Jaw cysts: Difference between revisions

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They occasionally have:<ref name=PathologyOutlinesDentigerous/>
They occasionally have:<ref name=PathologyOutlinesDentigerous/>
*Dystrophic calcifications
*Dystrophic calcifications
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! Residual cyst
! Residual cyst
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In early cysts, the epithelial lining tend to be proliferative and arcading, with an intense inflammation.
In early cysts, the epithelial lining tend to be proliferative and arcading, with an intense inflammation.
<br>Established cysts tend to rather have fairly regular lining with a higher degree of differentiation, resembling a simple stratified squamous epithelium
<br>Established cysts tend to rather have fairly regular lining with a higher degree of differentiation, resembling a simple stratified squamous epithelium
| Cyst lumen may demonstrate fluid and cellular debris.<ref name=PathologyOutlinesResidual/>
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All types above can occasionally have scattered mucous or ciliated cells, as well as Rushton bodies, which are amorphic, eosinophilic, linear to crescent-shaped bodies in the cyst epithelium.<ref name=Tsesis2016/><ref name=PathologyOutlinesPeriapical/><ref name=PathologyOutlinesDentigerous/><ref name=PathologyOutlinesResidual/>
All types above can occasionally have scattered mucous or ciliated cells, as well as Rushton bodies, which are amorphic, eosinophilic, linear to crescent-shaped bodies in the cyst epithelium.<ref name=Tsesis2016/><ref name=PathologyOutlinesPeriapical/><ref name=PathologyOutlinesDentigerous/><ref name=PathologyOutlinesResidual/>
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Revision as of 10:47, 25 February 2020

Author: Mikael Häggström [note 1]

Microscopic examination

File:Relative incidence of odontogenic cysts.jpg
Relative incidence of odontogenic cysts.[1]

By epidemiology, look for signs of being either a periapical cyst (also called radicular cyst), a dentigerous cyst or a residual cyst:

Cyst type Lining epithelium Other characteristics Image
Periapical (radicular) cyst Stratified squamous epithelium of variable thickness, except when originating in a maxillary sinus where there is respiratory epithelium (pseudostratified ciliated columnar epithelium).[2]
  • A fibrous capsule of varying thickness, with chronic inflammatory cells, wherein a plasma cells may be abundant.[2]

They sometimes have the following features:[2]

  • Cholesterol clefts in the cyst lining.
File:Histopathology of a periapical cyst, with metaplastic changes of mucous secreting cells, and ciliated cells.jpg
Histopathology of a periapical cyst, with metaplastic changes of mucous secreting cells (B), and ciliated cells (C).[3]
Non-inflamed dentigerous cyst
  • 2 - 4 layers of cuboidal epithelium, devoid of superficial keratinization.[4]
  • Sometimes partially a thin, fragmented layer of eosinophilic columnar cells or low cuboidal epithelium[4]
 Typically:[4]
  • Fibrous to fibromyxoid connective tissue
  • No rete ridges, flat interface

They occasionally have:

  • Dystrophic calcifications
Inflamed dentigerous cyst Hyperplastic non-keratinized epithelium[4]
  • Fibrous connective tissue
  • Chronic inflammatory cells

Sometimes:[4]

  • Elongated interconnecting rete ridges
  • Cholesterol clefts, possibly cholesterol granuloma

They occasionally have:[4]

  • Dystrophic calcifications
Residual cyst Stratified squamous epithelium:[5]
  • May demonstrate exocytosis, spongiosis, and/or hyperplasia
  • May be discontinuous in part and range in thickness from 1 to 50 cell layers, but usually 6 - 20 cell layers

In early cysts, the epithelial lining tend to be proliferative and arcading, with an intense inflammation.
Established cysts tend to rather have fairly regular lining with a higher degree of differentiation, resembling a simple stratified squamous epithelium

Cyst lumen may demonstrate fluid and cellular debris.[5]

All types above can occasionally have scattered mucous or ciliated cells, as well as Rushton bodies, which are amorphic, eosinophilic, linear to crescent-shaped bodies in the cyst epithelium.[3][2][4][5]

Notes

  1. ↑ For a full list of contributors, see article history. Creators of images are attributed at the image description pages, seen by clicking on the images. See Patholines:Authorship for details.

Main page

References

  1. ↑ Leandro Bezerra Borges; Francisco Vagnaldo Fechine; Mário Rogério Lima Mota; Fabrício Bitu Sousa; Ana Paula Negreiros Nunes Alves (2012). "Odontogenic lesions of the jaw: a clinical-pathological study of 461 cases. ". Revista Gaúcha de Odontologia 60 (1). Archived from the original. . 
  2. ↑ 2.0 2.1 2.2 2.3 Annie S. Morrison, Kelly Magliocca. Mandible & maxilla - Odontogenic cysts - Periapical (radicular) cyst. Pathology Outlines. Topic Completed: 1 March 2014. Revised: 13 December 2019
  3. ↑ 3.0 3.1 Tsesis, I; Rosen, E; Dubinsky, L; Buchner, A; Vered, M (2016). "Metaplastic changes in the epithelium of radicular cysts: A series of 711 cases ". Journal of Clinical and Experimental Dentistry: 0–0. doi:10.4317/jced.52846. ISSN 19895488. 
    - "Fig 2- available via license: Creative Commons Attribution 2.5 Generic"
  4. ↑ 4.0 4.1 4.2 4.3 4.4 4.5 4.6 Kelly Magliocca, Annie S. Morrison. Mandible & maxilla - Odontogenic cysts - Dentigerous. Pathology Outlines. Topic Completed: 1 October 2013. Revised: 2 December 2019
  5. ↑ 5.0 5.1 5.2 Annie S. Morrison, Kelly Magliocca. Mandible & maxilla - Odontogenic cysts - Residual cyst. Pathology Outlines. Topic Completed: 1 April 2014. Revised: 13 December 2019

Image sources


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