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{{ Infobox diagnosis | |||
| Name = {{PAGENAME}} | |||
| Image = Ameloblastoma - high mag.jpg | |||
| Width = | |||
| Caption = Ameloblastoma. [[H&E stain]]. | |||
| Synonyms = | |||
| Micro = stellate reticulum (star-shaped cells), tall columnar cells that have palisaded nuclei with reverse polarization, subnuclear vacuolization, +/-giant cells, +/-subepithelial hyalinization (eosinophilic acellular amorphous material) | |||
| Subtypes = solid/multicystic, unicystic | |||
| LMDDx = [[adenomatoid odontogenic tumour]], [[ameloblastic fibroma]] | |||
| Stains = | |||
| IHC = | |||
| EM = | |||
| Molecular = | |||
| IF = | |||
| Gross = | |||
| Grossing = | |||
| Site = usu. mandible - see ''[[odontogenic tumours and cysts]]'' | |||
| Assdx = | |||
| Syndromes = | |||
| Clinicalhx = | |||
| Signs = | |||
| Symptoms = | |||
| Prevalence = uncommon | |||
| Bloodwork = | |||
| Rads = | |||
| Endoscopy = | |||
| Prognosis = locally aggresive, rarely malignant | |||
| Other = | |||
| ClinDDx = [[keratocystic odontogenic tumour]], odontogenic cysts | |||
| Tx = | |||
}} | |||
'''Ameloblastoma''' is an [[odontogenic tumour]]. | |||
==General== | |||
*Osteous lesion. | |||
*Usually mandible.<ref>URL: [http://www.waent.org/archives/2010/Vol3-2/20100618-ameloblastoma/jaw-tumor.htm http://www.waent.org/archives/2010/Vol3-2/20100618-ameloblastoma/jaw-tumor.htm]. Accessed on: 30 November 2011.</ref> | |||
**In a review of 3677 cases, the mandible-to-[[maxilla]] ratio was 5 to 1.<ref name=pmid7633291>{{Cite journal | last1 = Reichart | first1 = PA. | last2 = Philipsen | first2 = HP. | last3 = Sonner | first3 = S. | title = Ameloblastoma: biological profile of 3677 cases. | journal = Eur J Cancer B Oral Oncol | volume = 31B | issue = 2 | pages = 86-99 | month = Mar | year = 1995 | doi = | PMID = 7633291 }}</ref> | |||
*May arise from an odontogenic cyst,<ref name=pmid10587275>{{Cite journal | last1 = Eversole | first1 = LR. | title = Malignant epithelial odontogenic tumors. | journal = Semin Diagn Pathol | volume = 16 | issue = 4 | pages = 317-24 | month = Nov | year = 1999 | doi = | PMID = 10587275 }}</ref> e.g. [[dentigerous cyst]].<ref name=pmid21957386>{{Cite journal | last1 = Moosvi | first1 = Z. | last2 = Tayaar | first2 = SA. | last3 = Kumar | first3 = GS. | title = Neoplastic potential of odontogenic cysts. | journal = Contemp Clin Dent | volume = 2 | issue = 2 | pages = 106-9 | month = Apr | year = 2011 | doi = 10.4103/0976-237X.83073 | PMID = 21957386 | PMC = 3180832 }}</ref> | |||
*Can be malignant<ref name=pmid15454770>{{Cite journal | last1 = Goldenberg | first1 = D. | last2 = Sciubba | first2 = J. | last3 = Koch | first3 = W. | last4 = Tufano | first4 = RP. | title = Malignant odontogenic tumors: a 22-year experience. | journal = Laryngoscope | volume = 114 | issue = 10 | pages = 1770-4 | month = Oct | year = 2004 | doi = 10.1097/00005537-200410000-00018 | PMID = 15454770 }}</ref> - rare.<ref name=pmid23775022>{{Cite journal | last1 = Chou | first1 = YH. | last2 = Jhuang | first2 = JY. | last3 = Chang | first3 = MH. | last4 = Huang | first4 = WC. | last5 = Hsieh | first5 = MS. | title = Metastasizing Ameloblastoma With Localized Interstitial Spread in the Lung: Report of Two Cases. | journal = Int J Surg Pathol | volume = | issue = | pages = | month = Jun | year = 2013 | doi = 10.1177/1066896913491321 | PMID = 23775022 }}</ref> | |||
===Classification=== | |||
Location: | |||
#Intra-osseous. | |||
#*Locally aggressive. | |||
#Peripheral. | |||
#*Benign. | |||
====Subclassification of intra-osseous type==== | |||
Histology: | |||
#Solid/multicystic. | |||
#*More commonly reoccur. | |||
#Unicystic. | |||
#*Unlikely to reoccur. | |||
#*Classically found in younger individuals. | |||
==Gross== | |||
*Mass - usu. mandible or maxilla.<ref name=pmid23775022/> | |||
**Mandile most common. | |||
==Microscopic== | |||
Features:<ref>URL: [http://www.pathconsultddx.com/pathCon/diagnosis?pii=S1559-8675%2806%2970616-7 http://www.pathconsultddx.com/pathCon/diagnosis?pii=S1559-8675%2806%2970616-7]. Accessed on: March 9, 2010.</ref> | |||
*Stellate reticulum - star-shaped cells, found in a developing tooth. | |||
*Tall columnar cells. | |||
**Palisaded nuclei with reverse polarization. | |||
***Reverse polarization of nuclei = nuclei distant from the basement membrane/nuclei at pole opposite of basement membrane. | |||
***Palisaded nuclei = picket fence appearance; columnar-shaped nuclei with long axis perpendicular to the basement membrane -- '''key feature'''. | |||
**Subnuclear vacuolization. | |||
*+/-Giant cells. | |||
*+/-Subepithelial hyalinization (eosinophilic acellular amorphous material). | |||
**Seen deep to the basement membrane. | |||
*Variable morphology (see below - ''morphology''). | |||
DDx (nuclear palisading): | |||
*[[Adenomatoid odontogenic tumour]]. | |||
*[[Ameloblastic fibroma]]. | |||
===Images=== | |||
<gallery> | |||
Image: Ameloblastoma - low mag.jpg | Ameloblastoma - low mag. (WC) | |||
Image: Ameloblastoma - intermed mag.jpg | Ameloblastoma - intermed. mag. (WC) | |||
Image: Ameloblastoma - high mag.jpg | Ameloblastoma - high mag. (WC) | |||
Image: Ameloblastoma - very high mag.jpg | Ameloblastoma - very high mag. (WC) | |||
</gallery> | |||
===Morphology=== | |||
*Not prognostic. | |||
Morphologic variants: | |||
*Follicular ameloblastoma (classic appearance). | |||
*Plexiform ameloblastoma (does not have prominent palisading). | |||
*Acanthomatous ameloblastoma. | |||
*Desmoplastic ameloblastoma. | |||
*Basaloid ameloblastoma. | |||
==See also== | |||
*[[Odontogenic tumours and cysts]]. | |||
==References== | |||
{{Reflist|2}} | |||
[[Category:Odontogenic tumours and cysts]] | |||
[[Category:Diagnosis]] | [[Category:Diagnosis]] |
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