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Analysis of the frequency and nature of hyaline ring granulomas in inflammatory odontogenic cysts

2012; Wiley; Volume: 46; Issue: 1 Linguagem: Inglês

10.1111/j.1365-2591.2012.02086.x

1365-2591

Águida Cristina Gomes Henriques, Joabe dos Santos Pereira, Cassiano Francisco Weege Nonaka, R. A. Freitas, Leão Pereira Pinto, Márcia Cristina da Costa Miguel,

dental development and anomalies

Abstract Aim To determine the prevalence of hyaline ring granulomas ( HRG s) in a large case series of inflammatory odontogenic cysts, and to investigate the nature of these structures. Methodology All records from the patients diagnosed with inflammatory odontogenic cysts between January 1970 and April 2009 were reviewed. Histologic sections were evaluated by light microscopy and cases with HRG s for which sufficient biological material was available were submitted to histochemical analysis ( M asson's trichrome) and immunohistochemistry ( CD 34, CD 68 and collagen IV ). Results Twenty‐two (3.3%) of the 661 cases of inflammatory odontogenic cysts diagnosed during the study period presented HRG s. The relative frequency of HRG s was higher amongst residual radicular cysts (6.1%), followed by paradental cysts (5.6%) and radicular cysts (3.0%). HRG s appeared as roughly circular homogeneous/fibrillar masses in 14 (63.6%) cases and as round structures enclosing amorphous material in 3 (13.6%) cases. Most (77.8%) roughly circular homogeneous/fibrillar masses were positive for collagen, whereas all (100.0%) round structures enclosing amorphous material were negative for this protein. Immunohistochemistry showed that most mononucleated cells and all multinucleated giant cells were positive for CD 68, but negative for CD 34, in all cases. In addition, collagen IV immunostaining was negative in amorphous structures and weakly positive in homogeneous/fibrillar masses. Conclusions The present results suggest a very low frequency of HRG s in inflammatory odontogenic cysts and support the hypothesis that these structures arise from the implantation of foreign material, most likely food particles of plant or vegetable origin. The diverse microscopic features of HRG possibly represent different developmental stages of this structure.