developmental and odontogenic cysts day 3 Flashcards
Orthokeratinizing Odontogenic Cyst
relation to OKC?
occurence?
- A developmental odontogenic cyst with an orthokeratin lining, NOT parakeratin
- Originally described as the “orthokeratinized variant of the odontogenic keratocyst”
- Does not behave as an odontogenic keratocyst
- no recurrence
- not related to OKC
orthokeratinizing odontogenic cyst radio
well defined uniloc lucency
Orthokeratinizing Odontogenic Cyst histo
orthokeratin in lumen
Calcifying Odontogenic Cyst
(Gorlin Cyst)
* WHO classified as
* additional names
* location/demo
* radio
* key cell
* Sometimes associated with?
- WHO: Calcifying Cystic Odontogenic Tumor
- Gorlin cyst, calcifying and keratinizing odontogenic cyst
- Anterior jaws of adults
- Radiolucent to mixed
- Ghost cells
- Sometimes associated with odontomas
Calcifying Odontogenic Cyst
(Gorlin Cyst) locations
orthokeratinizing odontogenic cyst
dif dx?
Calcifying Odontogenic Cyst (Gorlin Cyst)
Ca epithelial odontogenic tumor
AOT
odontogenic fibroma
dif dx?
ca odontogenic cyst
ca epithelial odontogenic tumor
ameloblastic fibro-odontoma
Calcifying Odontogenic Cyst
(Gorlin Cyst) histo
possess non-nucleated epi cells= ghost cells
ghost cells= Calcifying Odontogenic Cyst
(Gorlin Cyst)
Calcifying Odontogenic Cyst
(Gorlin Cyst)
note: ghost cells and calcification present
Glandular Odontogenic Cyst
* defined
* locations, demo
* radio
* behavior / recurrence
- Sialodontogenic cyst –an odontogenic cyst with glandular
(salivary) features - Anterior jaws of middle-aged adults, mandible > maxilla
- Commonly multilocular, crosses midline
- Aggressive behavior - 30% recurrence
glandular odontogenic cyst radio
well defined multilocular radiolucency
Glandular Odontogenic Cyst histo
normal cyst histo with pseudoglandular spaces and cilia on epithelium with goblet cells present
biopsy from anterior maxilla of 50 y/o female, presented as a multilocular lucency crossing the midline
glandular odontogenic cyst
Biopsy from the anterior mandible of a 45y/o male presented as a multilocular lucency crossing the midline
glandular odontogenic cyst
SOFT TISSUE CYSTS
Nasolabial Cyst
Lymphoepithelial Cyst
Cervical Lymphoepithelial Cyst
Thyroglossal Duct Cyst
Nasolabial Cyst
* additional names
* location
* from
* demo
- Nasoalveolar cyst, Klestadt cyst
- Soft tissue cyst of upper lip lateral to midline
- Developmental cyst, remnants of nasolacrimal duct
- Adult females (3:1)
Nasolabial Cyst histo
cilia on epithleium with mucus cells present
NL cyst radio
none
Oral Lymphoepithelial Cyst
demo?
locations?
- Cystic change of crypt epithelium of lymphoid aggregate
- Young adults
- Waldeyer’sring
- Tonsillar pillar
- Floor of mouth
- Ventral tongue
oral lymphoepithelial cyst histo
lumen surrounded with epi and large conn tissue wall containing germinal centers or lymphoid aggregates
Cervical Lymphoepithelial Cyst
- Branchial Cleft Cyst
- Cystic change of branchial epithelium
- Upper lateral neck anterior to border of sternocleidomastoid muscle in young adults
DST with cervical lymphoepithelial cysts
may occur with infection
Cervical Lymphoepithelial Cyst histo
- Stratified squamous epithelial lining exhibiting lymphoid tissue with or without germinal centers in wall
cervical lymphoepithelial cyst radio
none
Thyroglossal Duct Cyst
- Cystic change of thyroglossal tract epithelium
- Midline of neck in young people
thyroglossal duct cyst histo
follicles in conn tissue wall
thyroglossal duct cyst
PSUEDOCYSTS
Lack epithelial lining
Traumatic Bone Cyst
Aneurysmal Bone Cyst
Static Bone Cyst
Traumatic Bone Cyst additonal names
- Idiopathic bone cavity
- Solitary bone cyst
- Hemorrhagic bone cyst
- Simple bone cyst
- Unicameral bone cyst
Traumatic Bone Cyst
structure?
theory of origin?
- Empty cavity - not a true cyst, pesudocyst
- Trauma-hemorrhage theory of origin
Traumatic Bone Cyst
*demo
* location
* radio
* outline
* symptomatic
* Expansion
* teeth
* Biopsy
- Male (2:1)
- Teenagers –young adults
- Mandible
- Lucency
- Scalloped border frequent
- Asymptomatic
- Expansion rare (20%)
- Vital teeth
- Biopsy initiates healing, little tissue and cells maybe bone fragments
traumatic bone cyst radio
Aneurysmal Bone Cyst
*demo
* growth, symptoms
* location
*radio
- Young individuals < 20 years
- Rapidly growing, may blow out the cortex, painful
- Mandible most commonly
- Lucency, frequently multilocular
Aneurysmal Bone Cyst
how else could a aneurysmal bone cyst look on radio
unilocular
Surgical Findings Aneurysmal Bone Cyst
*bone
* blood
* gross appearence
* pigmentation
- 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
Aneurysmal Bone Cyst histo
- Not a true cyst
- Cyst-like cavities, filled with blood (lots of RBC)
- Multinucleated giant cells
biopsy, from a multilocular luceny in mandible
Aneurysmal Bone Cyst
biopsy, from a multilocular luceny in mandible
Aneurysmal Bone Cyst
Static Bone Cyst (Stafne Defect)
* symptoms
* Radio
*etiology
- Asymptomatic
- Radiolucency below inferior alveolar nerve canal
- portion of Submandibular gland stuck in bone with man development
Static Bone Cyst (Stafne Defect) histo
resembles subman gland=mixed, mainly serous
Classes of ODONTOGENIC TUMORS
Epithelial
Mesenchymal
Mixed
epithelial odontogenic tumors
- Ameloblastoma
- Adenomatoid Odontogenic Tumor
- Calcifying Epithelial Odontogenic Tumor
- Mesenchymal derived odontogenic tumors
- Odontogenic myxoma
- Odontogenic fibroma
- Cementoblastoma
*
mixed odontogenic tumors
- Odontoma
- Ameloblastic Fibroma
- Ameloblastic Fibro-odontoma
Spectrum of Odontogenic Tumors
Ameloblastoma radio app
can be multi or unilocular, mainly uniloc
Ameloblastoma
defined?
demo?
location?
recurrence?
histo resembles what structure?
does not form what tissue?
- An expansive, slow-growing, locally invasive lesion, typically of the posterior mandible of adults (mean = 35 y)
- Recurrence is common but does not metastasize *
- The histopathology of ameloblastoma recapitulates the enamel organ
- Ameloblastoma does not form and hard tissue
ameloblastoma locations
dif dx
ameloblastoma
OKC
aneurysmal bone cyst
Histologic Types Ameloblastoma
- Solid: Follicular, Plexiform, Desmoplastic, Many more………
- Unicystic
The histopathology of ameloblastoma
does not form?
The histopathology of ameloblastoma recapitulates the
enamel organ
* Ameloblastoma does not form and hard tissue
histo of ameloblastoma (high power)
odontogenic epithelium with basal cells possessing reverse polarity surrounding stellate reticululm
Follicular Ameloblastoma histo
same but with follicles containig the distinct ameloblastoma histo
Plexiform Ameloblastoma
similar to follicular but follicles form anastomoses
Desmoplastic Ameloblastoma
* Location
* density
- Anterior jaws, equally distributed between mandible and maxilla
- Mottled mixed density with diffuse margins
- Solid tumor with dense, collagenous stroma
desmoplastic ameloblastoma radio
can be mixed or opaque, dense fibrous conn tissue creates the opacity
what could this opacity be?
desmoplastic ameloblastoma
what type of ameloblastoma is this?
desmoplastic, dense fibrous conn tissue with compression of the odontogeic islands
peripheral vs central ameloblastomas
can arise in the jaw or at its periphery
Unicystic Ameloblastoma
radio?
location?
demo age?
recurrence?
- Cystogenic ameloblastoma
- Unilocular pericoronal radiolucency, usually of posterior mandible –mimics a dentigerous cyst radiographically
- 2nd to 3rd decades (Mean age = 18 y)
- Recurrence uncommon
dif dx
unicystic ameloblastoma
OKC
dentigerous cyst
Unicystic Ameloblastoma(Vickers-Gorlin Change) histo
- Nuclear hyperchromatism
- Nuclear palasading
- Reverse polarity of basal cell nuclei
- Subnuclear vacuolation
unicystic ameloblastoma, note the loose epithelium palasaded basal cells and reverse polarity of basal cells
- Sialodontogenic cyst –an odontogenic cyst with glandular
(salivary) features - Anterior jaws of middle-aged adults, mandible > maxilla
- Commonly multilocular, crosses midline
- Aggressive behavior - 30% recurrence
Glandular Odontogenic Cyst
* defined
* locations, demo
* radio
* behavior / recurrence
normal cyst histo with pseudoglandular spaces and cilia on epithelium with goblet cells present
Glandular Odontogenic Cyst histo
cilia on epithleium with mucus cells present
Nasolabial Cyst histo
- Cystic change of crypt epithelium of lymphoid aggregate
- Young adults
- Waldeyer’sring
- Tonsillar pillar
- Floor of mouth
- Ventral tongue
Oral Lymphoepithelial Cyst
demo?
locations?
lumen surrounded with epi and large conn tissue wall containing germinal centers or lymphoid aggregates
oral lymphoepithelial cyst histo
- Branchial Cleft Cyst
- Cystic change of branchial epithelium
- Upper lateral neck anterior to border of sternocleidomastoid muscle in young adults
Cervical Lymphoepithelial Cyst
- Stratified squamous epithelial lining exhibiting lymphoid tissue with or without germinal centers in wall
from region anterior to SCM mm
Cervical Lymphoepithelial Cyst histo
- Empty cavity - not a true cyst
- Trauma-hemorrhage theory of origin
Traumatic Bone Cyst
structure?
theory of origin?
- Male (2:1)
- Teenagers –young adults
- Mandible
- Lucency
- Scalloped border frequent
- Asymptomatic
- Expansion rare (20%)
- Vital teeth
- Biopsy initiates healing, little tissue and cells maybe bone fragments
Traumatic Bone Cyst
*demo
* location
* radio
* outline
* symptomatic
* Expansion
* teeth
* Biopsy
- Young individuals < 20 years
- Rapidly growing, may blow out the cortex, painful
- Mandible most commonly
- Lucency, frequently multilocular
Aneurysmal Bone Cyst
*demo
* growth, symptoms
* location
*radio
- Not a true cyst
- Cyst-like cavities, filled with blood (lots of RBC)
- Multinucleated giant cells
Aneurysmal Bone Cyst histo
- Asymptomatic
- Radiolucency below inferior alveolar nerve canal
- portion of Submandibular gland stuck in bone with man development
Static Bone Cyst (Stafne Defect)
* symptoms
* Radio
*etiology
resembles subman gland=mixed, mainly serous
Static Bone Cyst (Stafne Defect) histo
- An expansive, slow-growing, locally invasive lesion, typically of the posterior mandible of adults (mean = 35 y)
- Recurrence is common but does not metastasize *
- The histopathology resembles the enamel organ
- does not form and hard tissue
Ameloblastoma
odontogenic epithelium with basal cells possessing reverse polarity surrounding stellate reticululm
histo of ameloblastoma
- Anterior jaws, equally distributed between mandible and maxilla
- Mottled mixed density with diffuse margins
- Solid tumor with dense, collagenous stroma
Desmoplastic Ameloblastoma
* Location
* density
- Unilocular pericoronal radiolucency, usually of posterior mandible –mimics a dentigerous cyst radiographically
- 2nd to 3rd decades (Mean age = 18 y)
- Recurrence uncommon
Unicystic Ameloblastoma
- Nuclear hyperchromatism
- Nuclear palasading
- Reverse polarity of basal cell nuclei
- Subnuclear vacuolation
Unicystic Ameloblastoma(Vickers-Gorlin Change) histo