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Odontogenic tumours part 2

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Derived from odontogenic epithelium continued..

Derived from odontogenic epithelium continued..

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  • 1. CEOT Dr. Ali Tahir. M.Phil Oral Pathology
  • 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. 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. 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. RadiographCalcifications areprominent around thecrown of impacted tooth Dr. Ali Tahir. M.Phil Oral Pathology
  • 6. CEOT D.D:  Dentigerous cyst  AOT  Ameloblastic fibro-odontoma Dr. Ali Tahir. M.Phil Oral Pathology
  • 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. HistopathologySheets of Polyhedral cellsProminent intercellularbridgesPools of Eosinophilic material Dr. Ali Tahir. M.Phil Oral Pathology
  • 9. HistopathologySpherical calcifications canbe seen Dr. Ali Tahir. M.Phil Oral Pathology
  • 10. Clear cell variant Dr. Ali Tahir. M.Phil Oral Pathology
  • 11. Congo red stain in polarized light Dr. Ali Tahir. M.Phil Oral Pathology
  • 12. AOT Dr. Ali Tahir. M.Phil Oral Pathology
  • 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. 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. 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. 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. Extra-follicular type Dr. Ali Tahir. M.Phil Oral Pathology
  • 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. 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. Gorlin cystOdontogenic Ghost Cell Tumour Dr. Ali Tahir. M.Phil Oral Pathology
  • 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. 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. 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. R/F Dr. Ali Tahir. M.Phil Oral Pathology
  • 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.  Eosinophilic epithelial cells without nuclieHistopathology referred to as ‘ghost cells’  Spherical calcifications  Hyalinized material Dr. Ali Tahir. M.Phil Oral Pathology
  • 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. Radiographical features Small lesions have Unilocular radiolucency Large are multilocular Indistinct borders Displaces teeth Dr. Ali Tahir. M.Phil Oral Pathology
  • 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. Histopathology Dr. Ali Tahir. M.Phil Oral Pathology

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