Difference between revisions of "Ameloblastoma"

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#redirect [[Odontogenic tumours and cysts#Ameloblastoma]]
{{ 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]]

Latest revision as of 17:31, 26 May 2022

Ameloblastoma
Diagnosis in short

Ameloblastoma. H&E stain.
LM 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
LM DDx adenomatoid odontogenic tumour, ameloblastic fibroma
Site usu. mandible - see odontogenic tumours and cysts
Prevalence uncommon
Prognosis locally aggresive, rarely malignant
Clin. DDx keratocystic odontogenic tumour, odontogenic cysts

Ameloblastoma is an odontogenic tumour.

General

Classification

Location:

  1. Intra-osseous.
    • Locally aggressive.
  2. Peripheral.
    • Benign.

Subclassification of intra-osseous type

Histology:

  1. Solid/multicystic.
    • More commonly reoccur.
  2. Unicystic.
    • Unlikely to reoccur.
    • Classically found in younger individuals.

Gross

  • Mass - usu. mandible or maxilla.[6]
    • Mandile most common.

Microscopic

Features:[7]

  • 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):

Images

  • Ameloblastoma - low mag. (WC)

  • Ameloblastoma - intermed. mag. (WC)

  • Ameloblastoma - high mag. (WC)

  • Ameloblastoma - very high mag. (WC)

Morphology

  • Not prognostic.

Morphologic variants:

  • Follicular ameloblastoma (classic appearance).
  • Plexiform ameloblastoma (does not have prominent palisading).
  • Acanthomatous ameloblastoma.
  • Desmoplastic ameloblastoma.
  • Basaloid ameloblastoma.

See also

References

  1. ↑ URL: http://www.waent.org/archives/2010/Vol3-2/20100618-ameloblastoma/jaw-tumor.htm. Accessed on: 30 November 2011.
  2. ↑ Reichart, PA.; Philipsen, HP.; Sonner, S. (Mar 1995). "Ameloblastoma: biological profile of 3677 cases.". Eur J Cancer B Oral Oncol 31B (2): 86-99. PMID 7633291.
  3. ↑ Eversole, LR. (Nov 1999). "Malignant epithelial odontogenic tumors.". Semin Diagn Pathol 16 (4): 317-24. PMID 10587275.
  4. ↑ Moosvi, Z.; Tayaar, SA.; Kumar, GS. (Apr 2011). "Neoplastic potential of odontogenic cysts.". Contemp Clin Dent 2 (2): 106-9. doi:10.4103/0976-237X.83073. PMC 3180832. PMID 21957386. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3180832/.
  5. ↑ Goldenberg, D.; Sciubba, J.; Koch, W.; Tufano, RP. (Oct 2004). "Malignant odontogenic tumors: a 22-year experience.". Laryngoscope 114 (10): 1770-4. doi:10.1097/00005537-200410000-00018. PMID 15454770.
  6. ↑ 6.0 6.1 Chou, YH.; Jhuang, JY.; Chang, MH.; Huang, WC.; Hsieh, MS. (Jun 2013). "Metastasizing Ameloblastoma With Localized Interstitial Spread in the Lung: Report of Two Cases.". Int J Surg Pathol. doi:10.1177/1066896913491321. PMID 23775022.
  7. ↑ URL: http://www.pathconsultddx.com/pathCon/diagnosis?pii=S1559-8675%2806%2970616-7. Accessed on: March 9, 2010.
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