HISTOPATHOLOGICAL FEATURES OF COMMON ODONTOGENIC CYSTS

DENTIGEROUS CYST

• The lining epithelium is derived from reduced enamel epithelium and hence appears as uniformly thin non-keratinized epithelium.

• The epithelium comprises of 2-3 layers of flattened cells and is characteristically devoid of rete ridges.

Connective tissue capsule is derived from dental follicle, consists of young fibroblasts widely separated by ground substance rich in mucopolysaccharide.

• Connective tissue capsule may show odontogenic epithelial remnants.

• Cystic lumen contains cystic fluid which is thin, watery or may be blood tinged.

ODONTOGENIC KERATOCYST

• Typically shows a thin friable wall which is often difficult to enucleate from the bone in one piece.

• Cystic lumen may contain a clear liquid that is similar to a transidase of serum or it may be filled with a cheesy material, that on microscopic examination consists of keratinaceous debris.

• Microscopically, thin fibrous wall is essentially derated of any inflammatory infiltrate.

• Epithelium may show infoldings into the connective tissue capsule and may be separated from capsule in some areas.

CALCIFYING ODONTOGENIC CYST

• The lining epithelium is of variable thickness commonly around 5-10 layers.

• Spinous cells are loosely arranged.

• Presence of Ghost cells.

• Ghost cells are degenerating cells that appear as void, eosinophilic cells with nucleus showing different stages of degeneration.

• These cells are seen in thickened areas of lining epithelium.

• Connective tissue capsule is often scanty and sometimes contain discrete islands of odontogenic cells.

RADICULAR CYST

• The epithelial lining of the radicular cyst is stratified squamous in type of variable thickness.

• Epithelium shows spongiogenesis and inflammatory cell infiltration.

• Epithelium may show arc-shaped structures called Rushton bodies.

• The surrounding connective tissue shows granulomatous reaction due to the presence of Cholesterol clefts.

Source: Maji Jose

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