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Neville and Damm > Ch15-Ectomesenchyme Odontogenic Tumors > Flashcards

Ch15-Ectomesenchyme Odontogenic Tumors Flashcards

1
Q

What are the four odontogenic tumors derived from odontogenic ectomesenchyme?

A
  1. Odontogenic fibroma (central/peripheral) 2.Granular Cell Odontogenic Tumor 3. Odontogenic Myxoma 4.Cementoblastoma
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2
Q

What entity is often diagnosed INSTEAD of an odontogenic fibroma?

A

hyperplastic dental follicle (not a neoplasm)

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3
Q

Odontogenic fibroma: age? sex? location (complicated lol)? Recurrence?

A

40 years. female..maxillary anterior to 1st molar…mandibular posterior to first molar..recurrence is LOW

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4
Q

What % of odontogenic fibromas are associated with an unerupted tooth?

A

33%

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5
Q

What entity can cause this? Interestingly, the palatal mucosa that overlies the tumor occasionally may exhibit a defect or groove.

A

Odontogenic fibroma

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6
Q

About 12% of odontogenic fibromas have what radiographic feature?

A

RO flecks

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7
Q

What are the two histologic types of odontogenic fibroma?

A
  1. epithelium poor (simple) 2. epithelial rich (WHO odontogenic fibroma)
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8
Q

The _______ type of odontogenic fibroma is composed of stellate fibroblasts, often arranged in a whorled pattern with fine collagen fibrils and considerable ground substance

A

simple

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9
Q

The ______ type of odontogenic fibroma has a more
complex pattern, which often consists of a fairly cellular
fibrous connective tissue with collagen fibers arranged in interlacing bundles.

A

epithelium-rich

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10
Q

The ______ type of OF: Odontogenic epithelium in the form of long strands or isolated nests is present throughout the lesion

A

epithelium-rich

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11
Q

The ______ type of OF: Small foci of odontogenic
epithelial rests should be present, Spindle cell collagenous lesions that do not have epithelial rests may represent other entities, such as desmoplastic fibroma, myofibroma, or neurofibroma. Occasional foci of dystrophic calcification may be seen.

A

simple

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12
Q

The ______ type of OF: The fibrous component may vary from myxoid to densely hyalinized. Calcifications composed of cementum-like material or dentinoid present

A

epithelium-rich

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13
Q

Which type of OF can have focal deposits of ODAM (odontogenic ameloblast-associated protein) and therefore may represent a CEOT?

A

Epithelium-rich

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14
Q

Approximately 20 examples of central odontogenic fibroma associated with _________???

A

giant cell granuloma-LIKE component (lol)

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15
Q

It’s likely that odontogenic epithelial hamartoma and peripheral fibroameloblastic dentinoma refer to WHAT entity?

A

Peripheral Odontogenic Fibroma

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16
Q

Where is the peripheral odontogenic firboma most often found? Age?

A

facial gingiva of the mandible…2nd-4th decades

17
Q

The PERIPHERAL odontogenic fibroma is most similar to which type of central OF?

A

Epithelium-rich (WHO type) (so you can get giant cell granuloma features too)

18
Q

What might this be describing? odontogenic epithelium may be prominent or scarce The epithelial cells may show vacuolization. Dysplastic dentin, amorphous
ovoid cementum-like calcifications, and trabeculae of
osteoid may also be present.

A

Peripheral Odontogenic Fibroma

19
Q

Granular Cell Odontogenic Tumor: age? sex? location? recurrence?

A

older than 40 years…70% female..posterior mandible..RARE one recurrence recorded

20
Q

Granular Cell Odontogenic Tumor: Histogenesis is CONTROVERSIAL: studies reveal the features of _______ cells, and bodies consistent with _______ structures have been identified within the lesional cell cytoplasm.

A

mesenchymal….lysosomal

21
Q

Granular Cell Odontogenic Tumor: IHC,
the granular cells DO NOT react with antibodies directed against _______, in contrast to the positive reactivity
of the granular cell tumor.

A

S-100 protein

22
Q

______ of the jaws are believed to arise from odontogenic ectomesenchyme. They bear a close microscopic resemblance to the mesenchymal portion of a developing tooth.

23
Q

Interesting…most authorities in orthopedic pathologic practice DO NOT accept that _______ occur in the extragnathic skeleton, and all of them in the jaws are currently considered to be of odontogenic origin.

24
Q

Myxoma: age? sex? location?

A

young adults..average age for patients with myxomas is 25 to 30 years. There is no sex predilection. The tumor may be found in almost any area of the jaws, and the mandible is involved more commonly than the maxilla

25
Q

What two lesions are associated with the radiographic BUZZ WORD of “SOAP BUBBLE”

A

myxoma and ameloblastoma

26
Q

Besides a SOAP BUBBLE radiographic appearance, what is another buzz word for a myxoma on radiograph?

A

“stepladder”

27
Q

Histochemical study of myxomas show that the ground substance is primarily made of _______, chiefly ________ and ________

A

GAGs…hyaluronic acid and chondroitin sulfate

28
Q

What are the two (BS) stains that will be positive for a myxoma?

A

vimentin (diffuse), muscle-specific actin (focal)

29
Q

In some patients, a myxoma may have a greater tendency to form collagen fibers; such lesions are sometimes designated as ________ or ________ (lol)

A

fibromyxomas…myxofibromas

30
Q

What is on the other end of the spectrum from a myxoma? What are two entities in between?

A

Myxoma->myxofibroma->fibromyxoma->odontogenic fibroma

31
Q

A myxoma may be microscopically confused with other

myxoid jaw neoplasms, such as the rare ________ or the _________

A

chondromyxoid fibroma OR the myxoid neurofibroma

32
Q

A myxoma can be confused with a Chondromyxoid fibroma, but it should have areas of _______ differentiation, and myxoid neurofibromas, which
have vague fascicles, as well as scattered cells that are positive for ____ protein.

A

cartilaginous…. S-100

33
Q

Myxoid change in an enlarged _____ or the ______ of a developing tooth may be microscopically similar to a myxoma

A

dental follicle or the dental papilla

34
Q

Myxoma recurrence? What is it called if malignant features show up?

A

25%…myxosarcoma or malignant odontogenic myxoma

35
Q

How aggressive IS that odtontogenic cyst or tumor? (Keep scrolling)

  • Ameloblastoma (conventional w/ curettage, conventional with marginal resection, and unicystic with curettage, peripheral)
  • GOC
  • OKC
  • Myxoma
  • CEOT
  • Ameloblastic Fibroma
  • Ameloblastic Fibro-odontoma
  • OOC
  • COC (peripheral COC too)
  • LPC
  • Granular Cell OT
  • Odontogenic Fibroma
A
  • Ameloblastoma (conventional w/ curettage 50-90%, conventional with marginal resection 15%, and unicystic with curettage 30% (controversial), peripheral 15-20%)
  • GOC 30%
  • OKC 30%
  • Myxoma 25%
  • CEOT 15%
  • Ameloblastic Fibroma 0-18%
  • Ameloblastic Fibro-odontoma 7%
  • OOC 2%
  • COC (peripheral COC too) “Few” (perpheral 15-20%)
  • LPC “unusual”
  • Granular Cell OT “rare”
  • Odontogenic Fibroma “low”

Neville and Damm (72 decks)

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