Objective: To characterize the subtypes of ameloblastoma by differentiation markers.
Study design: Expression of 9 major acidic epithelial keratins was immunohistochemically examined in 28 ameloblastomas.
Results: Keratin 15 (K15) expression patterns corresponded to histological variants: follicular, plexiform and acanthomatous. Tumor nests comprising K15-expressing basal cells mimicked oral epithelium or dental lamina, and tumor nests comprising K15-negative basal cells mimicked outer enamel epithelium. Keratin 19 (K19) was consistently expressed in solid/multicystic ameloblastoma and unicystic ameloblastoma, while peripheral ameloblastoma and desmoplastic ameloblastoma contained K19-negative cells.
Conclusions: The 4 current subtypes had unvaried expression patterns within each group. However, they could be divided into 2 groups by K19 expression pattern: solid/multicystic and unicystic versus extraosseous/peripheral and desmoplastic. K15 expression pattern represented various types of differentiation for tumor nests mimicking tooth germ and oral epithelium. The results clarify the homogeneity and heterogeneity of ameloblastoma cell lineage and differentiation.
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