Ectopic production of hair keratin constitutes Rushton's hyaline bodies in association with hematogenous deposits.

A Rushton's hyaline body (HB) is a concretion occasionally found in odontogenic cysts. Unspecified substances produced by the lining epithelium or derived from blood components have been suggested as possible causes of HB formation, but the origin of HBs is still elusive. This study aimed to clarify the origin of HBs. Ten specimens with HBs were obtained from 400 odontogenic cysts. HBs were stained by orcein and Congo red. Immunohistochemical examination revealed that HBs were positive for hair keratin and keratin 17. Hair keratin was concentrated in HBs, and cells with hair keratin expression were hardly seen, while cells with keratin 17 expression were observed near HBs. HBs were also positive for hemoglobin alpha chain. The presence of hair keratin in HBs was confirmed by Western blot analysis. The present study suggests that HBs are formed as a consequence of two independent events: unusual alteration of epithelial differentiation so as to provide hair keratin, and hemorrhage so as to provide erythrocytic substances. Although the ectopic production of hair keratin appears more essential, our results reconcile the long-standing debate between two theories, the keratin theory versus the hematogenous theory, concluding that both substances are required for the genesis of HBs, and also suggesting that they might be novel non-pathological amyloidogenic proteins.