Characteristic Cells in Oral Pathology

Muhad Noorman P, Team dentowesome, Final year

Anitschkow cell: Modified macrophages with nuclei having caterpillar apperance ( linear bar of chromatin with peripheral radiating chromatins . Found in Recurrent Apthous stomatitis, Iron deficiency Anemia, megaloblastic Anemia, children receiving chemotherapy.

Langerhans cells : Bone marrow derived antigen presenting cells found in epidermis positive for CD1a and Bierbeck Granules. Increased in Langerhans cell histocytosis and decreased in Psoriasis etc.. Named after Paul Langerhans

Tzank Cells: Enlarged , Balooned up degenerating keratinocytes with enlarged vesicular hyperchromatic nucleus, basophilic cytoplasm and diminished nucleoli and perinuclear halo appearance. Named after Arnault Tzank. Found in Herpes Simplex infection, Herpes Zoster, Pemphigus vulgaris, Varicella.

Langhans Giant cells: They are formed by the fusion of epithelioid cells and contain multiple nuclei arranged in a horseshoe-shaped pattern in the cell periphery or are arranged circumferentially. Named after Theodor Langhans. Found in granulomatous lesions like Tuberculosis, tuberculous Leprosy.

Downey cells : Atypical lymphocytes, abundant pale blue cytoplasm and irregular chromatin . Found in infectious mononucleosis. Named after Hal Downey.

Warthin Finkeldy Giant cells : Giant cells with upto 100 nuclei, cytoplasmic and nuclear inclusions. Pathognomic of measels infection. Named after Warthin and Finkeldy.

Reed–Sternberg cells: They are named after Dorothy Reed Mendenhall and Carl Sternberg. They are large cells that either are multinucleated or have a bilobed nucleus (having an “owl’s eye” appearance) with prominent eosinophilic nucleoli.Reed–Sternberg cells are giant cells found in Hodgkin’s lymphoma (HL).

Gaucher Cells : Glucocerebroside laden macrophages containing tubular cytoplasmic inclusions. (Crumbled tissue paper apperance) Hallmark of gaucher disease. Staining positive for Wright and PAS stain.

Rushton bodies : Peculiar linear , curved- hyaline homogeneous structure found in wall of ODONTOGENIC cysts like periapical cyst, dentigerous cyst etc..

Ghost cells: Well defined, eosinophilc, elliptoid fused epithelial cells with blurred apperance. Found in Ghost cell odontogenic tumor, Calcifying epithelial odontogenic cyst, odontoma, craniopharyngioma etc..

Rusells bodies : Large eosinophilc immunoglobulin containing inclusion bodies found in plasma cells. Distented endoplasmic reticulum staining positive for PAS, CD38 etc. Found in chronic inflammations. Aggregate Is called Mott bodies.

Reference : Internet, Shafers oral pathology, Neville Oral pathology

Unique Clinical appearance in Oral pathology and Medicine

Muhad Noorman, Team dentowesome , Final year

Apple jelly nodules in nasal septum: It is the nodular form of the tuberculosis in nasal mucosa. It begins in the vestibule and extends to adjoining skin and mucosa.

Arnold head: In Cleidocranial dysplasia, the fontanelles may remain open until adulthood, but the sutures often close with interposition of wormian bones

Blue Sclera: Osteogenesis imperfecta , EHLER danlos syndrome, Fetal Rickets, MARFANS Syndome etc.. Asymptomatic bluish discoloration of sclera due to thinning of sclera and exposing underlying vascular choroid.

Ash-leaf spots: Hypomelanic macules in Tuberous sclerosis.

Buffalo hump: Cushing’s syndrome, the fat relocalization in nape of the neck resembling the buffalo’s hump

Bull neck: Diptheria, Cherubism

Cerebriform tongue: Pemphigus vegetans. Also known as Furrowed tongue with numerous sulci and gyri

Chipmunk facies: Thalassemia and Sickle cell anemia. The bones of the head and face become enlarged and deformed causing an abnormal appearance resulting in a typical “chipmunk/ rodent facies” appearance. This occurs because the bone marrow, the site of red blood cell production, becomes hyperactive in an attempt to produce sufficient red cells to over profound anemia.

Cobble stone appearance: Lymphangioma, Inflammatory papillary hyperplasia, Heck’s disease

Forschemmier spots : Forscheimer spots are enanthem seen as small, red spots (petechiae) on the soft palate in patients with rubella. Also found in palatal mucosa of Scarlet fever.

Fournier’s molars: congenital syphilis, Mulberry molars

Hamman’s crunch: Cervicofacial emphysema. It’s a crunching, rasping sound, synchronous with the heartbeat, heard over the precordium .

Hebra nose: Rhinoscleroma. Epistaxis, nasal deformity, and destruction of the nasal cartilage are also noted.

Iris pearl’s: Leprosy. Miliary lepromas or iris pearls near the pupillary margins, which are spherical yellowish opaque micronodules

Koplik’s spots: Measles. Koplik spots are a prodromic viral enanthem of measles manifesting two days before the measles erythmatous cutaneous rash itself. They are characterized as clustered, white lesions on the buccal mucosa ( table salt appearance) near each Stensen’s duct (on the buccal mucosa opposite the maxillary 2nd molars) and are pathognomonic for measles.

Lisch nodules: Neurofibromatosis. A Lisch nodule is a pigmented hamartomatous nodule found in iris which is an aggregate of melanocytes.

Pastia’s lines: Scarlet fever. Pastia’s sign, Pastia lines or Thompson’s sign is a clinical sign in which pink or red lines formed of confluent petechiae are found in skin creases, particularly the crease in the antecubital fossa. Caused by erythrogenic toxins staphylococcus.

References : Shafers Oral pathology. Burkets Oral Medicine

Clinical Signs In Oral Pathology/ Medicine

Dentowesome- Muhad Noorman P
Final year

Asboe-Hansen sign (also known as indirect Nikolsky sign) refers to the extension of a blister to adjacent unblistered skin when pressure is put on the top of the intact bulla.

Auspitz’s sign is the appearance of punctate bleeding spots when psoriasis scales are scraped off, named after Heinrich Auspitz.This happens because there is thinning of the epidermal layer overlying the tips of the dermal papillae and blood vessels within the papillae are dilated and tortuous, which bleed readily when the scale is removed.

Button-hole sign: Neurofibromatosis. invagination of a nodule when pressed with a finger, a characteristic of neurofibromatosis

Carpet tack lesions: Discoid lupus erythematosus. There are follicular hyperkeratotic plugs causing a carpet tack appearance as they project from the undersurface of the scale when it is removed from advanced lesions.

Charcot’s triad: Seen in multiple sclerosis, characterized by intention tremor, nystagmus, dysarthria

Crowe’s sign: Found in Neurofibromatosis. Presence of axillary freckling in people with neurofibromatosis type I.

Gorlin sign: Ehler -Danlos Syndrome. Ability to touch the tip of the nose with tongue and touch the elbow with the tongue

Higomenakis’s sign: Congenital syphilis. A unilateral enlargement of the sternoclavicular portion of the clavicle, seen in congenital syphilis

Millian sign: Erysipelas. Involvement of the ear (Milian’s ear sign) is a distinguishing feature for erysipelas since this region does not contain deeper dermis tissue.

Nikolsky’s sign: Epidermolysis bullosa, pemphigus, Severe Steven –Johnson syndrome etc. Application of lateral oblique pressure to skin yeild formation of new blisters.

Oil drop sign: Psoriasis. A translucent discolouration in the nail bed that resembles a drop of oil beneath the nail plate.

Reference: Neville Textbook of oral Pathology. Cawsons essential oral pathology
Regezi and Batsakis Oral pathology