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법랑아세포종의 병리학적 및 조직화학적 연구

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 Pathological and histochemical studies of ameloblastoma 
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법랑아세포종에 대한 임상적, 조직학적 연구는 많았으나 재발과 조직학적 관계와의 연구는 드물어 이에 저자는 술후 재발한 군과 재발하지 않은 군을 병리학적 및 조직화학적으로 비교분석하여 다음과 같은 결론을 얻었다.

1. 술후 재발된 예는 25예중 7예였으며 재발된 7예는 소파술에 의한 2예중 2예(100%), 적출술에 의한 10예중 4예 (40%), 분할골절제술 8예중 1예 (12.5%)였다.

2. 연령별 빈도는 전 연령층에 고루 분포하였으나, 30세 이전이 13예로서 검색대상의 절반 이상이었고 남녀별 빈도는 1.8 : 1로 남자에서 많았으며 재발된 예에서는 남녀비가 5 : 2었다.

3. 발생부위는 하악 근치부가 19예 (76%)로 가장 빈발하였고 재발된 예에서는 하악 구치부 4예, 전치부 2예, 상악 구치부 1예 순이었다.

4. 임상 증상으로는 종창이 가장 많았으며 그외에 동통 및 배농의 순이었다. 병력 기간은 1년 이하가 14예 (56%)로 가장 많았으며 21예 (84%)가 2년 이하였다.

5. 방사선 소견은 단방형 13예 (54%), 다방형 9예, 비누거품형이 3예의 순이었다.

6. 병리 조직학적 분류는 망상형 12예 (48%), 여포형 9예 (36%), 혼합형 4예 (16%)의 순이었으며 재발된 군에서는 여포형이 5예로 가장 많았다.

7. 치성 낭종에서 유래된 법랑아세포종은 6예였고 그중 5예가 함치성 낭종에서, 1예는 치성 각화성 낭종에서 유래되었다.

8. 조직 화학적 소견에서 종양실질 상피도는 재발하지 않은 군과 재발한 군 모두 기저막에 둘러쌓여 있었으며 초자화물질과 당원 과립의 정도는 두군 모두 차이가 없었다.


The purpose of this study is to compare ameloblastoma with and without recurrence on pathological and histochemical findings.

The author studies 25 cases of ameloblastomas obtained materials from the Dept. of Oral pathology, College of Dentistry, Yonsei University for the period of Jan. 1977 to Dec. 1986.

1. Of 25 cases, recurrent cases were 7 cases, among which 4 cases were treated by enucleation, 2 cases by curettage and 1 case by segmental resection.

2. 25 cases of ameloblastoma occurred at any age groups but the 2nd decade was the most commonly involved. The average age was 33.6 years. The ratio of male and female was 1.8 : 1 which has slight predilection for male, and it was 5 : 2 in recurrent cases.

3. The most favorate site of ameloblastoma was posterior region of mandible (19 cases) and the next was anterior region (4 cases). The anterior and posterior region of maxilla were also involved (1 case, each other).

4. The major sign and symptom was swelling. Pain and pus discharge were also noticed. As to the clinical duration, 14 cases (56%) were found within 1 year and 21 cases (84%) within 2 years.

5. Radiographically, unilocular pattern (13 cases, 54%) was the most common form and multilocular (9 cases) and soap bubble (3 cases) were also common forms.

6. Histopathologically, the main histologic pattern was plexiform pattern (12 cases, 48%). Follicular pattern (9 cases, 36%) and mixed pattern (4 cases, 16%) were also exhibited. In recurrent cases, the most common pattern was follicular pattern (5 cases) and the next common patterns were plexiform (1 case) and mixed (1case).

7. Histopathologically, ameloblastomas originated from odontogenic cyst were 6 cases, of which 5 cases were originated from dentigerous cyst and 1 case from odontogenic keratocyst.

8. In histochemical findings, the ameloblastic epithelial islands were surrounded by basement membrane. And there were no differences about hyalinized materials and glycogen in tumor cells between ameloblastoma with and without recurrent cases.
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