title: Pseudoepitheliomatous hyperplasia associated with bisphosphonate-related osteonecrosis of the jaw.
abstract: Bisphosphonate-related osteonecrosis of the jaw (BRONJ) is a well-characterized oral complication of systemic therapy with bisphosphonates. Pseudoepitheliomatous hyperplasia was observed in some of the lesions. Because podoplanin expression has been linked to malignant lesions of the oral mucosa, we aimed to investigate podoplanin expression in the pseudoepitheliomatous hyperplasia. We analyzed archival paraffin- and plastic-embedded specimens from BRONJ using both conventional and immunohistochemical (AE1/AE3, D2-40) staining methods. Eleven out of seventeen BRONJ cases showed pseudoepitheliomatous hyperplasia. All these cases were positive for AE1/AE3 and pseudoepitheliomatous hyperplasia displayed a strong basal and parabasal reaction against podoplanin. The podoplanin expression in pseudoepitheliomatous hyperplasia in BRONJ specimens should not be considered a sign of malignancy. We discuss the current and possible future roles of surgical pathologists in diagnosing morphological changes associated with the development and therapy of BRONJ lesions.
authors.affiliation: Institute of Pathology, University Medical Centre Hamburg Eppendorf, Martinistr.52, 20246 Hamburg, Germany. j.zustin@uke.uni-hamburg.de.
authors.forename: Jozef
authors.initials: J
authors.lastname: Zustin
authors.forename: Dennis
authors.initials: D
authors.lastname: Reske
authors.forename: Tomislav A
authors.initials: TA
authors.lastname: Zrnc
authors.forename: Max
authors.initials: M
authors.lastname: Heiland
authors.forename: Hanna A
authors.initials: HA
authors.lastname: Scheuer
authors.forename: Alexandre T
authors.initials: AT
authors.lastname: Assaf
authors.forename: Reinhard E
authors.initials: RE
authors.lastname: Friedrich
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D059266:Bisphosphonate-Associated Osteonecrosis of the Jaw / Q000150:complications / Q000000981:diagnostic imaging / Q000473:pathology*; D004164:Diphosphonates / Q000008:administration & dosage / Q000009:adverse effects*; D005260:Female; D005786:Gene Expression Regulation; D006801:Humans; D006965:Hyperplasia / Q000139:chemically induced* / Q000175:diagnosis / Q000473:pathology; D007568:Jaw / Q000000981:diagnostic imaging / Q000187:drug effects / Q000473:pathology*; D007573:Jaw Neoplasms / Q000139:chemically induced / Q000175:diagnosis / Q000209:etiology / Q000473:pathology; D008297:Male; D008562:Membrane Glycoproteins / Q000096:biosynthesis; D008875:Middle Aged; D016612:Paraffin Embedding; D011859:Radiography; D000098853:Podoplanin
chemical_list: D004164:Diphosphonates; D008562:Membrane Glycoproteins; C117468:PDPN protein, human; D000098853:Podoplanin
keywords: BRONJ; D2-40; Pseudoetheliomatous hyperplasia; bisphosphonate; podoplanin