A Clinicopathological Approach to Odontogenic Cysts: the Role of Cytokeratin 17 and bcl2 Immunohistochemistry in Identif
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ORIGINAL ARTICLE
A Clinicopathological Approach to Odontogenic Cysts: the Role of Cytokeratin 17 and bcl2 Immunohistochemistry in Identifying Odontogenic Keratocysts Dorottya Cserni 1 & Tamás Zombori 2 Zoltán Baráth 1 & Gábor Cserni 2,3
2
& András Vörös & Anette Stájer
1
3
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& Annamária Rimovszki & Krisztián Daru &
Received: 7 June 2020 / Accepted: 23 June 2020 # The Author(s) 2020
Abstract Odontogenic keratocysts (OKCs) are developmental cysts of the jaws that require proper diagnosis due to their potential for local aggressive growth and recurrences. OKCs have a typical parakeratotic epithelium demonstrating transepithelial cytokeratin 17 (CK17) and basal bcl2 staining on immunohistochemistry (IHC), which distinguishes them from other common jaw cysts. Secondary to inflammation, the epithelial lining may be altered and loses the typical IHC phenotype. The aim of the present study was to analyse a series of consecutive jaw cysts for their expression of CK17 and bcl2 and assess how these IHC stains may help in their diagnosis. All cysts were retrospectively assessed for available clinical, radiological and pathological findings and diagnoses were revised whenever needed. 85 cysts from 72 patients were collected from two departments. The series had 21 OKCs, the remaining non-OKCs included radicular/residual, dentigerous, paradental, lateral periodontal, botryoid odontogenic cysts. OKCs with typical epithelium showed the typical IHC phenotype, which was generally lost in inflammation-associated altered epithelium. Contrarily to earlier descriptions, a wide variety of CK17 positivity was seen in the majority of non-OKCs, including focal transepithelial staining. Basal bcl2 staining was also seen in 16 non-OKCs. These stainings were never as strong in intensity as seen in OKCs. One case was histopathologically identified as OKC due to focally maintained IHC profile. CK17 and bcl2 IHC may help in the diagnosis of OKCs, but must be interpreted with caution and is not a yes or no tool in the diagnostic puzzle. Keywords Odontogenic keratocyst . Cytokeratin 17 . B cell lymphoma – 2 (bcl2) . Dentigerous cyst . Radicular cyst
Introduction Dorottya Cserni and Tamás Zombori equally contributed to the work and qualify as first authors. Zoltán Baráth and Gábor Cserni equally contributed to the work and qualify as last authors. Electronic supplementary material The online version of this article (https://doi.org/10.1007/s12253-020-00866-4) contains supplementary material, which is available to authorized users. * Gábor Cserni [email protected] 1
Department of Prosthodontics, Faculty of Dentistry, University of Szeged, Tisza Lajos krt 64-66, Szeged H-6720, Hungary
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Department of Pathology, University of Szeged, Állomás u. 1, Szeged H-6725, Hungary
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Department of Pathology, Bács-Kiskun County Teaching Hospital, Nyíri út 38, Kecskemét H-6000, Hungary
Cystic or cyst-like lesions of odontogenic origin include inflammatory, developmental and neoplastic lesions [1]. They may lead to the loosening of the teeth, predispo
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