Jaw cysts: Difference between revisions

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! Periapical (radicular) cyst
! 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).<ref name=PathologyOutlinesPeriapical/>
| '''Stratified squamous''' epithelium of variable thickness, except when originating in a maxillary sinus where there is respiratory epithelium (pseudostratified ciliated columnar epithelium).<ref name=PathologyOutlinesPeriapical/>
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*A fibrous capsule of varying thickness, with chronic inflammatory cells, wherein a plasma cells may be abundant.<ref name=PathologyOutlinesPeriapical>{{cite web|url=https://www.pathologyoutlines.com/topic/mandiblemaxillaperiapicalcyst.html|title=Mandible & maxilla - Odontogenic cysts - Periapical (radicular) cyst|website=Pathology Outlines|author=Annie S. Morrison, Kelly Magliocca}} Topic Completed: 1 March 2014. Revised: 13 December 2019</ref>
*A fibrous capsule of varying thickness, with chronic inflammatory cells, wherein a plasma cells may be abundant.<ref name=PathologyOutlinesPeriapical>{{cite web|url=https://www.pathologyoutlines.com/topic/mandiblemaxillaperiapicalcyst.html|title=Mandible & maxilla - Odontogenic cysts - Periapical (radicular) cyst|website=Pathology Outlines|author=Annie S. Morrison, Kelly Magliocca}} Topic Completed: 1 March 2014. Revised: 13 December 2019</ref>

Revision as of 11:24, 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
 File:Histopathology of dentigerous cyst.jpg
Inflamed dentigerous cyst Hyperplastic non-keratinized epithelium[4] Typically:[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 4.7 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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