivary gland neoplasms. We investigated the immunolocalization of maspin in LGMEC and GOC and evaluated its potential to distinguish between these two entities. Cases of LGMEC (n=6), GOC (n=8) and various odontogenic cysts with marked mucous metaplasia (OCMM, n=7), which served as controls, were immunohistochemically labeled for the binding of an antibody directed against maspin. Immunomorphometry was performed separately for maspin-immunopositive epithelial cells and epithelial-mucous cells in either their nuclear or cytoplasmic compartments. Results were presented as the volume fraction (Vv) of each element. The Vv of the maspin-immunopositive epithelial-mucous cytoplasm and nuclei was significantly higher in LGMEC than in GOC and OCMM (p<0.001 and p=0.026, respectively). In the epithelial cells, no significant differences were observed among the lesions (p>0.05). It is suggested that the high levels of maspin in the epithelial-mucous cells (in both cytoplasm and nuclei) in LGMEC may serve as a tool to distinguish it from GOC. This may be useful especially in equivocal cases and in small incisional biopsy samples.

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    • "This cyst is lined by stratified squamous epithelium with variable thickness and surface cuboidal or columnar ciliated cells. Small microcysts and clusters of mucous cells are also depicted [10]. Islands, resembling intraosseous MEC, were noted in the GOC wall; which may possibly cause diagnostic drawback [9]. "
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    ABSTRACT: Intraosseous mucoepidermoid carcinoma is a rare tumor which affects women more than men and is more common in the mandible. The radiological examination reveals a well-defined unilocular or multilocular radiolucent lesion. This tumor may resemble a glandular odontogenic cyst, particularly in incisional biopsies. The accurate diagnosis of these lesions is imperative because the subsequent treatment of each lesion would be different. The purpose of this study is to report two cases of intraosseous mucoepidermoid carcinoma and explicate the differentiating criteria of this lesion from the glandular odontogenic cyst.
    06/2014; 15(2):86-90.
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    • "It has been suggested the use of Ki67 to distinguish GOC from CMEC [25]. Vered et al. [26] found levels of MASPIN (mammary serine protease inhibitor) significantly higher in the epithelial-mucous cells of CMEC than in GOC, that may help the differential diagnosis. Another marker was p63; immunostaining showed that this protein was confined to the basal and parabasal layers of the epithelium, with stained cells composed between 5% and 50% of the total [27]. "
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    ABSTRACT: The glandular odontogenic cyst (GOC) was a rare jawbone cyst described in 1988 as a distinct entity. This lesion can involve either jaw, and the anterior region of the mandible was the most commonly affected area. Clinical and radiographic findings were not specific, and the diagnosis of GOC can be extremely difficult due to the rarity of this lesion. The cyst presented a wall constituted by fibrous connective tissue and was lined by a non-keratinized stratified squamous epithelium of variable thickness. Large areas of the lining epithelium presented cylinder cells, sometimes ciliated. A variable amount of mucina was occasionally noted. Due to the strong similarities, this cyst can be easily misdiag-nosed as a central mucoepidermoid carcinoma (CMEC). Immunohistochemistry may be an aid in diagnosis; in fact has been demonstrated that there were differences in the expression of cytokeratins (CK) in GOC and CMEC. In this study, we reported a new case of GOC in a 38 year female patient. In addition, we carried out a review of 110 previous cases reported in literature.
    The Open Dentistry Journal 02/2014; 8(1):1-12. DOI:10.2174/1874210601408010001
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    • "According to Toida et al. (1994) it is important to differentiate GOC from central mucoepidermoid carcinoma (MEC), particularly the low-grade and predominantly cystic type. Vered et al. (2010) report that, in cases for which the differential diagnosis of GOC or central MEC cannot be made based on morphological features alone, especially when the biopsy sample is small, extensive maspin immunolabeling in the epithelial-mucous cells (in both the cytoplasm and nuclei) may be used as a tool to favour the diagnosis of central MEC over GOC. These lesions share some histopathological features, but have a wide range of biological behaviour that may differ among lesions of the same type, and among different types of lesions. "
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    ABSTRACT: The glandular odontogenic cyst (GOC) is an uncommon jaw bone cyst of odontogenic origin with unpredictable and potentially aggressive behaviour. It also has the propensity to grow to a large size and tendency towards recurrence. GOC can be easily misdiagnosed microscopically as a central mucoepidermoid carcinoma. This paper reports a case of GOC in a 56-year-old male and reviews the main criteria for accurate diagnosis. The diagnosis of GOC can be extremely difficult due to the rarity of the cyst and lack of clear diagnostic criteria.
    Journal of cranio-maxillo-facial surgery: official publication of the European Association for Cranio-Maxillo-Facial Surgery 03/2011; 40(2):e46-50. DOI:10.1016/j.jcms.2011.03.018 · 2.93 Impact Factor
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