A comparative study of osteopontin and MMP-2 protein expression in peripheral and central giant cell granuloma of the jaw / Estudo comparativo da expressão das proteínas osteopontina e MMP-2 no granuloma central e periférico de células gigantes de mandíbula

Abstract Introduction: Oral peripheral and central giant cell granulomas are lesions with little-known etiology and pathogenesis. Objective: The aim of this study was to compare matrix metalloproteinases-2 and osteopontin protein expression in the multinucleated giant cells and mononuclear cells of the peripheral and central giant cell granuloma lesions. Methods: In this retrospective study, the presence of matrix metalloproteinases-2 and osteopontin in 37 cases of central giant cell granuloma and 37 cases of peripheral giant cell granuloma paraffin blocks were assessed by streptavidin-biotin immunohistochemistry. Independent sample t-test, Chi-square, Mann-Whitney tests and Spearman's rank correlation coefficient were used. Results: The osteopontin was expressed in both multinucleated giant cells and mononuclear cells in all cases of peripheral and central giant cells granulomas. However, the matrix metalloproteinases-2 expression was positive in 86.5% of giant cells and it was positive in all of mononuclear cells in peripheral giant cells granuloma. In central giant cells granulomas, 91.8% of giant cells and all mononuclear cells were positive for matrix metalloproteinases-2 marker. Percentage and Intensity of staining were significantly higher in central than peripheral giant cells lesions, for both markers (p ˂ 0.05). Conclusion: This study showed that the expression of osteopontin in giant cells supports the theory of osteolcastic nature of these cells. Also, the presence of osteopontin and matrix metalloproteinases-2 in mononuclear cells may indicate the monocyte-macrophage origin of these cells, as the differentiation of the precursors of the mononuclear stromal monocyte/macrophage to osteoclasts is possibly affected by the expression of osteolytic factors. Also, may be differences in biological behaviors of these lesions are associated with the level of osteopontin and matrix metalloproteinases-2 expression.

Resumo Introdução: Os granulomas periféricos e centrais de células gigantes são lesões com etiologia e patogênese pouco conhecidas. Objetivo: Comparar a expressão das proteínas metaloproteinases da matriz-2 e osteopontina nas células gigantes multinucleadas e células mononucleares no granuloma periférico e central de células gigantes. Método: Neste estudo retrospectivo, a presença de metaloproteinases da matriz-2 e osteopontina em 37 casos de granuloma central de células gigantes e 37 casos de granuloma periférico de células gigantes em blocos de parafina foi avaliada por imuno-histoquímica pela estreptavidina-biotina. Foram usados teste t para amostra independente, teste de qui-quadrado, Mann-Whitney e coeficiente de correlação de Spearman. Resultados: A osteopontina foi expressa em células gigantes multinucleadas e células mononucleares em todos os casos de granuloma periférico de células gigantes e granuloma central de células gigantes. No entanto, a expressão de metaloproteinases da matriz-2 foi positiva em 86,5% de células gigantes e foi positiva em todas as células mononucleares em granuloma periférico de células gigantes. Em granuloma central de células gigantes, 91,8% das células gigantes e todas as células mononucleares foram positivas para o marcador metaloproteinases da matriz-2. A porcentagem e intensidade de coloração em granuloma central de células gigantes foram significantemente maiores do que em granuloma periférico de células gigantes para ambos os marcadores (p ˂ 0,05). Conclusão: Este estudo mostrou que a expressão de osteopontina em células gigantes apoia a teoria da natureza osteoclástica dessas células. Além disso, a presença de osteopontina e metaloproteinases da matriz-2 em células mononucleares pode indicar a origem dos monócitos-macrófagos dessas células, uma vez que a diferenciação dos precursores do monócito/macrófago estromal mononuclear em osteoclastos é possivelmente afetada pela expressão de fatores osteolíticos. Além disso, as diferenças nos comportamentos biológicos dessas lesões estão associadas ao nível de expressão de osteopontina e metaloproteinases da matriz-2.

Central Giant Cell Granuloma ; A Case Report.

Central giant cell granuloma ( CGCG) was classified as rarely aggressive idiopathic benign intraosseous lesion that occurs mostly exclusively in the jaws. It occurs most frequently in young women. It is usually slow growing and non neoplastic lesion which exhibits a spectrum of clinical behavior ranging from non aggressive to aggressive variants. The striking feature of this case is its aggressive nature and presence of this lesion in the anterior part of maxilla which considers being a rare finding as the lesion commonly occurs in the mandibular region anterior to first molar.

Giant cell lesion of the jaw: A case report in a child.

Giant cell lesions of the jaw include cherubism, central giant cell granuloma (CGCG) peripheral giant cell granuloma (PGCG) aneurysmal bone cyst, traumatic bone cyst and jaw tumour of hyperparathyroidism. The histological, radiographic and clinical diagnosis is particularly difficult in these types of lesions due to their variable clinical behavior and identical histological presentation with abundant giant cells. We present the case of a 12-year-old boy, who developed a painless swelling of approximately 4 cm, in the left angle of the mandible. The lesion demonstrated slow, progressive and continuous growth. The patient was surgically treated by a conservative approach. The histopathology confirmed the suspected diagnosis of central giant cell granuloma.

Imaging Diagnosis of Central Giant Cell Granuloma showing Massive Osteoid Material / 대한구강악안면방사선학회지

A 19-year-old man was referred to Seoul National University Dental Hospital for evaluation of a large painless swelling of the left mandibular angle area in August, 1999. The growth had been first noted 6 years ago. He had visited other hospital in 1997. In spite of the treatment given at the hospital, the mass continued to grow rapidly. Conventional radiographs in 1999 showed an expansile, lobulated, and destructive lesion of the left mandibular body. CT scan demonstrated an expansile mass with a corticated margin. Bony septa were seen within the lesion. Internal calcification noted on the bone-setting CT image, and corresponded to the hypointense area in T1-weighted MRI image. MRI clearly delineated the extent of the lesion which had heterogenous intermediate signal intensity in T1-weighted images and heterogenous hyperintense signal intensity in T2-weighted images. The lesion was well-enhanced. Histopathologically, the lesion was completely encapsulated. Multinucleated giant cells were presented in a fibrous background, demonstrating a storiform pattern. Areas of osteoid rimmed by a few osteoblasts were scattered throughout the lesion. Inflammatory cells, blood vessels, and hemosiderin deposition were also shown. CGCG may show lots of internal calcification foci on the CT, and varied signal intensity in MRI. More cases will be needed to understand the features of the CT and MR finding of CGCG.