Ann Dermatol.  2009 Nov;21(4):345-351. 10.5021/ad.2009.21.4.345.

Clinical and Immunohistochemical Characteristics of Mucoceles

• Lee E
• Cho SH
• Park CJ

• KMID: 2156495
• DOI: http://doi.org/10.5021/ad.2009.21.4.345

Abstract

BACKGROUND
Mucoceles have diverse clinical and histological features. Their pathogenesis remains to be elucidated.
OBJECTIVE
To determine the structural and/or pathogenic differences between two clinically different types of mucoceles.
METHODS
Seventeen oral mucoceles were examined clinically and immunohistologically. The mucoceles were divided into two groups by their clinical manifestations: papular group (PG) and nodular group (NG).
RESULTS
Histologically, granulation tissue formed more frequently in the NG group, while CD4 and CD8 positive cells were more abundant in the PG group. There were no significant differences in the tumor necrosis factor-alpha or the matrix metalloproteinases (MMP)-2 and 9, between the two groups.
CONCLUSION
There were significant differences in the depth of the lesions, granulation tissue formation and infiltrating T lymphocytes between the PG and NP type of mucoceles. These findings suggest that the clinical manifestations may be influenced by the type of inflammatory response and extracellular matrix remodeling.

Keyword

Clinical characteristics; Immunochemistry; Mucocele

MeSH Terms

Extracellular Matrix
Granulation Tissue
Immunochemistry
Matrix Metalloproteinases
Mucocele
T-Lymphocytes
Tumor Necrosis Factor-alpha
Matrix Metalloproteinases
Tumor Necrosis Factor-alpha

Figure

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  Fig. 1 (A) Asymptomatic, solitary, protruding, horn-shaped, whitish papule on the lower lip. (B) Asymptomatic, solitary, swollen, dome-shaped, erythematous nodule on the lower lip.

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  Fig. 2 (A) A skin biopsy specimen obtained from the lower lip showed a well-defined mucous retention cyst with complete definitive epithelial lining in the lamina propria. (B) A skin biopsy specimen from the lower lip showed intermixing of mucus and granulation tissue in the submucosa. (C) Inside a well-defined cavity, faintly eosinophilic amorphous material, vacuolated macrophages, lymphocytes, and a few eosinophils were observed (A, B: H&E stain, ×40, C: H&E stain, ×400).

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  Fig. 3 (A) Many CD4+ lymphocytes were observed in the granulation tissue of a mucocele. (B) Moderate number of CD4+ lymphocytes were observed in the wall and cavity of a mucocele. (C) Moderate numbers of CD8+ lymphocytes were observed in the mucosal basal layer and lamina propria. (D) A few CD8+ lymphocytes were observed in the granulation tissue, which formed the wall of a mucocele. (E) Apoptotic mucosal keratinocytes were observed evenly in the whole layer of the mucosa. (F) Apoptotic mucosal keratinocytes were observed especially on the basal layer of the mucosa (Left column photographs were taken from the PG and right column photographs were taken from NG. A, B: CD4, PAP, ×100, C: CD8, PAP, ×100, D: CD8, PAP, ×400, E, F: apoptosis, PAP, ×100).

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  Fig. 4 MMP-2+ materials (A, B), MMP-9+ materials (C, D), and TNF-α+ materials (E, F) were observed in the intercellular spaces of the granulation tissues and cavities of the mucoceles (Left column photographs were taken from PG and right column photographs were taken from the NG. A: MMP-2, PAP, ×100, B: MMP-2, PAP, ×40, C, D: MMP-9, PAP, ×100, E: TNF-α, PAP, ×40, F: TNF-α, PAP, ×200)

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