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Quick Review #127 - #pathology #oralpathology #doctorgallagher #oralsurgery #oralsurgeon #dentist #dentistry #dental
Aneurysmal Bone Cyst (ABC)
• Clinical Characteristics:
- Occurs predominantly in children and young adults.
- Rapid, painless swelling; may become painful if there is impingement on nerves or other structures.
- Commonly affects the long bones and vertebrae, but also seen in the jaws.
• Radiographic Findings:
- Exhibits a "soap bubble" or "honeycomb" appearance, radiolucent.
- Expansile, multilocular lesion with well-defined borders.
- Can cause thinning of the cortex, showing ballooning of the bone.
• Histological Features:
- Multiple blood-filled cystic spaces without endothelial lining.
- Fibrous septa containing multinucleated giant cells, osteoid, and reactive woven bone.
- Occasionally shows areas of solid fibrous proliferation.
Differential Diagnoses and Differentiating Features:
1. Ameloblastoma
- Clinical: Typically slower growing; occurs mainly in adults.
- Radiographic: “Honeycombed" or "soap bubble" radiolucencies, but more localized and defined; does not typically cause the same degree of expansile distortion.
- Histological: Consists of odontogenic epithelial cells arranged in palisaded columns with reverse polarity; lacks blood-filled cystic spaces.
2. Odontogenic Keratocyst (OKC)
- Clinical: Can be aggressive; high recurrence rate.
- Radiographic: Presents as a unilocular or multilocular radiolucency; scalloping around the roots of teeth.
- Histological: Lined by thin, parakeratinized epithelium; contains keratin debris; no giant cells or blood-filled spaces.
3. Traumatic Bone Cyst (TBC)
- Clinical: Often asymptomatic; discovered incidentally.
- Radiographic: A unilocular radiolucency without a sclerotic border, often scalloping between the roots.
- Histological: An empty cavity or one with serous fluid; lacks an epithelial or cellular lining; no solid tissue components.
4. Giant Cell Granuloma (GCG)
- Clinical: More common in younger individuals; may present with pain or swelling.
- Radiographic: Radiolucent lesion, can be unilocular or multilocular; lacks the expansile feature seen in ABCs.
- Histological: Contains multinucleated giant cells in a background of fibrous stroma; reactive bone present but lacks blood-filled spaces typical of ABC.
References:
1. Exodontia.info. (n.d.). Aneurysmal Bone Cyst. Retrieved April 22, 2024, from https://lnkd.in/dH835BTA
2. Motamedi, M. H. K., & Yazdi, E. (2012). Aneurysmal bone cyst of the jaws: Analysis of 11 cases. Journal of Oral and Maxillofacial Surgery, Medicine, and Pathology, 24(3), 175-178. doi:10.1016/j.ajoms.2011.08.002
3. Neville, B. W., Damm, D. D., Allen, C. M., & Bouquot, J. E. (2016). Oral and Maxillofacial Pathology (4th ed.). St. Louis, MO: Elsevier.
4. ChatGPT. 2024.
