Odontojen kistlerde yağ bezi lobulüsü

Amaç: Dermoid kistlerde bulunan yağ bezi lobulüsü odontojen kistlerde enderdir. Dermoid kistler yavaş büyür ve biyolojik davranışları sesizdir, kist çıkartıldıktan sonra yerel yineleme görülmez. Oysaki bazı gelişimsel odontojen kistler lokal agresif bir klinik gidiş gösterir, yerel yineleme oranları yüksektir; bu tip kistlerde yağ bezi lobülüsü bulunabilir. Bu çalışmanın amacı yağ bezi lobülüsü içeren odontojen kistlerin klinik ve histopatolojik olarak incelenmesidir. Gereç ve Yöntem: Çalışmada yağ bezi lobulüsü içeren 14 odontojen kist olgusunun histopatolojik özellikleri, yağ bezi lobulüslerinin sayısı ve yerleşim özellikleri dikkate alınarak incelendi. Histokimyasal (PAS) ve immunhistokimyasal (S100 proteini, Pan Sitokeratin, Sitokeratin 19 and EMA ) incelemeleri de yapıldı. Bulgular: Çalışmada 14 olgu incelendi, bunların 9’u erkek (%64), 5’i (%36) kadındı. 14 odontojen kist olgusunun, 10’u mandibulada, 4’ü maksillada bulunuyordu. Lezyonların hepsi gelişimsel odontojen kistti. Mikroskopik incelemede 11 olguda yağ bezi lobulusü yalnızca fibrotik kist duvarında, 1’inde yağ bezi lobulüsü epitel içinde yer almıştı, 2’sinde ise hem epitel içinde, hem epitelin hemen altında, hem de fibrotik duvarda izlendi. Sonuç: Bir kistte histopatolojik olarak yağ bezi lobulüsü görüldüğünde dermoid kist tanısı koyulması eğilimi vardır. Bu nedenle ayırıcı tanıya yağ bezi lobulüsü içeren odontojen kistlerin alınması hasta yönetimi ve farklı izlem seçenekleri açısından oldukça önemlidir

Sebaceous glands within odontogenic cysts

Aim: Sebaceous glands are rarely observed in odontogeniccysts whereas these structures are the histopathologicfeatures of dermoid cysts. Dermoid cyst growth isslow and its biologic behaviour is silent; after the cyst isremoved, recurrence is not observed. However, there aresome developmental odontogenic cysts that have a localaggressive course and high levels of recurrence and sebaceousglands may present in these types of cyst. Theaim of the study is to evaluate the histopathologic and clinicalfeatures of odontogenic cyst with sebaceous gland.Materials and Method: 14 odontogenic cysts with sebaceousglands were reported in the present study. Histopathologicalfeatures, locations and numbers of sebaceousglands were evaluated. Histochemical (PAS) andimmunohistochemical (S100 protein, Pan Cytokeratin,Cytokeratin 19 and EMA ) examinations were also performed.Results: In the present study, 14 patients, 9 (64%) maleand 5 (36%) female with a mean age of 42 years wereincluded. The cysts were located in the mandible of 10;while four of them were in the maxilla. All lesions were developmentalodontogenic cysts. Microscopic evaluationrevealed that sebaceous glands were only in the fibroticcyst wall in 11 cases, in the intraepithelial location in 1case and 2 cases showed three different sites as intraepithelial,subepithelial and wall.Conclusions: When the sebaceous glands are observedhistopathologically, there is a tendency to diagnoisis as adermoid cyst. Therefore, the differential diagnosis betweenodontogenic cyst with sebaceous glands and intraosseousdermoid cysts has great importance for managementor different follow-up options.

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