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. 2018 May-Aug;22(2):173-179.
doi: 10.4103/jomfp.JOMFP_260_17.

Clinicopathological profile of central giant cell granulomas: An institutional experience and study of immunohistochemistry expression of p63 in central giant cell granuloma

Mahadevi B Hosur  1 , Rudrayya S Puranik  1 , Shreenivas S Vanaki  1 , Surekha R Puranik  2 , Pramod S Ingaleshwar  1
Affiliations

Clinicopathological profile of central giant cell granulomas: An institutional experience and study of immunohistochemistry expression of p63 in central giant cell granuloma

Mahadevi B Hosur et al. J Oral Maxillofac Pathol. 2018 May-Aug.

Abstract

Background: The central giant cell granuloma(CGCG) of bone constitutes about 10% of benign jawbone lesions. It affects females more often than males, mandible than maxilla. Biological behavior of CGCG ranges from a slow growing asymptomatic swelling to an aggressive process. True giant cell tumor (GCT) should be distinguished from CGCG. The histological distinction between these lesions depends on quite subtle differences. Expression of p63 has been demonstrated in GCT of bone conversely, has not been detected in CGCG. Therefore this short study attempts to study the expression of p63 in CGCG in conjunction with clinicopathological profile of the cases reported in the institute.

Aims and objectives: To review all the cases of CGCGs of the jaws reported in the institute from 1998 to 2015 and study their clinicopathological profile.To study the immunohistochemical (IHC) expression of p63 in CGCG cases.

Methods and materials: The retrospective study reviewed records for clinically and histopathologically diagnosed cases of CGCG from the archives of department of Oral pathology. Data was recorded and analyzed. These cases were subjected for IHC analysis for expression of p63, also RANK, RANKL in selected cases to study the nature of giant cells.

Results and conclusion: This paper is an institutional experience of clinicopathological profile of diagnosed cases of CGCG. Clinicopathological findings were in concurrent with previous literature. Total number of cases was ten. Six occurred in females and four in males. Most of them occurred in the second decade, more commonly involving mandible. Three cases showed recurrence. Histologically most showed classical features. Expression of p63 showed negativity in all the cases in accordance with the previous studies. RANK and RANKL showed strong and diffuse immunoexpression in both mononuclear and giant cells. Thus study supports the finding that p63 expression can be used to differentiate between CGCG and GCT. However, more number of studies with larger sample size are required to confirm reliability of using p63 as a distinguishing marker between GCT and CGCG.

Keywords: Central giant cell granuloma; giant cell tumor; p63.

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Conflict of interest statement

There are no conflicts of interest.

Figures

Graph 1
Graph 1
Age- and gender-wise distribution of central giant cell granuloma cases
Graph 2
Graph 2
Location of the central giant cell granuloma cases
Figure 1
Figure 1
Photomicrograph (×40) showing negative immunohistochemistry expression of p63 by both mononuclear cells and giant cells
Figure 2
Figure 2
Photomicrographs (×10) showing strong and diffuse expression of RANK by mononuclear cells and multinucleated giant cells
Figure 3
Figure 3
Photomicrographs (×4) showing strong and diffuse expression of RANKL
Figure 4
Figure 4
(a) Clinical photograph showing diffuse swelling in the maxillary anterior region extending from 21 to 15 associated with noticeable palatal expansion (case 10). (b) Well-defined unilocular radiolucency extending from 22 to 14 with displacement of regional teeth (case 10). (c) An extensive multilocular radiolucency involving the entire mandible. Displaced developing tooth germs noted (case 2). (d) Ill-defined radiolucent lesion showing wispy trabeculae with resorption of distal root of 36 (case 1)
Figure 5
Figure 5
Histological picture (×10) showing round to oval and plump spindle shaped cells with scattered giant cells and hemorrhagic areas
See this image and copyright information in PMC

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