HISTOPATHOLOGY OF CONNECTIVE TISSUE TUMORS

FIBROMA

  • Overlying epithelium is of St.Squamous epithelium and is flat devoid of rete pegs.
  • Connective tissue contains bundles of collagen fibres interspersed with many fibroblasts and blood vessels.
  • Inflammatory cell infiltate present in cases of infection and trauma.

LIPOMA

  • It is composed of mature adipocytes mixed with connective tissue septa.
  • Adipocytes are round to oval with flat nuclei giving rise to “signet ring” appearance
  • Thin fibrous capsule seen.
  • Lipomas can be classified as classical lipoma and variants.
  • Classical lupoma and fibrolipoma-most common
  • Intramuscular and spindle cell variant- second most common.

CAPILLARY HEMANGIOMA

  • It contains minute,numerous endothelial lined capillaries.
  • The endolial cell lining is single layered.
  • Endothelial cells are flat,elongated or plump.
  • Endothelial cells form aggregates or rosette around capillaries.

CAVERNOUS HEMANGIOMA

  • It contains large dilated endothelial lined sinuses.
  • These sinuses contain erythrocytes.
  • Flattened endothelial cells and single layered.
  • Fibrous conn tissue stroma
  • Focal areas of haemorrhage and hemosiderin seen.

LYMPHANGIOMA

  • It contains large dilated lymphatics with flat single layered endothelial cells.
  • These lymphatics contain lymph.
  • The lymphatics replace the connective tissue papillae.
  • Cavernous type mostly seen.

NEUROFIBROMA

  • It contains wavy, elongated cels with dark staining nuclei in a collagenous stroma.
  • Appears as “shredded carrot” like appearance.
  • Cells arranged in fascicles or stripriform pattern.
  • Connective tissue shows myxomatous area.

NEURILEMMOMA(SHWANNOMA)

  • Tumor derived from shwann cells.
  • Two types of arrangement seen.
  • Antoni type A- made of cells with elongated or spindle shaped nucleus which are arranged parallel with their intacellular fibres arranged parallel between the rows of nuclei to form characteristic palisading pattern.
  • The cells are around eosinophilic acellular area called Verocay bodies.
  • Antoni type B- disorganized arrangement of cells and fibres. No palisading pattern.

OSTEOMA

  • Maybe compact or cancellous.
  • Compact osteoma made up of dense cortical bone with lamellar pattern.
  • Both circumferential and interstitial lamellae seen arranged around a central haversian system.
  • Osteocytes seen in lacunae.
  • Cancellous osteoma made up of trabecular bone with osteocytes,osteoclasts and osteoblasts.

REFERENCES- Shafer’s textbook of oral pathology 9th edition

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