- 期刊
齒源性鬼影細胞相關病灶－病例報告
Odontogenic Ghost Cell Related Lesion-Report of Two Cases
摘要
鬼影細胞通常被描述為增大或卵圓形的嗜酸性染色上皮細胞，無細胞核或有時可識別出模糊的核膜輪廓，細胞外觀輪廓大多數情況是清晰的，但有時候也可能是模糊。關於鬼影細胞的形成雖然許多假說被提出，不過至今我們仍對鬼影細胞形成的機轉尚未確認。鈣化齒源性囊腫、牙本質生成性影細胞瘤以及鬼影細胞齒源性上皮細胞癌，在這三種疾病的組織切片中，鬼影細胞是其必要特徵，因而被視為「齒源性鬼影細胞病變家族」。從臨床角度來看，其存在一系列組織病理學模式：從良性囊腫到具有實質型態的腫瘤，再進一步是具有上皮細胞癌特徵的惡性腫瘤。本篇介紹了兩個齒源性鬼影細胞病變的病例，分別為是牙本質生成性鬼影細胞瘤及鈣化齒源性囊腫。齒源性鬼影細胞病變在臨床上並不常見，對於該系列病變是腫瘤還是發育性囊腫一直以來都充滿爭論，世界衛生組織在2017年有了最新的定義。治療方面，鈣化齒源性囊腫的治療準則係以手術進行囊腫切除以及削除術，其預後良好。而牙本質生成性鬼影細胞瘤雖為良性腫瘤，但其侵犯性強且復發率高，目前則建議較更廣泛的手術切除。
並列摘要
Ghost cells are often described as ovoid or enlarged epithelial cells with eosinophilic cytoplasm, with well-defined or sometimes blurred outlines. Nucleus of ghost cells are absence or faint. The term "ghost" is used to describe these cells due to their shadowy or translucent appearance when visualized using routine H&E staining. Although many hypotheses have been proposed regarding the formation of ghost cells, the mechanism of their formation remains unclear. Ghost cells are a necessary feature in the histological sections of calcifying odontogenic cysts, dentinogenic ghost cell tumors, and ghost cell odontogenic carcinomas, and are thus regarded as the "odontogenic ghost cell lesion family". Clinically, these lesions exhibit a series of histopathological patterns, ranging from benign cysts to tumors with a solid pattern, and further to malignant tumors with features of epithelial cell carcinomas. We present two cases of odontogenic ghost cell lesions, namely dentinogenic ghost cell tumors and calcifying odontogenic cysts. The odontogenic ghost cell lesions are not commonly seen clinically, and there has been a long-standing debate on whether these lesions are tumors or developmental cysts. The WHO provided the latest definition in 2017. Regarding the treatments, the standard treatment for calcifying odontogenic cysts is cyst enucleation and curettage. Although dentinogenic ghost cell tumors are benign lesions, they are highly invasive and with feature of high recurrence. More extensive procedure is currently recommended.