2.16.24
Quick Review #109 - #pathology #oralpathology #doctorgallagher #oralsurgery #oralsurgeon #dentist #dentistry #dental
Ameloblastoma, a benign but locally aggressive odontogenic tumor, exhibits 6 subtypes within its most common form, the Conventional (solid or multicystic) Ameloblastoma:
1. Follicular Ameloblastoma:
- *Most Common Subtype*
- Clinical: Often presents in the posterior mandible as a painless swelling.
- Radiographic: Shows well-demarcated, unilocular or multilocular radiolucencies often described as "soap bubble" or "honeycomb" appearances.
- Histological: Follicles or islands of odontogenic epithelium surrounded by a fibrous stroma. Central stellate reticulum-like cells with peripheral columnar or cuboidal ameloblast-like cells.
2. Plexiform Ameloblastoma:
- Clinical: Similar to the follicular subtype, with a preference for the mandible.
- Radiographic: Radiolucent, often multilocular lesions, but the internal structure may appear more "net-like" due to the plexiform pattern.
- Histological: Anastomosing strands or cords of odontogenic epithelium within the stroma, resembling a plexus.
3. Acanthomatous Ameloblastoma:
- Clinical: Slightly more aggressive behavior and may cause more bone destruction.
- Radiographic: Radiolucent areas, similar to other subtypes.
- Histological: Notable for squamous metaplasia and keratin formation within the epithelial islands, resembling squamous epithelium.
4. Granular Cell Ameloblastoma:
- Clinical: Tends to occur in a slightly older age group, with a slow-growing mass in the jaw.
- Radiographic: Radiolucent areas, similar to other subtypes.
- Histological: Granular eosinophilic cytoplasm of the stellate reticulum-like cells, giving a granular appearance.
5. Desmoplastic Ameloblastoma:
- Clinical: Often involves the anterior maxilla; less common for other subtypes.
- Radiographic: Distinct for its mixed radiolucent-radiopaque "honeycomb" or "soap bubble" appearance, often mistaken for fibro-osseous lesions.
- Histological: Extensive stromal collagenization (desmoplasia) with small, compressed islands of odontogenic epithelium.
6. Basal Cell Ameloblastoma:
- *Least Common Subtype*
- Clinical: Rare and may present similarly to other ameloblastomas; can have a more aggressive course.
- Radiographic: Radiolucent areas, similar to other subtypes.
- Histological: Uniform, small, basaloid cells with less cytoplasm, arranged in compact islands with peripheral palisading.
References:
1. Reichart, P. A., Philipsen, H. P., & Sonner, S. (2000). Ameloblastoma: biological profile of 3677 cases. European Journal of Cancer Part B: Oral Oncology, 36(1), 46-50. https://lnkd.in/dg6m2eiq
2. Neville, B. W., Damm, D. D., Allen, C. M., & Chi, A. C. (2015). Oral and Maxillofacial Pathology (4th ed.). Saunders.
3. Abubaker, A.O., Lam, D., & Benson, K. (2016). OMFS Secrets (3rd ed.). Elsevier.
4. ChatGPT. 2024.