Odontogenic tumours and cysts
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This article covers odontogenic tumours and cysts, which is a subset of oral pathology and can be grouped under the heading of head and neck pathology.
The general topic of head and neck pathology is covered in the head and neck pathology and head and neck cytopathology articles.
Radicular cyst
- AKA periapical cyst.
Clinical
- Non-vital tooth - key feature.
- The tooth that has lost its nerve.
Microscopic
Features:
- Squamous epithelium - always non-keratinized.
- +/-Giant cells.
- +/-Cholesterol clefts.
DDx:
- Dentigerous cyst (history is the key to differentiate).
Notes:
- Keratinized epithelium: think keratocytic odontogenic tumour.
=Dentigerous cyst
Clinical
- Unerupted tooth - usually wisdom teeth.
- Young adults.
Gross
- Lesion at crown of tooth.
Microscopic
Features:
- Squamous epithelium - always non-keratinized.
- +/-Giant cells.
- +/-Cholesterol clefts.
DDx:
- Radicular cyst (history is the key to differentiate).
Notes:
- Keratinized epithelium: think keratocytic odontogenic tumour.
Keratocystic odontogenic tumour
General
- Used to be known as odontogenic keratocyst.[1]
- May be associated with nevoid basal cell carcinoma syndrome.
Clinical
Features:[2]
- Most common presentation: swelling.
- Location: usually mandible.
- May mimic ameloblastoma radiologically.
Microscopic
Features: [3]
- Stratified epithelium resembling squamous epithelium -- but:
- Lacks rete ridges.
- Artefactual separation of epithelium from the basement membrane.
DDx:
- Odontogenic cyst.
Images:
Ameloblastoma
General
- Osteous lesion.
Microscopic
Features:[4]
- Stellate reticulum - star-shaped cells, found in a developing tooth.[5]
- Tall columnar cells.
- Nuclei distant from the basement membrane (reverse polarization of the nuclei).
- +/-Giant cells.
Images:
See also
References
- ↑ Madras, J.; Lapointe, H. (Mar 2008). "Keratocystic odontogenic tumour: reclassification of the odontogenic keratocyst from cyst to tumour.". J Can Dent Assoc 74 (2): 165-165h. PMID 18353202.
- ↑ Habibi, A.; Saghravanian, N.; Habibi, M.; Mellati, E.; Habibi, M. (Sep 2007). "Keratocystic odontogenic tumor: a 10-year retrospective study of 83 cases in an Iranian population.". J Oral Sci 49 (3): 229-35. PMID 17928730.
- ↑ Thompson LDR. Head and neck pathology - (Foundations in diagnostic pathology). Goldblum JR, Ed.. Churchill Livingstone. 2006. ISBN 0-443-06960-3.
- ↑ URL: http://www.pathconsultddx.com/pathCon/diagnosis?pii=S1559-8675%2806%2970616-7. Accessed on: March 9, 2010.
- ↑ URL: http://en.wikipedia.org/wiki/Stellate_reticulum. Accessed on: March 9, 2010.