Odontogenic tumours part 2

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Derived from odontogenic epithelium continued..

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Odontogenic tumours part 2

  1. 1. CEOT Dr. Ali Tahir. M.Phil Oral Pathology
  2. 2. CEOT Also called ‘Pindborg’ tumour Rare, < 1% of all tumours Locally aggressive like ameloblastoma Arises from rests of dental lamina or reduced enamel epithelium Central & peripheral types Dr. Ali Tahir. M.Phil Oral Pathology
  3. 3. Clinical features 20-60yrs of age More common in mandible Molar premolar area Slow growing painless mass Maxillary lesions can cause nasal, sinus & eye sypmtoms Peripheral appears as a small, sessile mass, often without calcification Oral Pathology Dr. Ali Tahir. M.Phil
  4. 4. Radiographical Features Radiolucent with flecks of radio-opacities Less commonly appears as a mixture of radio-opaque & radiolucent areas Unilocular/Multilocular May appear as mixed areas Mostly associated with an impacted tooth Indistinct line of demarcation Dr. Ali Tahir. M.Phil Oral Pathology
  5. 5. RadiographCalcifications areprominent around thecrown of impacted tooth Dr. Ali Tahir. M.Phil Oral Pathology
  6. 6. CEOT D.D:  Dentigerous cyst  AOT  Ameloblastic fibro-odontoma Dr. Ali Tahir. M.Phil Oral Pathology
  7. 7. Histological Features Sheets of polyhedral cells Prominent intercellular bridges Nuclie vary in size, pleomorphism may be seen but it doesn’t indicate malignancy Unlike ameloblastoma, it has calcifications which may be spherical or diffuse Pools of amorphous, eosinophilic, hyalinized material A clear cell variant also exists Nature of Eosinophilic material is controversial Dr. Ali Tahir. M.Phil Oral Pathology
  8. 8. HistopathologySheets of Polyhedral cellsProminent intercellularbridgesPools of Eosinophilic material Dr. Ali Tahir. M.Phil Oral Pathology
  9. 9. HistopathologySpherical calcifications canbe seen Dr. Ali Tahir. M.Phil Oral Pathology
  10. 10. Clear cell variant Dr. Ali Tahir. M.Phil Oral Pathology
  11. 11. Congo red stain in polarized light Dr. Ali Tahir. M.Phil Oral Pathology
  12. 12. AOT Dr. Ali Tahir. M.Phil Oral Pathology
  13. 13. Adenomatoid Odontogenic tumourAn odontogenic tumour arising from odontogenic epithelium, around the crowns of un-erupted anterior teeth in young patientsBiologically non-aggressive Dr. Ali Tahir. M.Phil Oral Pathology
  14. 14. Clinical Features 3-7% of all odontogenic tumours Common in anterior jaws More common in maxilla Frequently associated with an impacted tooth Common in younger patients (14-15yrs) Female predilection Presents as swelling around un-erupted tooth Usually asymptomatic Peripheral appears as small, sessile mass on Dr. Ali Tahir. M.Phil Oral Pathology gingiva
  15. 15. Clinical Features Presents 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 Dr. Ali Tahir. M.Phil Oral Pathology
  16. 16. Radiographic features Well corticated, unilocular radiolucency around an impacted tooth Flecks of radio-opacity (snow-flake calcifications) Extends apically beyond CE junction Dr. Ali Tahir. M.Phil Oral Pathology
  17. 17. Extra-follicular type Dr. Ali Tahir. M.Phil Oral Pathology
  18. 18. Histological Features Outer capsule of thick fibrous CT Surrounds a nodular,/ductal/whorled pattern of epithelium (spindled or columnar) surrounding pools of PAS positive material (type of basement membrane) Spherical calcifications Dr. Ali Tahir. M.Phil Oral Pathology
  19. 19. Histological Features • Columnar epithelium arranged in duct-like tubular structures • These are not true ducts or glands • Foci of calcifications may be seen Dr. Ali Tahir. M.Phil Oral Pathology
  20. 20. Gorlin cystOdontogenic Ghost Cell Tumour Dr. Ali Tahir. M.Phil Oral Pathology
  21. 21. COC A rare, well circumscribed solid or cystic lesion with a wide spectrum of histological features & contains ghost cells & spherical calcifications Associated with odontomas Mostly occurs as solid, non-cystic lesion called odontogenic ghost cell tumour Dr. Ali Tahir. M.Phil Oral Pathology
  22. 22. Clinical Features Common in areas anterior to molars 2nd decade Intraosseous/extraosseo us Intraosseous causes expansion of cortical plates Usually painless Dr. Ali Tahir. M.Phil Oral Pathology
  23. 23. Radiographical Features Well 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 Dr. Ali Tahir. M.Phil Oral Pathology
  24. 24. R/F Dr. Ali Tahir. M.Phil Oral Pathology
  25. 25. Histology Variable Cystic/Solid Epithelium resembles that of ameloblastoma Outer layer of palisaded columnar cells Inner layer ressembels stellate reticulum Dr. Ali Tahir. M.Phil Oral Pathology
  26. 26.  Eosinophilic epithelial cells without nuclieHistopathology referred to as ‘ghost cells’  Spherical calcifications  Hyalinized material Dr. Ali Tahir. M.Phil Oral Pathology
  27. 27. Squamous Odontogenic Tumour Rare benign odontogenic neoplasm that may be clinically aggressiveClinical Features: Anterior to molars Peak incidence in 3rd decade Presents as painless swelling with loosening of teeth Slow growing Dr. Ali Tahir. M.Phil Oral Pathology
  28. 28. Radiographical features Small lesions have Unilocular radiolucency Large are multilocular Indistinct borders Displaces teeth Dr. Ali Tahir. M.Phil Oral Pathology
  29. 29. Histology Islands of normal appearing stratified squamous epithelium Islands may have microcyst formation in the centre Spherical or irregular shaped calcifications Dr. Ali Tahir. M.Phil Oral Pathology
  30. 30. Histopathology Dr. Ali Tahir. M.Phil Oral Pathology

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