Mandible&Maxilla برای بزرگنمایی عکسها کلیک را روی ان نگه دارید Figure 5.1 Pulse granuloma. Foreign body giant cells surround residual plant material (pulse) with associated fibrosis and chronic inflammation Figure 5.2 Simple bone cyst of mandible in an 11-year-old girl. Note thin shell of remaining bone at the inferior aspect of the mandible Figure 5.3 Radiographic appearance of recurrent central giant cell granuloma in a 10-year-old girl. The inferior border of mandible has been eroded and the involved teeth are displaced Figure 5.4 Central giant cell granuloma. Osteoclast-like giant cells are scattered within a fibroblastic matrix Figure 5.5 Fibrous dysplasia. Curvilinear bone trabeculae are surrounded by a dense fibrous stroma. Osteoclasts are lacking Figure 5.6 Ossifying fibroma in a 17-year-old girl. Note the sharp border of the lesion. (Courtesy of Dr. C.A. Waldron, Atlanta.) Figure 5.7 Gross appearance of ossifying fibroma. The lesion is hard, whitish, and well defined Figure 5.8 Conventional ossifying fibroma is less homogeneous compared to fibrous dysplasia and contains irregular globoid bone with a bland cellular spindled stroma Figure 5.9 Psammomatous ossifying fibroma are more cellular and have psammoma-like ossicles and trabeculae Figure 5.10 Periapical cemental dysplasia. (From Pindborg JJ, Kramer IRH, Torloni H. Histological Typing of Odontogenic Tumours, Jaw Cysts, and Allied Lesions. Geneva: World Health Organization, 1971.) Figure 5.11 Radiograph illustrating mandibular benign osteoblastoma or cementoblastoma without calcification that was associated with periapical regions of permanent premolars (arrows) Figure 5.12 Typical radiographic appearance of cementoblastoma. A dense, homogeneous mass is seen in continuity with the tooth root. (Courtesy of Dr. C.A. Waldron, Atlanta.) Figure 5.13 Cementoblastoma. Numerous neoformed osteoid trabeculae are lined by osteoblasts and separated by a highly vascularized matrix Figure 5.14 Calcifying cystic odontogenic tumor (CCOT). The epithelial cells resemble cystic ameloblastoma but the presence of ghost kerati- nocytes, some of which calcify, easily distinguish CCOT from ameloblas- tomas which lack them Figure 5.15 Periapical/radicular cyst demonstrating continuity with pulp canal of nonvital tooth Figure 5.16 Periapical/radicular cyst. These are squamous lined cysts with marked inflammation and epithelial proliferation, the latter manifesting as elongated rete-like pegs Figure 5.17 Periapical/radicular cyst with numerous intraepithelial eosinophilic Rushton bodies Figure 5.18 Radiograph demonstrating portion of maxillary odontogenic keratocyst in a 15-year-old with a 2-week history of facial swelling Figure 5.19 Odontogenic keratocyst. Note the corrugated parakeratinized surface and prominent palisaded basal cell layer Figure 5.20 Glandular odontogenic cysts can be unilocular or multilocular. They are lined by squamoid epithelial cells with occasional thickened plaques. Other features include eosinophilic surface cells, mucous cells, and intraepithelial glandular lumens Figure 5.21 Adenomatoid odontogenic tumor of maxilla in an edentulous patient. Radiographically, a dentigerous cyst is suggested (arrows) Figure 5.22 Adenomatoid odontogenic tumor. Gland-like structures are present with more cellular solid areas. Eosinophilic tumor droplets are present on the left Figure 5.23 Calcifying epithelial odontogenic tumor. Nests of eosinophilic epithelial cells are set within an amyloid stroma with areas of dystrophic calcification Figure 5.24 Squamous odontogenic tumor. Well-defined nests of monotonous clear cells are separated by an abundant collagen stroma Figure 5.25 Radiographic appearance of ameloblastic fibroma of mandible in a 17-year-old youth. The defect is multilocular but suggests irregularity Figure 5.26 Ameloblastic fibroma. The neoplastic fibrous stroma encloses thin strips of ameloblastic epithelium Figure 5.27 Radiograph illustrating benign complex odontoma involving posterior maxilla of a 16-year-old girl. Note molar superiorly and absence of one molar Figure 5.28 Complex odontomas contain a disorganized proliferation of enamel, dentin, and cementum (bone) Figure 5.29 Compound odontomas are more organized than complex odontomas having the appearance of a misshapen tooth Figure 5.30 Odontoameloblastoma. (From Pindborg JJ, Kramer IRH, Torloni H. Histological Typing of Odontogenic Tumours, Jaw Cysts, and Allied Lesions Geneva: World Health Organization; 1971.) Figure 5.31 Radiograph illustrating a large recurrent odontogenic myxoma of mandible in male adult Figure 5.32 Odontogenic myxoma. The lesion is highly myxoid, hypocel- lular, and devoid of atypia. Native bone trabeculae are entrapped indicative of infiltrative growth Figure 5.33 Four radiographs illustrating history of ameloblastoma associated with impacted third molar tooth in a 19-year-old female patient. A (April 1971), Subtle, atypical radiolucency can be discerned below tooth. Tooth was surgically removed. No surgical specimen was obtained. B (September 1974), Routine dental roentgenogram revealed residual or recurrent cystic lesion. Surgical curettage was performed and "early" ameloblastoma demonstrated. No further treatment was given. C (February 1978), Multilocular radiolucency of more typical character. Tumor was resected. D (December 1978), There is no evidence of residual tumor. (Courtesy of Dr. William Randall and Dr. Clark Borstad, Minneapolis.) Figure 5.34 Gross appearance of ameloblastoma showing an expansile solid and cystic mass in the posterior mandible and ramus Figure 5.35 Ameloblastoma exhibiting the classic "follicular" appearance with central stellate reticulum and peripheral palisaded columnar cells with so-called reverse polarization Figure 5.36 Acanthotic ameloblastoma. Ameloblastic epithelium surrounds large keratin-filled cavities Figure 5.37 Granular cell ameloblastoma. Most of the tumor cells in the stellate reticulum area have an abundant, deeply granular cytoplasm Figure 5.38 Unicystic ameloblastoma fulfilling the minimum criteria for this entity, which should be distinguished from reactive epithelial changes in a radicular cyst Figure 5.39 Ameloblastic carcinoma. The geographic configuration of the tumor nests and the overall basophilic staining quality give this lesion a distinctly basaloid quality. Other areas had a more typical ameloblastoma appearance Figure 5.40 Clear cell odontogenic carcinoma. Infiltrative nests of large polygonal clear cells are set within a hyalinized to cellular spindled stroma Figure 5.41 Ameloblastic fibrosarcoma. Islands of well-differentiated ameloblastic epithelium are separated by a neoplastic stroma showing marked pleomorphism and mitotic activity Figure 5.42 Radiograph illustrating cystlike appearance of aneurysmal bone cyst of mandible in a 19-year-old man Figure 5.43 Melanotic neuroectodermal tumor of infancy. The neoplastic islands located between the bone trabeculae contain abundant melanin pigment Figure 5.44 Melanotic neuroectodermal tumor of infancy. This example shows the classic pattern of neuroblast-like cells surrounded by larger melanin-containing epithelial cells Figure 5.45 Gross appearance of a destructive osteosarcoma of mandible Figure 5.46 Osteosarcoma of jaw. The neoplastic bone (left) is clearly distinguishable from the residual normal bone (right) Figure 5.47 Tophaceous pseudogout. The lobules of deposited soft tissue uric acid have the appearance of slightly atypical cartilage and are surrounded by foreign body giant cells
