Difference between revisions of "Ameloblastoma"

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#redirect [[Odontogenic tumours and cysts#Ameloblastoma]]
'''Ameloblastoma''' is an [[odontogenic cyst]].


==General==
*Osteous lesion.
*Usually mandible.<ref>URL: [http://www.waent.org/archives/2010/Vol3-2/20100618-ameloblastoma/jaw-tumor.htm http://www.waent.org/archives/2010/Vol3-2/20100618-ameloblastoma/jaw-tumor.htm]. Accessed on: 30 November 2011.</ref>
**In a review of 3677 cases, the mandible-to-maxilla ratio was 5 to 1.<ref name=pmid7633291>{{Cite journal  | last1 = Reichart | first1 = PA. | last2 = Philipsen | first2 = HP. | last3 = Sonner | first3 = S. | title = Ameloblastoma: biological profile of 3677 cases. | journal = Eur J Cancer B Oral Oncol | volume = 31B | issue = 2 | pages = 86-99 | month = Mar | year = 1995 | doi =  | PMID = 7633291 }}</ref>
*May arise from an odontogenic cyst,<ref name=pmid10587275>{{Cite journal  | last1 = Eversole | first1 = LR. | title = Malignant epithelial odontogenic tumors. | journal = Semin Diagn Pathol | volume = 16 | issue = 4 | pages = 317-24 | month = Nov | year = 1999 | doi =  | PMID = 10587275 }}</ref> e.g. [[dentigerous cyst]].<ref name=pmid21957386>{{Cite journal  | last1 = Moosvi | first1 = Z. | last2 = Tayaar | first2 = SA. | last3 = Kumar | first3 = GS. | title = Neoplastic potential of odontogenic cysts. | journal = Contemp Clin Dent | volume = 2 | issue = 2 | pages = 106-9 | month = Apr | year = 2011 | doi = 10.4103/0976-237X.83073 | PMID = 21957386 | PMC = 3180832 }}</ref>
===Classification===
Location:
#Intra-osseous.
#*Locally aggressive.
#Peripheral.
#*Benign.
====Subclassification of intra-osseous type====
Histology:
#Solid/multicystic.
#*More commonly reoccur.
#Unicystic.
#*Unlikely to reoccur.
#*Classically found in younger individuals.
==Microscopic==
Features:<ref>URL: [http://www.pathconsultddx.com/pathCon/diagnosis?pii=S1559-8675%2806%2970616-7 http://www.pathconsultddx.com/pathCon/diagnosis?pii=S1559-8675%2806%2970616-7]. Accessed on: March 9, 2010.</ref>
*Stellate reticulum - star-shaped cells, found in a developing tooth.
*Tall columnar cells.
**Palisaded nuclei with reverse polarization.
***Reverse polarization of nuclei = nuclei distant from the basement membrane/nuclei at pole opposite of basement membrane.
***Palisaded nuclei = picket fence appearance; columnar-shaped nuclei with long axis perpendicular to the basement membrane -- '''key feature'''.
**Subnuclear vacuolization.
*+/-Giant cells.
*+/-Subepithelial hyalinization (eosinophilic acellular amorphous material).
**Seen deep to the basement membrane.
*Variable morphology (see below - ''morphology'').
DDx (nuclear palisading):
*[[Adenomatoid odontogenic tumour]].
*[[Ameloblastic fibroma]].
===Images===
www:
*[http://www.estomatologia.com.br/diagnosticos_det2.asp?cod_diag=12 Ameloblastoma - several images (estomatologia.com.br)].
*[http://www.cytochemistry.net/microanatomy/digestive/devtooth9.jpg Stellate reticulum (cytochemistry.net)].
<gallery>
Image: Ameloblastoma - low mag.jpg | Ameloblastoma - low mag. (WC)
Image: Ameloblastoma - intermed mag.jpg | Ameloblastoma - intermed. mag. (WC)
Image: Ameloblastoma - high mag.jpg | Ameloblastoma - high mag. (WC)
Image: Ameloblastoma - very high mag.jpg | Ameloblastoma - very high mag. (WC)
</gallery>
===Morphology===
*Not prognostic.
Morphologic variants:
*Follicular ameloblastoma  (classic appearance).
*Plexiform ameloblastoma (does not have prominent palisading).
*Acanthomatous ameloblastoma.
*Desmoplastic ameloblastoma.
*Basaloid ameloblastoma.
==See also==
*[[Odontogenic tumours and cysts]].
==References==
{{Reflist|2}}
[[Category:Odontogenic tumours and cysts]]
[[Category:Diagnosis]]
[[Category:Diagnosis]]

Revision as of 15:08, 23 February 2014

Ameloblastoma is an odontogenic cyst.

General

  • Osteous lesion.
  • Usually mandible.[1]
    • In a review of 3677 cases, the mandible-to-maxilla ratio was 5 to 1.[2]
  • May arise from an odontogenic cyst,[3] e.g. dentigerous cyst.[4]

Classification

Location:

  1. Intra-osseous.
    • Locally aggressive.
  2. Peripheral.
    • Benign.

Subclassification of intra-osseous type

Histology:

  1. Solid/multicystic.
    • More commonly reoccur.
  2. Unicystic.
    • Unlikely to reoccur.
    • Classically found in younger individuals.

Microscopic

Features:[5]

  • Stellate reticulum - star-shaped cells, found in a developing tooth.
  • Tall columnar cells.
    • Palisaded nuclei with reverse polarization.
      • Reverse polarization of nuclei = nuclei distant from the basement membrane/nuclei at pole opposite of basement membrane.
      • Palisaded nuclei = picket fence appearance; columnar-shaped nuclei with long axis perpendicular to the basement membrane -- key feature.
    • Subnuclear vacuolization.
  • +/-Giant cells.
  • +/-Subepithelial hyalinization (eosinophilic acellular amorphous material).
    • Seen deep to the basement membrane.
  • Variable morphology (see below - morphology).

DDx (nuclear palisading):

Images

www:

  • Ameloblastoma - low mag. (WC)

  • Ameloblastoma - intermed. mag. (WC)

  • Ameloblastoma - high mag. (WC)

  • Ameloblastoma - very high mag. (WC)

Morphology

  • Not prognostic.

Morphologic variants:

  • Follicular ameloblastoma (classic appearance).
  • Plexiform ameloblastoma (does not have prominent palisading).
  • Acanthomatous ameloblastoma.
  • Desmoplastic ameloblastoma.
  • Basaloid ameloblastoma.

See also

References

  1. ↑ URL: http://www.waent.org/archives/2010/Vol3-2/20100618-ameloblastoma/jaw-tumor.htm. Accessed on: 30 November 2011.
  2. ↑ Reichart, PA.; Philipsen, HP.; Sonner, S. (Mar 1995). "Ameloblastoma: biological profile of 3677 cases.". Eur J Cancer B Oral Oncol 31B (2): 86-99. PMID 7633291.
  3. ↑ Eversole, LR. (Nov 1999). "Malignant epithelial odontogenic tumors.". Semin Diagn Pathol 16 (4): 317-24. PMID 10587275.
  4. ↑ Moosvi, Z.; Tayaar, SA.; Kumar, GS. (Apr 2011). "Neoplastic potential of odontogenic cysts.". Contemp Clin Dent 2 (2): 106-9. doi:10.4103/0976-237X.83073. PMC 3180832. PMID 21957386. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3180832/.
  5. ↑ URL: http://www.pathconsultddx.com/pathCon/diagnosis?pii=S1559-8675%2806%2970616-7. Accessed on: March 9, 2010.
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