Benign Fibrohistiocytic Gnathic Lesions: A 48 Year Clinicopathologic and Immunohistochemical Analysis and Review of the Literature
Abstract
Introduction: Intra-osseous fibrohistiocytic lesions of the jaws are rare entities variably described in the literature. It is postulated they represent a heterogenous group of both reactive and neoplastic processes. Purpose: This case series categorized clinical, radiographic and morphologic features of gnathic fibrohistiocytic lesions. Materials and Methods: A search of archival material at the NPDS, WRNMMC and the Joint Pathology Center (including the Armed Forces Institute of Pathology) was conducted (1970-2017). Diagnosis was confirmed viahistologic evaluation. Adjunct immunohistochemical staining was performed as required. Demographic, radiographic, clinical and follow-up data were recorded if available. Results: The 50 cases meeting inclusion criteria consisted of 29 males and 21 females. Ages ranged from 11-70 years (mean 29). The majority of lesions (82%) were found in the 2nd through 4th decades. Most were identified incidentally or presented with mild expansion in the posterior body/ramus of the mandible (84%). Although radiographic presentation varied, a distinctive sclerosing and punctate pattern was identified. Approximately 80% of the cases demonstrated characteristic morphologic features, while a minority demonstrated a predominant xanthomatous component. Immunohistochemical staining revealed strong, positive CD68 and CD163 expression with variable smooth muscle actin staining. Preoperative radiographic and/or follow-up data was available in 21 cases. Ages ranged from 6 months to 34 years (mean 85 months). The vast majority (92%) of cases were treated conservatively. Lesional stability was demonstrated with serial radiographs; only two cases recurred. Conclusions: This is the largest case series to date and demonstrates distinctive radiographic and histologic findings, along with characteristic clinical and immunophenotypic features.
Document Details
- Document Type
- Technical Report
- Publication Date
- Jun 01, 2019
- Accession Number
- AD1128045
Entities
People
- Parth Mewar
Organizations
- Uniformed Services University of the Health Sciences