Difference between revisions of "Odontogenic tumours and cysts"
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The general topic of ''head and neck pathology'' is covered in the ''[[head and neck pathology]]'' and ''[[head and neck cytopathology]]'' articles. | The general topic of ''head and neck pathology'' is covered in the ''[[head and neck pathology]]'' and ''[[head and neck cytopathology]]'' articles. | ||
==Tooth histiology 101== | |||
Teeth develop from a combination of: | |||
#Epithelium (downward growth). | |||
#Mesenchyme. | |||
==Enamel 101== | |||
*Arises from ''reduced enamel epithelium''. | |||
===Reduced enamel epithelium=== | |||
====Microscopic==== | |||
Features: | |||
*Bilayered epithelium consisting of: | |||
**Cuboidal/columnar cells with: | |||
***Moderate eosinophilic cytoplasm. | |||
***Round (slightly irregular) centrally place nuclei. | |||
Notes: | |||
*Transforms into squamous epithelium. (???) | |||
==Radicular cyst== | ==Radicular cyst== | ||
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*Keratinized epithelium: think keratocytic odontogenic tumour. | *Keratinized epithelium: think keratocytic odontogenic tumour. | ||
===Dentigerous cyst== | ===Dentigerous cyst=== | ||
===Clinical=== | ===Clinical=== | ||
*Unerupted tooth - usually wisdom teeth. | *Unerupted tooth - usually wisdom teeth. | ||
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===General=== | ===General=== | ||
*Osteous lesion. | *Osteous lesion. | ||
===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. | |||
===Microscopic=== | ===Microscopic=== | ||
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*Stellate reticulum - star-shaped cells, found in a developing tooth.<ref>URL: [http://en.wikipedia.org/wiki/Stellate_reticulum http://en.wikipedia.org/wiki/Stellate_reticulum]. Accessed on: March 9, 2010.</ref> | *Stellate reticulum - star-shaped cells, found in a developing tooth.<ref>URL: [http://en.wikipedia.org/wiki/Stellate_reticulum http://en.wikipedia.org/wiki/Stellate_reticulum]. Accessed on: March 9, 2010.</ref> | ||
*Tall columnar cells. | *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 aligned perpendicular to the basement membrane -- '''key feature'''. | |||
**Subnuclear vacuolization. | |||
*+/-Giant cells. | *+/-Giant cells. | ||
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*[http://www.cytochemistry.net/microanatomy/digestive/devtooth9.jpg Stellate reticulum (cytochemistry.net)]. | *[http://www.cytochemistry.net/microanatomy/digestive/devtooth9.jpg Stellate reticulum (cytochemistry.net)]. | ||
==Odontogenic myxoma== | |||
===General=== | |||
*Benign tumour of mesenchymal origin. | |||
*Often reoccurs. | |||
*Radiologic DDx includes ameloblastoma. | |||
===Gross=== | |||
*Gelatinous mass. | |||
===Microscopic=== | |||
Features: | |||
*Paucicellular lesion with pale staining. | |||
==See also== | ==See also== | ||