Cysts and Odontogenic Tumors Part 3 Flashcards
what are the soft tissue cysts
- nasolabial cysts
- lymphoepithelial cyst
- cervical lymphopithelial cyst
- thyroglossal duct cyst
what is another name for the naslabial cyst
- nasoalveolar cyst
- klestadt cyst
describe the nasolabial cyst, the location and predeliction
- soft tissue cyst of the upper lip lateral to midline
- developmental cyst, remants of nasolacrimal duct
- adult females 3:1
describe the histology of the nasolabial cyst
- goblet cells
- cilia
- respiratory like epithelium
how do you tell the difference between the nasolabial cyst and the glandular odontogenic cyst
there will be radiographic presentation with glandular odontogenic cyst
describe the oral lymphoepithelial cyst
- cystic change of crypt epithelium of lymphoid aggregate
who is the oral lymphoepithelial cyst common in and where is it found
- young adults
- waldeyer’s ring
- tonsillar pillar
- FOM
- ventral tongue
describe the histology for the oral lymphoepithelial cyst
- lymphoid tissue with germinal centers
what is another name for the cervical lymphoepithelial cyst
branchial cleft cyst
describe the cervical lymphoepithelial cyst and the location
- cystic change of branchial epithelium
- upper lateral neck anterior to border of sternocleidomastoid muscle in young adults
describe the cervical lymphoepithelial cyst histology
- stratified squamous epithelial lining exhibiting lymphoid tissue with or without germinal centersin the wall
describe the thyroglossal duct cyst and the predilection
- cystic change of thyroglossal tract epithelium
- midline of neck in young people
describe the histology of the thyroglossal duct cyst
- thyroid follicles
what are the pseudocysts
- traumatic bone cysts
- aneurysmal bone cyst
- static bone cyst
what makes pseudocysts not real cysts
missing the epithelium
what are the other names for the traumatic bone cyst
- idiopathic bone cavity
- solitary bone cyst
- hemorrhagic bone cyst
- simple bone cyst
- unicameral bone cyst
describe the traumatic bone cyst and the theory of origin
- empty cavity- not a true cyst
- trauma- hemorrhage theory of origin
describe the traumatic bone cyst incluing the predeliction
- male (2:1)
- teenagers- young adults
- mandible
- lucency
- scalloped border frequent
- asymptomatic
- expansion rare (20%)
- vital teeth
- biopsy initiates healing
if you decide to put traumatic bone cyst in the DDX make sure:
there is no root resorption
describe the aneurysmal bone cyst and the predilection
- young individuals less than 20 years old
- rapidly growing, may blow out the cortex, painful
- mandible most common
- lucency, frequently multilocular
what are the surgical findings of the aneurysmal bone cyst
- ballooning dilation of bone
- blood welling up from within the cavity, like a blood-soaked sponge
- fleshy aggregates of tumor surrounding cystic spaces filled with blood
- hemosiderin pigmentation
what is seen in the anuerysmal bone cyst
- not a true cyst
- cyst like cavities, filled with blood
- multinucleated giant cells
describe the stafne bone cyst
- asymptomatic
- radiolucency below inferior alveolar nerve canal
- submandibular gland
what are the classes of odontogenic tumors
- epithelial
- mesenchymal
- mixed
what are the epithelial odontogenic tumors
- ameloblastoma
- adenomatoid odontogenic tumor
- calcifying epithelial odontogenic tumor
what are the mesenchymal odontogenic tumors
- odontogenic myxoma
- odontogenic fibrome
- cementoblastoma
what are the mixed odontogenic tumors
- odontoma
- ameloblastic fibroma
- ameloblastic fibro odontoma
ameloblastoma is the ___ differentiated and ____ aggressive
least; most
odontoma is the -_______ differentiated and the ___ aggresive
most; least
describe an ameloblastoma
- conventional ameloblastoma
- an expansile, slow growing, locally invasive lesion, typically of posterior mandible of adults - mean = 35years
- recurrence is common but does not metastasize
- the histopathology of ameloblastoma recapitulates the enamel organ
- ameloblastoma does not form hard tissue!!
- radiolucent!!
what percentage of ameloblastomas occur in the anterior maxilla
6%
what are the clinicpathologic forms of ameloblastomas
- multilocular radiolucency
- expanding from bone- desmoplastic
- pericoronal radiolucency - unicystic
- bump on gums: extra/osseous/peripheral ameloblastoma
what are the histologic types of ameloblastomas
- solid: follicular, plexiform, desmoplastic
- unicystic
describe the histology of an ameloblastoma
- the histopathology of ameloblastoma recapitulates the enamel organ
- ameloblastoma does not form hard tissue
- large ameloblastic island
- loose epithelium called stellate reticulum
- at the periphery there a clear area called cytoplasmic vacuolization because of reverse polarity
what is the difference in histology between the follicular ameloblastoma and the plexiform ameloblastoma
- the plexiform tends to connect where the islands come together
describe the desmoplastic ameloblastoma and its predilection
- anterior jaws, equally distributed between mandible and maxilla
- mottled mixed density with diffuse margins
- solid tumor with dense collagenous stroma
- can cause root divergence
why does the desmoplastic ameloblastoma appear radiopaque
because it has very dense fibrous CT stroma
what is the histologic presentation of desmoplastic ameloblastoma
- does not have mineralization
- can see ameloblastic islands
- cannot see stellate reticulum or cytoplasmic vacuolization here because it is squished
what is a peripheral ameloblastoma
if it appears on the bump on the gums with no radiographic presentation and feels firm
what is a central ameloblastoma
means it is inside the bone
describe the unicystic ameloblastoma and the prediclection
- cytogenic ameloblastoma
- unilocular radiolucency usually of posterior mandible
- 2nd to 3rd decade of life, mean age = 18 years
- recurrence uncommon
what does a unicystic ameloblastoma mimic radiographically
a dentigerous cyst
what is the vicker’s gorlin change in unicystic ameloblastomas
- nuclear hyperchromatism
- nuclear palasading
- reverse polarity of basal cell nuclei
- subnuclear vacuolation
what is the predilection for adenomatoid odontogenic tumors
- mixed density
- teenagers: 75%
- female: 2:1
- maxilla 2:1
- anterior 75%
what is the histologic presentation of the adenomatoid odontogenic tumor
- rolling pattern : Zell ballin
- calcifications
- pseudo ducts
what is the only tumor that has pseudo ducts
adenomatoid odontogenic tumor
