Odontogenic tumors ii/certified fixed orthodontic courses by Indian dental academy

Odontogenic Tumors
INDIAN DENTAL ACADEMY
Leader in continuing Dental Education
www.indiandentalacademy.com

LEARNING OBJECTIVES
At the end of the lecture student should be able to
– Enlist Clinical features,
– Enlist Radiological features,
–Enlist histopathological features of Ameloblastoma

Basal cell ameloblastoma
• It is the rarest histologic subtype occurs primarily in a
peripheral location but has been seen intraosseously,
rarely.
• Tends to grow in an island-like pattern. Basaloid
appearing cells rather than stellate reticulum like
cells occupy the central portion of the tumor islands.
• The basaloid cells tend to stain deeply basophilic.

• The cells in the central portion of the tumor islands
may be polyhedral to spindle shaped, but stellate
reticulum- like areas are absent.
• The peripheral cells tend to be low columnar to
cuboidal and often do not demonstrate reverse
nuclear polarity with subnuclear vacuole formation.
• Hyperchromatism and palisading of the nuclei
normally are retained. This histologic subtype shows
a remarkable resemblance to basal cell carcinoma.

Peripheral
palisading
cells
Follicles
Odontogenic cells

Desmoplastic ameloblastoma
• This type of ameloblastoma characteristically is
found in a dense collagen stroma that may appear
hyalinized and hypocellular.
• The desmoplastic ameloblastoma has a greater
tendency to grow in thin strands and cords of
epithelium rather than in an island-like pattern.
• The epithelial proliferation almost seems to be
squeezed out by the dense hyalinized stroma.

• Central cells are often scant in the epithelial
proliferation, and the cells making up the periphery
of the strands and cords often are flattened or
cuboidal rather than tall columnar in appearance
• Most desmoplastic ameloblastomas display
occasional classic islands of follicular ameloblastoma
among the predominant strands and cords
• Without these classic islands of ameloblastoma, the
diagnosis can be difficult.

Highly condensed
collagenous
stroma
Follicle Compressed follicles

Plexiform Ameloblastoma
• It is distinct, from other histologic subtypes in that it
often lacks many of the core histopathologic
characteristics that define the other variants.
• It usually shows a sparse fibrous connective tissue
stroma which is often loose and myxoid in appearance.
• The plexiform ameloblastoma shows a predominance
of a strand-like growth pattern with a strong tendency
to interconnection of the neoplastic epithelium

• This setup produce a plexiform network of
interanastamosing epithelium that gives this subtype its
name
• The cellular growth pattern most closely simulates the
dental lamina stage of normal odontogenesis, before
enamel organ morphodifferentiation and
histodifferentiation occur.
• The proliferating epithelial strands are composed of a
bilayer of cuboidal to low columnar cells.

• In other areas, the lamina-like strands may expand
because of proliferation of epithelial cells between
the bilayers.
• The proliferating cells may resemble stellate
reticulum, or they may be round to polyhedral in
shape.
• Areas of sheet-like growth of the epithelium also
may be a significant component of the plexiform
subtype.

Plexiform follicles

Summary
• Clinical features- Slow growing, relatively
asymptomatic swelling presents with facial
asymmetry
• Radiological features- Soap bubble multilocular
radiolucency/unilocular (dentigerous cyst type),with
cortical expansion
• Histopathological features-Vicker’s & Gorlin criteria
• Various histologic variants of Ameloblastoma

BIBLIOGRAPHY
Text book of oral pathology Shafer's, 5 & 6th edition
Odontogenic Tumors & Allied Lesions Reichart/
Philipsen Ist edition
Color Atlas of Oral Diseases Cawson, R. 2nd edition
Oral and Maxillofacial Pathology Neville, Brad W. 2nd
Lucas’s Pathology Of Tumor’s of the Oral Tissues
Cawson, R. A., Bennie, W. H 5th edition

Odontogenic tumors ii/certified fixed orthodontic courses by Indian dental academy

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