Histopathological Comparative Analysis between Syndromic and Non-Syndromic Odontogenic Keratocysts: A Retrospective Study

Histopathological Comparative Analysis between Syndromic and Non-Syndromic Odontogenic Keratocysts: A Retrospective Study

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(1) Background: The aim of this study was to compare the histopathological features of syndromic and non-syndromic odontogenic keratocysts (OKs) using conventional and Confocal Laser Scanning Microscopy (CLSM) with their biological behaviour.(2) Methods: Data from the medical records of 113 Home and Garden patients with histological diagnosis of (single and/or multiple) OKs were collected.Globally, 213 OKs (120 syndromic and 93 sporadic) were retrieved, and their histological slides were re-evaluated with conventional H&E staining and with autofluorescence on the same slides using CLSM (Nikon Eclipse E600 microscope).(3) Results: Syndromic OKs showed more satellite cysts than sporadic cases, as well as a basophilic layer in the basement membrane, which was absent in sporadic OKs; both were highlighted with CLSM.

The basement membrane in syndromic OKs appeared amorphous and fragile, thus possibly being responsible for the epithelial detachment and collapse, with T-Shirt scalloped features.Furthermore, the basal epithelial layers in such cases also showed increased cellularity and proliferative activity.All these histological features may possibly justify their higher tendency to recur.(4) Conclusions: CLSM is useful advanced technology that could help to quickly and easily discriminate between syndromic and non-syndromic OKs and to more accurately predict their biological behaviour in order to set fitter clinico-radiological follow-ups for individual patients.