線毛上皮を有する下顎歯根嚢胞の1例

ケラチン免疫組織化学的研究

抄録

The wall of radicular cysts is usually composed of non-keratinized squamous epithelium derived from an inflammatory event in the periapical region. The incidence of ciliated epithelium in radicular cysts is extremely rare and the origin of cyst epithelium is still obscure.
We have experienced a case (45-year-old male patient) of mandibular radicular cyst lined with ciliated epithelium including mucous cells and a keratin immunohistochemistry using monoclonal antibodies, PKK1, KL1, K8. 12 and K4. 62, was performed in order to analyze the etiology and the origin of cyst epithelium.
The cyst wall was divided into 3 categories histopathologically, Type 1; cyst epithelium with mucous cells, Type 2; desquamated cyst epithelium and Type 3; ciliated cyst epithelium. Three monoclonal antibodies, PKK1, KL1 and K4. 62, revealed a negative reaction in the basal cell layer of all cyst walls but K8. 12 showed a weak reaction. In addition, K8. 12 and K4. 62 reacted strongly with intermeditaed cell and superficial cell layers in all types. PKK1 and KL1 gave a negative or very weak staining in the same region. There are strong reactions of KL1 and K8. 12 and weak of PKK1 and K4. 62 in desquamated cells of type 2. A characteristic staining pattern of ciliated cells in type 3 implicated that KL1 and PKK1 reacted positively and K8. 12 and K4. 62 negatively.
It is suggested that the cyst lining epithelium is derived from glandular metaplasia based on the results of keratin staining and a high proportion of type 1 among all cyst walls. However, we could not deny that the cyst epithelium of dental origin differentiated into three different cell types including desquamated cell with a strong tendency of stratification.