The Journal
The associated teeth showed no evidence of dental decay or periodontal disease . Radiographically , the panoramic radiograph revealed a unilocular radiolucency extending from 1st premolar to beyond the 2nd molar with scallops extending upwards between the roots . Resorption of roots of 1st molar was observed .
Fig 2
Aspiration revealed straw colored fluid , which microscopically showed cholesterol crystals , RBC ’ s and inflammatory cells . Based on clinical and radiological findings a provisional diagnosis of traumatic cyst was made along w i t h a d i f f e r e n t i a l d i a g n o s i s o f
Odontogenickeratocyst . Biopsy was performed and microscopically showed features of calcifying odontogenic cyst .
Based on the biopsy report enucleation was done along with extraction of the involved teeth . The enucleated specimen was predominantly cystic but showed a solid portion as well .
Histopathology showed proliferative odontogenic epithelium with epithelial lining of varying thickness ranging from few cell layers to many cell layers thick . It was composed of tall to columnar basal cells with hyperchromatism maintaining a flat interface . The distinctive microscopic feature was presence of varying no . of duct like structures with lumina of varying size that are lined by single layer of cuboidal to columnar epithelial cells . Eosinophilic cells characteristics of ghost cells were seen in some areas of epithelial lining , along with dystrophic calcifications . Irregular to round calcified bodies resembling leisgang rings were present adjacent to epithelial cells . There was presence of an eosinophilic extracellular material juxtaposition to the proliferative lining epithelium , which was interpreted to be dentinoid . The interesting feature was the well defined tubular appearance of dentinoid as seen in the histology of dentin . In addition a homogenous eosinophilic material was observed which was later confirmed to be amyloid with congo red staining . Based on these features it was diagnosed as Dentinogenic ghost cell tumor along with Adenomatoidodontogenic tumor ( AOT ) features .
After Enucleation
Fig 3 : Incisional Biopsy
Fig 4
30 29 23 22 10 24 Vol . 12 13 No . 23 1 May-August Sept-Dec Jan-April 2016 2017