A Histopathology-based Assessment of Biological Behavior in Oral Hyalinizing Odontogenic Tumors and Bone Lesions by Differential Stains
Citation Information :
A Histopathology-based Assessment of Biological Behavior in Oral Hyalinizing Odontogenic Tumors and Bone Lesions by Differential Stains. J Contemp Dent Pract 2021; 22 (6):691-702.
Aim: Odontogenic tumors (OTs) and bone lesions of the oral cavity present diverse histological features and varying clinical behavior that makes predicting their biologic behavior difficult. The research undertaken in the current study aims to predict the biological behavior of oral hyalinizing odontogenic and bone lesions (OHO-BL) for the first time by employing four differential stains with clinicopathologic correlation.
Materials and methods: The study was performed on retrospectively diagnosed formalin-fixed paraffin-embedded cases of OTs (n = 53) and bone lesions (n = 10). The severity of hyalinization (SOH) was assessed from stained tissue sections. Polarizing microscopy was used to analyze hyalinization in tissues stained with differential special stains, namely periodic acid–Schiff (PAS), Safranin-O, Alcian Blue, and Picrosirius red. SOH was also analyzed for possible correlation with recurrence and clinicopathologic correlation in OHO-BL.
Results: Intense staining was observed with PAS, Alcian Blue, and Safranin-O in OTs with increased SOH with a statistical significance. Polarizing greenish yellow color correlated significantly with the recurrence potential of the OT group. Recurrence in individual lesions of the OT group showed a statistically significant association with SOH. Such individual correlation was not observed in bone diseases.
Conclusion: PAS, Alcian Blue, Safranin-O, and Picrosirius red are reliable stains to assess hyalinization in OHO-BL. Picrosirius red–polarizing microscopy is a dependable tool for identifying recurrent odontogenic lesions.
Clinical significance: SOH can be considered a histological predictor of aggressive biologic behavior in oral hyalinizing odontogenic lesions that can enable the surgeon to arrive at an appropriate management protocol.
Kato N, Takeda J, Fukase M, et al. Hyalinized stroma in clear cell carcinoma of the ovary: how is it formed? Hum Pathol 2012;43(11):2041–2046. DOI: 10.1016/j.humpath.2012.02.012.
Kato N, Takeda J, Fukase M, et al. Alternate mucoid and hyalinized stroma in clear cell carcinoma of the ovary: manifestation of serial stromal remodeling. Mod Pathol 2010;23(6):881–888. DOI: 10.1038/modpathol.2010.75.
Ropponen K, Tammi M, Parkkinen J, et al. Tumor cell-associated hyaluronan as an unfavorable prognostic factor in colorectal cancer. Cancer Res 1998;58(2):342–347.
Wright JM, Soluk Tekkesin M. Odontogenic tumors: where are we in 2017? J Istanb Univ Fac Dent 2017;51(3 Suppl. 1):S10–S30. DOI: 10.17096/jiufd.52886.
Siwach P, Joy T, Tupkari J, et al. Controversies in odontogenic tumours: review. Sultan Qaboos Univ Med J 2017;17(3):e268–e276. DOI: 10.18295/squmj.2017.17.03.003.
Jeyaraj P. Histological diversity, diagnostic challenges, and surgical treatment strategies of fibrous dysplasia of upper and mid-thirds of the craniomaxillofacial complex. Ann Maxillofac Surg 2019;9(2):289–314. DOI: 10.4103/ams.ams_219_19.
Feller L, Wood NH, Khammissa RA, et al. The nature of fibrous dysplasia. Head Face Med 2009;5:22. DOI: 10.1186/1746-160X-5-22.
Osunde O, Iyogun C, Adebola R. Juvenile aggressive ossifying fibroma of the maxilla: a case report and review of the literature. Ann Med Health Sci Res 2013;3(2):288–290. DOI: 10.4103/2141-9248.113685.
Alturkistani HA, Tashkandi FM, Mohammedsaleh ZM. Histological stains: a literature review and case study. Glob J Health Sci 2015;8(3):72–79. DOI: 10.5539/gjhs.v8n3p72.
Hui H, Ma W, Cui J, et al. Periodic acidSchiff staining method for function detection of liver cells is affected by 2% horse serum in induction medium. Mol Med Rep 2017;16(6):8062–8068. DOI: 10.3892/mmr.2017.7587.
Alibegović A, Blagus R, Martinez IZ. Safranin O without fast green is the best staining method for testing the degradation of macromolecules in a cartilage extracellular matrix for the determination of the postmortem interval. Forensic Sci Med Pathol 2020;16(2):252–258. DOI: 10.1007/s12024-019-00208-0.
Meyerholz DK, Rodgers J, Castilow EM, et al. Alcian Blue and Pyronine Y histochemical stains permit assessment of multiple parameters in pulmonary disease models. Vet Pathol 2009;46(2):325–328. DOI: 10.1354/vp.46-2-325.
Rittié L. Method for picrosirius red-polarization detection of collagen fibers in tissue sections. Methods Mol Biol 2017;1627:395–407. DOI: 10.1007/978-1-4939-7113-8_26.
Sharma PN, Ranka RK, Chaudhary MS, et al. Odontogenic tumors: a review of 93 cases in the Vidharba region of Maharashtra. J Oral Maxillofac Pathol 2020;24(1):185. DOI: 10.4103/jomfp.JOMFP_145_19.
Yang R, Liu Z, Gokavarapu S, et al. Recurrence and cancerization of ameloblastoma: multivariate analysis of 87 recurrent craniofacial ameloblastoma to assess risk factors associated with early recurrence and secondary ameloblastic carcinoma. Chin J Cancer Res 2017;29(3):189–195. DOI: 10.21147/j.issn.1000-9604.2017.03.04.
Shivashankara C, Nidoni M, Patil S, et al. Odontogenic myxoma: a review with report of an uncommon case with recurrence in the mandible of a teenage male. Saudi Dent J 2017;29(3):93–101. DOI: 10.1016/j.sdentj.2017.02.003.
Li T, Wu Y, Yu S, et al. Clinicopathological features of unicystic ameloblastoma with special reference to its recurrence. Zhonghua Kou Qiang Yi Xue Za Zhi 2002;37(3):210–212.
Assiri KI. Monostotic fibrous dysplasia involving the mandible: a case report. SAGE Open Med Case Rep 2020;8:2050313X20936954. DOI: 10.1177/2050313X20936954.
Thankappan S, Nair S, Thomas V, et al. Psammomatoid and trabecular variants of juvenile ossifying fibroma-two case reports. Indian J Radiol Imaging 2009;19(2):116–119. DOI: 10.4103/0971-3026.50832.
Cottom HE, Bshena FI, Speight PM, et al. Histopathological features that predict the recurrence of odontogenic keratocysts. J Oral Pathol Med 2012;41(5):408–414. DOI: 10.1111/j.1600-0714.2011.01113.x.
Syed S, Carvalho KM, Spadigam A, et al. Clinico-pathological correlations of odontogenic tumors: some critical observations based on a 20-year institutional study and a comprehensive review of literature. Indian J Dent Res 2019;30(4):516–520. DOI: 10.4103/ijdr.IJDR_579_17.
Carvalho KM, Dhupar A, Spadigam A, et al. Ameloblastoma: a 16-year clinicopathological study on Goan population. Indian J Pathol Microbiol 2017;60(2):157–160. DOI: 10.4103/0377-4929.208374.
Tabatabaei Shafiei M, Carvajal Gonczi CM, Rahman MS, et al. Detecting glycogen in peripheral blood mononuclear cells with periodic acid schiff staining. J Vis Exp 2014;(94):52199. DOI: 10.3791/52199.
Bogdani M, Simeonovic C, Nagy N, et al. The detection of glycosaminoglycans in pancreatic islets and lymphoid tissues. Methods Mol Biol 2015;1229:413–430. DOI: 10.1007/978-1-4939-1714-3_32.
Shetty A, Tamgadge A, Bhalerao S, et al. Study of polarization colors in the connective tissue wall of odontogenic cysts using picrosirius red stain. J Orofac Sci 2015;7(2):119–124. DOI: 10.4103/0975-8844.169771.
Sahni A, Rehani S, Kardam P, et al. Analysis of stromal mucin in oral epithelial dysplasia & oral squamous cell carcinoma – a histochemical study. J Oral Biol Craniofac Res 2019;9(1):40–46. DOI: 10.1016/j.jobcr.2018.07.004.
Kumari K, Ghosh S, Patil S, et al. Expression of type III collagen correlates with poor prognosis in oral squamous cell carcinoma. J Investig Clin Dent 2017;8(4):e12253. DOI: 10.1111/jicd.12253.
Kulkarni PG, Kumari MA, Jahagirdar A, et al. Collagen and its role in predicting the biological behavior of odontogenic lesions. J Contemp Dent Pract 2017;18(2):137–141. DOI: 10.5005/jp-journals-10024-2004.
Masthan KM, Anitha N, Krupaa J, et al. Ameloblastoma. J Pharm Bioallied Sci 2015;7(Suppl. 1):S167–S170. DOI: 10.4103/0975-7406.155891.
Jahagirdar PB, Kale AD, Hallikerimath S. Stromal characterization and comparison of odontogenic cysts and odontogenic tumors using picrosirius red stain and polarizing microscopy: a retrospective and histochemical study. Indian J Cancer 2015;52(3):408–412. DOI: 10.4103/0019-509X.176742.
Sathi GSA, Fujii M, Tamamura R, et al. Juxta-epithelial hyalinization inhibits tumor growth and invasion in ameloblastoma. J Hard Tissue Biol 2008;17(2):63–68. DOI: 10.2485/jhtb.17.63.
Sakamoto A, Oda Y, Iwamoto Y, et al. A comparative study of fibrous dysplasia and osteofibrous dysplasia with regard to expressions of c-fos and c-jun products and bone matrix proteins: a clinicopathologic review and immunohistochemical study of c-fos, c-jun, type I collagen, osteonectin, osteopontin, and osteocalcin. Hum Pathol 1999;30(12):1418–1426. DOI: 10.1016/s0046-8177(99)90162-4.