Abstract

VERA-SIRERA, Beatriz et al. Immunomorphological differential diagnosis of maxillary cystic lesions with keratinization. Rev Esp Cirug Oral y Maxilofac [online]. 2011, vol.33, n.4, pp.142-149. ISSN 2173-9161.  https://dx.doi.org/10.4321/S1130-05582011000400003.

Objectives: Maxillary cystic lesions with keratinization are controversial lesions that are clinically relevant due to the prognostic implication of the so-called keratocystic odontogenic tumor (KOT). The aim of this study was to assess the usefulness of immunohistochemistry in the identification of KOTs. Material and methods: Retrospective study of all maxillary cystic lesions exhibiting keratinization diagnosed over a 4-year period in one hospital center. Immunohistochemical study using a panel of five antibodies (Ki67, Bcl-2, p53, CK19, D2-40) was performed. Results: Of a total of 410 maxillary cystic lesions, 22 cases (5.36%) showing morphological features of internal keratinization were selected. Using WHO-2005 histological criteria, 15 KOTs and 4 orthokeratotic odontogenic cysts (OOC) were diagnosed, as well as 3 cases with hybrid morphological characteristics. Immunohistochemical results accurately differentiated between KOT and OOC and allowed the hybrid forms to be correctly identified. Conclusions: Immunohistochemical analysis with a panel of five antibodies allows an accurate diagnosis of maxillary cystic lesions with keratinization, enabling the differentiation between KOT and OOC and the correct identification of cases of hybrid morphological characteristics.

Keywords : Maxillary cysts; Keratocystic odontogenic tumor; Orthokeratotic odontogenic cyst; Immunohistochemistry; Differential diagnosis.

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