Path Slide Final Review

1. Path Slide Final Review 2009

2. Characteritures of enamel organ, but produce no enamel • Unencapsulated • Locally infiltrative, do not metatasize • Always radiolucent • Become multilocular as they grow • Can expand the jaw • Islands of odontogenic EP in stroma of fibrous CT • Loose stellate reticulum and columnar cells with reverse nuclear polarity • Does not form hard tissue

3. Ameloblastoma

4. Birbeck granules • S100+ • Luecenies • Lesions occur mainly in the jaws • Unexplained pain in max or man, overlying mucosa may be ulcerated • Teeth may be moved bodily or roots resorbed • “Teeth floating in air”

5. Langerhan’s Cell Granulomatosis/Histocytosis

6. Snowflake densities • Rossetes • Gland like structure • All unilociular • Mostly in the anterior

7. Adenmatoid Odontogenic Tumor

8. Smokey densities • Amyloid like material • Tree ring/ leisegang • Different sized nuclei

9. Calcifying Epithelial Odontogenic Tumor (Pindborg)

10. Benign tumor arising centrally in bone (BFOL) • Fibroblasts with whirled appearance • Producing calcified matrix • Vital teeth no pain no capsule • Women, 20-40

11. Cementifying/Ossifying Fibroma

12. Ghost cells • Anterior jaws adults, lucent to mixed • lining epithelium has an "odontogenic"appearance created by a flattened basement membrane, palisading of the basal cells with reverse nuclear polarity, loose areas resembling stellate reticulum, and finally, the epithelial cells acquire aneosinophilic (pink) cytoplasm and the nucleus disappears leaving a clear hole formerly occupied by the • Sometimes asstd with odontomas

13. Calcifying Odontogenic Cyst/Gorlin’s Syndrome

14. Benign neoplastic tumor of saliva glands • Most common tumor of salivary gland • microscopically  2 components • ductile elements lined by cuboidal cells • see chondroid/cartilage-looking mucoid material; similar to hyaline cartilage • see mixoid tissue background; cellular ductoidelemtns w/mixoid, ductal elements • usually severed cleanly • in the example in class, it was located on the upper L Palate

15. Mixed Tumor/ Pleomorphic Adenoma

17. Compound Odontoma

18. Localized widening of PDL space • Pain is often earliest symptom • Sunburst • Long bones around knee most common site

19. Osteosarcoma

20. Kids • Purely radiolucent • Islands and cords • Failure of teeth to erupt on time • No enamel or dentin is made

21. Ameloblastic Fibroma

22. Rule of 2/3 • Mandible, female, under 30 • Purely lucent, may be uni or multilocular • Pain, expansion or feeling or fullness

23. Central Giant Cell Reparative Granuloma • Cherubism is bilateral, and painless

25. Myxoma

26. High grade tumor metastasizes and grows in neuronsTends to invade both nerves and bonesOne of the worst salivary gland tumorsHistologically: Islands comprised of small cells that look like lymphocytes but are epithelial cells and are growing in a specific pattern microcystic spaces Cribiform pattern; Swiss Cheese patternMalignant

27. Adenoid Cystic Fibroma • Cribiform • Swiss cheese • Malignant • 2nd most common malignant to mucoepidermoid carcinoma

28. Dense masses with surrounding halos of luecency • No treatment required • Vital teeth • Asstd with simple bone cysts

29. Florid Osseus Dysplasia • Florid- simple bone cysts • Focal- TE site

30. Mural plaques • Vital teeth (adult males) • Developmental cyst, from rest of Serres • Mand premolar, max canine area

31. Lateral Periodontal Cyst • Botryoid Odontogenic Cyst is a variant of this, that is multilocular- vital premolars of adults

32. Slow painless enlargement of mandible • Ground glass • Woven bone

33. Fibrous Dysplasia • This disease appears more often in youth and there is no sex preference. A single • bone may be involved (monostotic form) or multiple bone involvement may occur (polyostotic form). In • the polyostotic form, other organ system abnormalities may be seen. Multiple bone lesions of fibrous dysplasia • accompanied by large patches of melanotic skin pigmentation had been referred to as the “Jaffe” • variant. Bone lesions with skin pigmentation and endocrinopathy are referred to as “Albright’s syndrome.” • Melanotic skin pigmentations= Jaffe • With endocrinopathy- Albright’s syndrome

34. Keratin filled cyst arising from the dental lamina that spontaneously marsupilize on infants

35. Dental Lamina Cyst of Newborn

37. Cementoblastoma

38. Sheets of compact round tumor cells, with uniform nuclear size and scant cytoplasm • Rich in glycogen- Periodic Acid Shiff Stain • Usually under 20 y/o • Onion skin appearance of bone • Always lucent • Rare in jaw, 60% in pelvis and legs • Increased ESR

39. Ewing Sarcoma • Glycogen • Young • Fever and leukocytosis • Increased ESR

40. Duct like spaces • Little known about this cyst • May recur, aggressive behavior • May cross midline • Ant jaw of adults • Commonly multilocular • Ciliated lining • Luecent • 30% recur • Intracytoplasmicmucin

41. Glandular Odontogenic Cyst

42. Respiratory EP

43. Nasopalatine Duct Cyst

45. Dentinogenesis imperfecta

46. Reversal lines • Mosaic • Apposition/resorption • Cotton wool density • Increased risk for osteosarcoma • Dentures and hat don’t fit anymore • Alkaline phophatase increase

47. Paget’s Disesae/ OsteitisDeformans

48. Vital teeth

49. OKC • If mulitple- Nevoid Basal Cell carcinoma/Gorlin’s