Abstract
BackgroundAngioleiomyoma (ALM) is a benign neoplasm that originates from vascular smooth muscle. It is extremely rare in oral cavity. The objective of this study was to evaluate the clinicopathological and immunohistochemical characteristics of all oral angioleiomyomas registered in a Center of Diagnosis of Oral Diseases from 1959 to 2017.Material and MethodsSlides from 14 cases of ALM stained with hematoxylin and eosin (H&E) were analyzed to confirm the diagnosis. Moreover, an immunohistochemical panel with alpha-smooth muscle actin (alpha-SMA), desmin, AE1/AE3, CD68, S-100, and CD34 antibodies was performed to evaluate semi-quantitatively the positive cells.ResultsALM correspond to 0.08% of all benign oral tumors analyzed during the 57-year period. The mean age of the patients was 45 years with a predilection to males (58%). The most frequently reported site was lips (50%). Microscopic analysis on H&E sections revealed similar pattern in all cases, showing well-circumscribed and encapsulated tumors, characterized by a proliferation of smooth muscle cells and wide vascular spaces of varying sizes. The predominant immuno profiles were: alpha-smooth muscle actin (alpha-SMA) positive (strong immunoreactivity); positive variable pattern for desmin, negative immunoprofile for AE1/AE3, CD68, and S-100. The endothelial cells of vascular spaces were CD34+.ConclusionsBased on the results, the alpha-SM actin can be elected as a good marker for angioleiomyomas and can help the confirmation of the morphologic diagnosis of this lesion. Key words:Angioleiomyoma, Alpha-SMA, vascular smooth muscle.
Highlights
Angioleiomyoma (ALM) is a neoplastic proliferation of vascular smooth muscle cells [1]
To the best of our knowledge, this is the first study of this neoplasia in which, besides hematoxylin and eosin (H&E) staining, all the samples were subjected to immunohistochemistry, using a panel of antibodies to investigate them, such as alpha-smooth muscle actin, desmin, AE1/AE3, CD68, S-100, and CD34 antibodies, aiming to make a definitive diagnosis
The study followed the recommendations of the Declaration of Helsinki for medical protocol 10 and was approved by the Ethical Review Board of the School of Dentistry of the Federal University of Pelotas. -Immunohistochemistry Tissues were submitted to immunohistochemical technique using the antibodies for alpha-smooth muscle actin, desmin, AE1/AE3, CD68, S-100, and CD34
Summary
Angioleiomyoma (ALM) is a neoplastic proliferation of vascular smooth muscle cells [1]. Microscopic analysis shows well-circumscribed and encapsulated tumor characterized by proliferation of smooth muscle cells and vascular spaces of varying sizes (Ide, 2004). It was proposed a classification system which divided ALM into three histological subtypes (solid, cavernous, and venous) [2]. Microscopic analysis on H&E sections revealed similar pattern in all cases, showing well-circumscribed and encapsulated tumors, characterized by a proliferation of smooth muscle cells and wide vascular spaces of varying sizes. Conclusions: Based on the results, the alpha-SM actin can be elected as a good marker for angioleiomyomas and can help the confirmation of the morphologic diagnosis of this lesion
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