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Lab Paget`s Disease

and Bone TumorsDr. Rima Safadi

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Torus palatinusEtiology: genetic versus environmentalArises at the midline of the hard palate

Can slowly increase in size

Peak prevalence is in adult- dynamic

Nodular torus Lobular torusSpindle torus and flat torus

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Torus mandibularis

At the lingual aspectPresent above themylohyoid line90% bilateralVaries in sizeCan correlate with

bruxismTrt: surgical removalfor dentureconstruction

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Exostoses

Buccalexostosis

Subpontine exostosis

Palatal exostosis

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Exostosis

Histopathology

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Dense Bone Island

IdiopathicosteosclerosisSclerotic bone

Premolar regionof the mandibleWell defined notsurrounded byradiolucent lineSeparated orattached to root

apex

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12 Well defined radiolucent radioopaque

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Ossifying fibroma

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Ossifying fibroma

Fibrous stroma

Bone trabeculae

Osteoblastic rimming

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Psammomatoid ossifying fibroma

Cementum like bodies

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Ossifying fibroma

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Loose teeth

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Also gingival swelling

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Differential diagnosis??

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Floating in air teeth

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Biopsy

Langehrans cell-malignanteosinophils

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Diagnosis?

Langerhans cell histiocytosis

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74 yr old hospitalized for low backpain

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Punched out radiolucencies

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Also present is gingival swelling

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Malignant plasmacells

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Malignant plasmacells

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Immunohistochemistrykappa light chain (positive)

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Immunohistochemistrylambda light chain(negative)

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Diagnosis:

Multiple myeloma

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Malignant osteoid

Malignantosteoblasts

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Hemangioma

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Central hemangioma

Cavernous blood spaces

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Ill defined RL in anterior maxilla

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Chondrosarcoma

Malignant chondroi

Malignant chondroblasts

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Hard swelling at right angle ofmandible

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Compact osteoma

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Colonic biopsy

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Adenoma

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Diagnosis

Gardner Syndrome

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Paget`s Disease of Bone

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Paget`s Disease of Bone

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Paget`s Disease of Bone

P ’ Di

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Paget’s Disease Oral Features

When teeth areinvolved:Ankylosis

HypercementosisRoot resorption inosteolytic phase

Postextractionhemorrhage in activephaseMore prone to infectionin sclerotic phase

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Paget`s Disease of Bone

Loss of diploeDense bone

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Paget`s Disease of Bone

Reversal lines ciss-cross lines

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Osteosarcoma

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Metastatic carcinoma

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Metastatic disease

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Mts