Rosai Chapter 5 - Mandible and Maxilla Flashcards
Major extracellular components of the tooth (3)
“DEC”
- Dentin
- Enamel
- Cementum
Major extracellular component of the tooth:
radially striated appearance caused by the presence of innumerable minute canals (the dentinal tubules) containing cytoplasmic processes from the odontoblasts
-Dentin
Major extracellular component of the tooth:
Consists of thin rods or prisms that on cross section are separated by concentric lines (lines of Retzius)
-Enamel
Major extracellular component of the tooth:
Very similar to bone in physicochemical characteristics and is indeed regarded as a special type of bone
-Cementum
Nests of cells in odontogenic epithelium (2)
- rests of Serres
- rests of Malassez
Nests of cells in odontogenic epithelium:
-located in alveolar mucosa
rests of Serres
Nests of cells in odontogenic epithelium
-resulting from breakup of the dental lamina
rests of Serres
Nests of cells in odontogenic epithelium
-embedded within the periodontium
-rests of Malassez
other name of Pulse Granulomas (4):
- Hyaline ring-like structures
- Lentil granuloma
- Oral vegetable granuloma
- Giant cell hyaline angiopathy
What disease entity?
Main microscopic finding:
-Acute suppurative inflammation and resorptive scalloping of margins of non-vital bone within a large portion of maxilla and mandible
-Acute and Subacute Osteomyelitis
component of SAPHO Syndrome (5):
- Synovitis
- Acne
- Pustulosis
- Hyperostosis
- Osteitis
True or False (re: SAPHO syndrome):
- There is non-suppurative osteomyelitis of the jaw
- Antibiotic therapy is NOT effective
1 & 2. True
other name of Simple Bone Cyst (3):
- Traumatic cyst
- Solitary cyst
- Hemorrhagic cyst
What histologic feature is common on these jaw lesions?
- Central giant cell lesion (granuloma)
- Cherubism
- Giant cell tumor (Osteoclastoma)
- Fibro-osseous lesions
- the bone lesion of Hyperparathyroidism (brown tumor)
- Hereditary hyperparathyroidism-jaw tumor syndrome
- Aneurysmal bone cyst
-Large numbers of Osteoclast-like multinucleated giant cells
Most common lesion of the jaw that feature large numbers of Osteoclast-like multinucleated giant cells
-Central giant cell lesion (granuloma)
other name of Central giant cell granuloma
Reparative giant cell granuloma
other name of Ossifying fibroma (2):
- Cementifying fibroma
- Cemento-ossifying fibroma
Types of Osseous dysplasia (3)
- Periapical
- Focal
- Florid
Type of Osseous dysplasia:
-Found in middle-aged black women
-Periapical
Type of Osseous dysplasia:
-Apex of a single tooth, usually a mandibular incisor
-Periapical
Type of Osseous dysplasia:
-Multiple teeth in the posterior mandible
-Focal
Type of Osseous dysplasia:
-Multiple jaw quadrants
-Florid
Type of Osseous dysplasia:
-Symptomatic
-Florid
Which entity?
Microscopically, the most typical feature:
-Presence of curvilinear trabecular (“ginger root” pattern) or irregularly-shaped cementum-like masses set within a vascular stroma
Osseous dysplasia
Two major categories of epithelial cysts
- Odontogenic cysts
- Fissural (Non-odontogenic) cysts
Category of Epithelial Cyst
-arise from the odontogenic epithelium
-Odontogenic cyst
Category of Epithelial Cyst
-located within the jaw (rarely in the adjacent soft tissue)
-Odontogenic cyst
Category of Epithelial Cyst
-arise from epithelial inclusions within soft or body portions of the region that lack the embryologic and tooth-forming heritage of odontogenic epithelium
-Fissural (Non-odontogenic) cyst
Category of Epithelial Cyst
-along embryologic fissure lines
-Fissural (Non-odontogenic) cyst
Category of Epithelial Cyst
-outside of the jaw bones
-Fissural (Non-odontogenic) cyst
Most frequent location of Adenomatoid Odontogenic Tumor
Anterior maxilla
Other name of Adenomatoid Odontogenic Tumor
Adenoameloblastoma
Other name of Calcifying Epithelial Odontogenic Tumor
Pindborg tumor
Ameloblastic Fibroma vs. Ameloblastoma
-Cellular myxoid connective tissue stroma - Present
Ameloblastic Fibroma
Ameloblastic Fibroma vs. Ameloblastoma
-Cellular myxoid connective tissue stroma - Absent
Ameloblastoma
Most common odontogenic tumor
Odontoma
Other name of Odontoameloblastoma (2):
- Ameloblastic Odontoma
- Odontoblastoma
Odontoameloblastoma vs. Ameloblastoma
-Dental hard tissues - Present
Odontoameloblastoma
Odontoameloblastoma vs. Ameloblastoma
-Dental hard tissues - Absent
Ameloblastoma
Positive IHCs of Myxoma cells in Odontogenic Myxoma (2)
- Vimentin
- SMA
Negative IHC of Myxoma cells in Odontogenic Myxoma
-S100
Intramuscular myxoma vs. Odontogenic myxoma
-Activating mutations in the GNAS1 gene - Present
Intramuscular myxoma
Intramuscular myxoma vs. Odontogenic myxoma
-Activating mutations in the GNAS1 gene - Absent
Odontogenic myxoma
Most common of the epithelial odontogenic tumors
Ameloblastoma
Two predominant patterns of ameloblastoma
- Follicular
- Plexiform
Positive IHCs of Ameloblastoma (2)
- Cytokeratins (5, 14, 8, 18, and 19)
- Calretinin
Cytokeratin IHC stain that is positive in Ameloblastoma cells in stellate reticulum-like areas (3)
- CK8
- CK18
- CK19
Ameloblastoma vs. Keratocyst
-Calretinin - Positive
Ameloblastoma
Ameloblastoma vs. Keratocyst
-Calretinin - Negative
Keratocyst
Positive or Negative
IHC of Granular cell Ameloblastoma:
-Keratin
Positive
Positive or Negative
IHC of Granular cell Ameloblastoma:
-CD68
Positive
S100
Negative
Type/s of Unicystic Ameloblastoma
-Ameloblastous epithelium confine to the cyst lining
-Luminal and Intraluminal types
Type/s of Unicystic Ameloblastoma
-Ameloblastous epithelium extends into the underlying stroma
-Mural type
Type/s of Unicystic Ameloblastoma
Tx: Simple enucleation
-Luminal and Intraluminal types
Type/s of Unicystic Ameloblastoma
Tx: treated like conventional solid/multicystic ameloblastomas because they have recurrence risk
-Mural type
Other name of ameloblastic fibrosarcoma (2)
- Odontogenic sarcoma
- Odontogenic fibrosarcoma
Other name of Melanotic neuroectodermal tumor of infancy (2)
- Melanotic progonoma
- Retinal anlage tumor
Most common location of Melanotic neuroectodermal tumor of infancy
Maxilla
Positive IHCs of MNET of infancy
-in the Small neuroblastic cells (4):
- NSE
- CD57
- Synaptophysin
- GFAP
Positive IHCs of MNET of infancy
-in the Epithelial cells (3)
- CK
- HMB45
- Vimentin
Most common primary malignant tumor of the jaw
Osteosarcoma
Clue to the diagnosis of Tophaceous pseudogout (humoral Calcium Pyrophosphate Dehydrate Crystal Deposition Disease [CPDCDD])
-identification by polarized light of birefringent crystals associated with granulomatous reaction
