Histochemical evaluation of stromal components in fibrous dysplasia, central ossifying fibroma and juvenile ossifying fibroma affecting the jaw bones

 
 
 
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  • Abstract


    Background: Oral Pathologists often come across fibro-osseous lesions involving the jaws with intersecting clinico-pathologic features which makes their diagnosis challenging. Due to the difference in their pathogenesis, the treatment varies and so does the prognosis which makes differentiation essential.

    Objectives: This study intended to evaluate the stromal components of fibrous dysplasias, central and juvenile ossifying fibromas affecting the jaw bones using histochemical stains and to determine the histological parameters important for their differentiation.

    Methods: Three sections each of forty-seven formalin-fixed decalcified paraffin-embedded tissues were stained with three special stains (Modified Tetrachrome, Modified Attwoods and Potassium-monopersulfate aldehyde fuschin stain) and analysed for morphology and structure of calcifications, osteoblastic rimming, cellularity and vascularity of the stroma, collagen pattern and oxytalan fibers.

    Results: Despite the overlap in the histopathological features, few parameters were more pertinent to one lesion than the others. Fibrous dysplasia cases had characteristic thin curvilinear calcifications which were discontinuous whereas central and juvenile ossifying fibromas had broader calcifications which were interconnected. The structure of calcifications was mostly woven in fibrous dysplasia but few longstanding cases did show lamellar bone. The cellularity and vascularity was considerably higher in ossifying fibromas than fibrous dysplasia. Oxytalan fibers were more evident in cases of ossifying fibromas.

    Conclusion: Histopathological analysis alone may not suffice for the diagnosis of fibro-osseous lesions due to the apparent similarity, thus stressing on the importance of radiologic and genetic analysis in the diagnosis of fibro-osseous lesions.


  • References


    1. Nwizu NN, Aguirre A, Chen F (2010) Diagnostic challenges of benign fibro-osseous lesions and psammomatous meningiomas of the craniofacial region: a comparative review of their clinico-pathological features. North American Journal of Medical Sciences. 3(1), 17-23.
    2. Ralis ZA, Watkins G (1992) Modified tetrachrome method for osteoid and defectively mineralized bone in paraffin sections. Biotechology Histochemistry. 67(6), 339-45.
    3. Putns S, Desa DJ (1977) Application of a modified Attwoods stain to the study of decalcified bone sections. Journal of Clinical Pathology. 30(9), 900-3.
    4. Toyosawa S, Yuki M, Kishino M, Ogawa Y, Ueda T, Murakami S, Konishi E, Iida S, Kogo M, Komori T, Tomita Y (2007) Ossifying fibroma vs fibrous dysplasia of the jaw: molecular and immunological characterization. Modern Pathology. 20(3), 38996.
    5. Hopyan S, Gokgoz N, Bell RS, Andrulis IL, Alman BA, Wunder JS. (1999) Expression of osteocalcin and its transcriptional regulators core-binding factor alpha 1 and MSX2 in osteoid-forming tumours. Journal of Orthopaedic Research. 17(5), 633-8.
    6. Waldron CA. (1970) Fibro-osseous lesions of the jaw. Journal of Oral Surgery. 28, 58-64.
    7. Riminucci M, Saggio I, Robey PG, Bianco P. (2006) Fibrous dysplasia as a stem cell disease. Journal of Bone and Mineral Research. 21(2), 125-31.
    8. Marie PJ, de Pollak C, Chanson P, Lomri A. (1997) Increased proliferation of osteoblastic cells expressing the activating Gs? mutation in monostotic and polyostotic fibrous dysplasia. American Journal of Pathology. 150(3), 1059-69.
    9. Eversole LR, Sabes WR and Rovin S. (1972) Fibrous dysplasia: A nosologic problem in the diagnosis of fibroosseous lesions of the jaws. Journal of Oral Pathology. 1(5), 189-220.
    10. Boysen ME, Olving JH, Vatne K, Koppang HS. (1979) Fibro-osseous lesions of the cranio-facial bones. Journal of lar-yngology and Otology. 93,793-807.
    11. Sissons HA, Steiner GC, Dorfman HD. (1993) Calcified spherules in fibro-osseous lesions of bone. Archives of Pathology and Laboratory Medicine. 117(3), 28490.
    12. Burkhardt A. (1989) Dentin formation in so called fibro-osteo-cemental lesions of the jaws: histologic, electron microscopic and immunohistochemical investigations. Oral Surgery Oral Medicine Oral Pathology. 68, 729-38.
    13. Neville BW, Damm DD, Allen CM, Bouquot JE (2009) Bone Pathology. Oral and Maxillofacial Pathology 3rd edition. WB Saunders Company.
    14. Sakamoto A, Chen M, Nakamura T, Xie T, Karsenty G, Weinstein LS. A comparative study of fibrous dysplasia and osteofibrous dysplasia with regard to Gsalpha mutation at the Arg201 codon: polymerase chain reaction-restriction fragment length polymorphism analysis of paraffin-embedded tissues. Journal of Biology and Chemistry. 2005 Jun 3; 280(22):2136975.
    15. Hamner JE 3rd, Fullmer HM. Oxytalan fibers in benign fibro-osseous jaw lesions. Archives of Pathology. 1966 Jul; 82(1):35-9.
    16. Ono A, Tsukamoto G, Nagatsuka H, Yoshihama Y, Rivera RS, Katsurano M, Yao M, Sasaki A. An immunohistochemical evaluation of BMP-2, -4, osteopontine, osteocalcin and PCNA between ossifying fibromas of the jaws and peripheral cement-ossifying fibromas on the gingival. Oral Oncology. 2007 Apr; 43(4):339-44.

 

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Article ID: 1442
 
DOI: 10.14419/ijdr.v2i1.1442




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