odontogenic tumours part 2
DESCRIPTION
Derived from odontogenic epithelium continued..TRANSCRIPT
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Dr. Ali Tahir. M.Phil Oral Pathology
Calcifying Epithelial Odontogenic TumourCEOT
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Dr. Ali Tahir. M.Phil Oral Pathology
CEOTAlso called ‘Pindborg’ tumourRare, < 1% of all tumoursLocally aggressive like ameloblastomaArises from rests of dental lamina or reduced
enamel epitheliumCentral & peripheral types
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Dr. Ali Tahir. M.Phil Oral Pathology
Clinical features20-60yrs of ageMore common in
mandibleMolar premolar areaSlow growing painless
massMaxillary lesions can
cause nasal, sinus & eye sypmtoms
Peripheral appears as a small, sessile mass, often without calcification
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Dr. Ali Tahir. M.Phil Oral Pathology
Radiographical FeaturesRadiolucent with flecks of radio-opacitiesLess commonly appears as a mixture of radio-
opaque & radiolucent areasUnilocular/MultilocularMay appear as mixed areasMostly associated with an impacted toothIndistinct line of demarcation
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Dr. Ali Tahir. M.Phil Oral Pathology
RadiographCalcifications are prominent around the crown of impacted tooth
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Dr. Ali Tahir. M.Phil Oral Pathology
CEOTD.D:
Dentigerous cystAOTAmeloblastic fibro-odontoma
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Dr. Ali Tahir. M.Phil Oral Pathology
Histological FeaturesSheets of polyhedral cellsProminent intercellular bridgesNuclie vary in size, pleomorphism may be seen
but it doesn’t indicate malignancyUnlike ameloblastoma, it has calcifications
which may be spherical or diffusePools of amorphous, eosinophilic, hyalinized
materialA clear cell variant also existsNature of Eosinophilic material is controversial
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Dr. Ali Tahir. M.Phil Oral Pathology
HistopathologySheets of Polyhedral cellsProminent intercellular bridgesPools of Eosinophilic material
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Dr. Ali Tahir. M.Phil Oral Pathology
HistopathologySpherical calcifications can be seen
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Dr. Ali Tahir. M.Phil Oral Pathology
Clear cell variant
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Dr. Ali Tahir. M.Phil Oral Pathology
Congo red stain in polarized light
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Dr. Ali Tahir. M.Phil Oral Pathology
Adenomatoid Odontogenic TumourAOT
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Dr. Ali Tahir. M.Phil Oral Pathology
Adenomatoid Odontogenic tumourAn odontogenic tumour arising from
odontogenic epithelium, around the crowns of un-erupted anterior teeth in young patients
Biologically non-aggressive
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Dr. Ali Tahir. M.Phil Oral Pathology
Clinical Features3-7% of all odontogenic
tumoursCommon in anterior jawsMore common in maxillaFrequently associated with
an impacted toothCommon in younger
patients (14-15yrs)Female predilectionPresents as swelling
around un-erupted toothUsually asymptomaticPeripheral appears as
small, sessile mass on gingiva
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Dr. Ali Tahir. M.Phil Oral Pathology
Clinical FeaturesPresents as swelling
around un-erupted tooth
Usually asymptomatic
Large lesions cause painless expansion of bone, although seldom exceeds 3cm
Peripheral appears as small, sessile mass on gingiva
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Dr. Ali Tahir. M.Phil Oral Pathology
Radiographic featuresWell corticated,
unilocular radiolucency around an impacted tooth
Flecks of radio-opacity (snow-flake calcifications)
Extends apically beyond CE junction
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Dr. Ali Tahir. M.Phil Oral Pathology
Extra-follicular type
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Dr. Ali Tahir. M.Phil Oral Pathology
Histological FeaturesOuter capsule of thick
fibrous CTSurrounds a
nodular,/ductal/whorled pattern of epithelium (spindled or columnar) surrounding pools of PAS positive material (type of basement membrane)
Spherical calcifications
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Dr. Ali Tahir. M.Phil Oral Pathology
Histological Features• Columnar epithelium
arranged in duct-like tubular structures
• These are not true ducts or glands
• Foci of calcifications may be seen
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Dr. Ali Tahir. M.Phil Oral Pathology
Calcifying Odontogenic CystGorlin cystOdontogenic Ghost Cell Tumour
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Dr. Ali Tahir. M.Phil Oral Pathology
COCA rare, well circumscribed solid or cystic
lesion with a wide spectrum of histological features & contains ghost cells & spherical calcifications
Associated with odontomasMostly occurs as solid, non-cystic lesion
called odontogenic ghost cell tumour
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Dr. Ali Tahir. M.Phil Oral Pathology
Clinical FeaturesCommon in areas
anterior to molars2nd decadeIntraosseous/
extraosseousIntraosseous causes
expansion of cortical plates
Usually painless
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Dr. Ali Tahir. M.Phil Oral Pathology
Radiographical FeaturesWell defined
unilocular radiolucency
Flecks of radio-opacities which may be irregular calcifications or tooth-like structures
1/3rd cases associated with unerupted canine
Root resorption & divergence
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Dr. Ali Tahir. M.Phil Oral Pathology
R/F
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Dr. Ali Tahir. M.Phil Oral Pathology
HistologyVariableCystic/SolidEpithelium
resembles that of ameloblastoma
Outer layer of palisaded columnar cells
Inner layer ressembels stellate reticulum
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Dr. Ali Tahir. M.Phil Oral Pathology
HistopathologyEosinophilic epithelial
cells without nuclie referred to as ‘ghost cells’
Spherical calcificationsHyalinized material
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Dr. Ali Tahir. M.Phil Oral Pathology
Squamous Odontogenic TumourRare benign odontogenic neoplasm that may
be clinically aggressiveClinical Features:Anterior to molarsPeak incidence in 3rd decadePresents as painless swelling with loosening
of teethSlow growing
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Dr. Ali Tahir. M.Phil Oral Pathology
Radiographical featuresSmall lesions have
Unilocular radiolucency
Large are multilocular
Indistinct bordersDisplaces teeth
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Dr. Ali Tahir. M.Phil Oral Pathology
HistologyIslands of normal appearing stratified
squamous epitheliumIslands may have microcyst formation in the
centreSpherical or irregular shaped calcifications
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Dr. Ali Tahir. M.Phil Oral Pathology
Histopathology