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MindMap Gallery Oral Histopathology Chapter 15 Detailed Lecture Notes on Oral and Maxillofacial Cysts

Oral Histopathology Chapter 15 Detailed Lecture Notes on Oral and Maxillofacial Cysts

This is a mind map of a detailed lecture on Oral Histopathology, Chapter 15, Oral and Maxillofacial Cysts for Oral Medicine. A cyst is a pathological cavity that contains liquid or semi-fluid material and is surrounded by a cyst wall. around.

Edited at 2024-02-11 10:46:30

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Oral Histopathology Chapter 15 Detailed Lecture Notes on Oral and Maxillofacial Cysts

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Outline

Oral and maxillofacial cysts

Cyst: a pathological cavity containing liquid or semi-fluid material surrounded by a cyst wall

jaw cyst

Odontogenic cyst: refers to a group of cysts arising from the epithelium or epithelial remnants of the adult odontium.

Epithelial origin of different cysts (fill in the blank)

Remaining dental lamina epithelium or remaining serres epithelium

developmental radicular cyst

gingival cyst

retracted enamel epithelium

dentigerous cyst

Erupted cyst

Inflammatory radicular cyst

Marasser's epithelial remnant

periapical cyst

odontogenic developmental cyst

Dentigerous cyst (key point)

Noun: Odontogenic cyst, also known as follicular cyst, refers to a cyst containing the crown of an unerupted tooth. The cyst wall surrounds the crown and is attached to the neck of the tooth, that is, the cementoenamel junction.

clinical

1: The most common site of occurrence is the mandibular third molar, which may be related to the tooth being easily impacted.

2: Causes protruding jaws and facial asymmetry. If secondary infection occurs, local swelling and pain may occur.

3: X-ray: Appears as a clearly defined single cystic radiograph containing an unerupted tooth crown.

pathology

lining epithelium

1: The lining epithelium is thin, similar to retracted enamel epithelium, composed of 2-5 layers of flat cells or short cuboidal cells, without keratinization and epithelial spikes.

2: Part of the lining epithelium may undergo mucus cell metaplasia, or ciliated columnar cells may appear, and occasionally sebaceous gland cells may be seen.

fibrous cyst wall

1: The fibrous cyst wall is stratified epithelium with uniform thickness.

2: Sometimes a varying number of small masses or cord-like odontogenic epithelial islands can be seen in the fibrous cyst wall.

Secondary infection may be seen in dentigerous cysts. At this time, a large number of inflammatory cells can be infiltrated in the cyst wall, and sometimes cholesterol crystals can be seen.

Odontogenic keratocyst (from residual dental plate epithelium) (potentially aggressive growth pattern, prone to recurrence)

clinical

1::Tends to expand forward and backward along the long diameter of the mandible, resulting in larger lesions and less obvious swelling.

2: The lesions often involve the molar area and ramus of the mandible

3: X-ray: Single-room or multi-room radiography, there may be notches on the edges, and unerupted teeth may also be involved.

4: With nevoid basal cell carcinoma syndrome

pathology

Macroscopic view: The cyst wall is thin and fragile, and the cyst cavity contains cheese-like material or thin yellowish liquid.

lining epithelium

1: It is stratified squamous epithelium with uniform thickness and corrugated superficial layer of parakeratosis.

2: The lining epithelium is thin (5-8 layers of cells), without epithelial spikes, and sometimes bud-like proliferation of basal cells can be seen.

fibrous cyst wall

1: Apocysts or odontogenic epithelial islands can be seen in the fibrous cyst wall.

2: The epithelial basal cells are arranged neatly in a palisade shape, and the nuclei are densely stained and far away from the basement membrane, showing polarity inversion.

3: Intracellular edema often occurs in the epithelial spinous layer, and the cytoplasm is vacuolated.

Reasons why odontogenic keratocysts are prone to recurrence

1: The cyst wall is thin and fragile, making it difficult to completely remove it with surgery.

2: Tumors grow in a special way, tending to grow in finger-like processes along the less resistant trabecular spaces.

3: There are daughter cysts or odontogenic epithelial islands in the fibrous cyst wall.

4: The lining epithelium can be derived from the bud-like proliferation of basal cells of the oral mucosal epithelium.

Odontogenic calcifying cyst (ghost cell calcification) (anterior teeth) (rarely recurs)

Together with odontogenic ghost cell tumor and odontogenic ghost cell carcinoma, it is a group of diseases with ghost cells.

clinical

1: More common in the anterior tooth area

2: X-ray shows a clearly defined single cystic radiograph, which is common (tooth displacement) and (tooth root resorption)

pathology

lining epithelium

1: The lesion is unicystic, with varying thickness of lining epithelium.

2: Epithelial basal cells are arranged neatly in a palisade shape, and the nuclei are far away from the basement membrane like ameloblasts.

3: The cells in the superficial layer are star-shaped or spindle-shaped, and are loosely arranged like the star-reticular layer of the glaze organ.

4: In the epithelium, varying numbers of ghost cells can be seen.

Ghost cells (noun): Ghost cells are larger in size, round in shape, with rich red-stained cytoplasm, and the disappearance of the nucleus, leaving only a blank nuclear outline.

odontogenic inflammatory cyst

Periapical cyst (maxillary anterior teeth) (most common jaw cyst) (derived from remnant of Marasser epithelium)

Residual cyst (noun): After the tooth with periapical cyst-related lesions is extracted, the inflammatory tissue in the apical area is not completely removed and the remaining cystic lesions are

clinical

1: X-ray: It shows a round or oval transmission shadow in the apical area of the tooth, with a diameter of 1-2cm, neat edges, and a thin layer of radiopaque white lines around it.

pathology

Macroscopic appearance: Cysts vary in size

lining epithelium

1: It is stratified squamous epithelium without keratinization, often irregularly proliferating, and the epithelial spikes are elongated and connected to form a mesh.

fibrous cyst wall

1: The cyst wall tissue is attached to the root tip of the affected tooth and is dark red or grayish yellow in color.

2: The cyst wall is composed of (granulation tissue) or (fibrous tissue rich in inflammatory cells)

3: Blood vessel proliferation and expansion, inflammatory cell infiltration

4: May be accompanied by bleeding and hemosiderin deposition

5: Cholesterol crystals can be seen in the cyst wall, often accompanied by reactive multinucleated giant cells.

Hyaline bodies (noun): In a few cases of periapical cysts, arcuate linear or hairpin-shaped homogeneous red-stained bodies can be seen in the epithelium, which are called hyaline bodies.

non-odontogenic cyst

Nasopalatine canal (incisive canal) cyst (the most common non-odontogenic cyst) (originates from the remaining epithelium in the incisive canal)

clinical

1: Located in the midline area of the front of the palate, it can be divided into

Nasopalatine duct cyst

Occurs deep within the bone

Incisive papilla cyst

Within the soft tissue of the superficial incisor papilla area

2: Swelling of the palatine papilla

3: X-ray findings: There is a well-defined oval or heart-shaped radiolucent area between the roots of the two central incisors in the front of the hard palate.

pathology

lining epithelium

1: The lining epithelium varies greatly. It can be stratified squamous epithelium, ciliated columnar epithelium, single-layer columnar or cuboidal epithelium. More than one type of epithelium can be seen in a cyst.

fibrous cyst wall

2: The fibrous cyst wall contains large blood vessel and nerve bundles, and occasionally small focal mucus glands or cartilage can be seen.

soft tissue cyst

Dermoid and epidermoid cysts (dough-feeling) (remnants of embryonic development)

clinical

Commonly occurs in the floor of the mouth, submental, forehead, temporal and other parts of the mouth.

sublingual

Superficial, located between the geniohyoid muscle and the floor of the mouth mucosa

bulge into the mouth

Submental position

Deeper, between the geniohyoid muscle and mylohyoid muscle

Swelling toward the submental area

It feels flexible and has a doughy feel to palpation, and depression may appear under pressure.

pathology

Macroscopic view: Cysts vary in size, the cyst wall is usually thin, and the cyst cavity contains a large amount of tofu-like material.

fibrous cyst wall

1: Lined by orthokeratinized stratified squamous epithelium with obvious granular layer.

2: Exfoliated eosinophilic keratinized material can be seen in the cyst cavity

3: If the fibrous cyst wall contains skin appendages such as sebaceous glands, it is called a dermoid cyst. If there are no appendages, it is an epidermoid cyst.

Branchial cleft cyst (lymphoepithelial cyst) (source of second branchial cleft)

clinical

2: Mostly located near the mandibular angle on one side of the neck, at the front edge of the upper third of the sternocleidomastoid muscle

1: It is a developmental cyst located on the side of the neck, also known as cervical lymphoepithelial cyst

3: More left neck than right neck

pathology

Cyst contents: yellow-green or brown clear liquid, or containing thick jelly-like material

lining epithelium

1: The lining epithelium is stratified squamous epithelium, with or without keratinization, and a few are lined with pseudostratified columnar epithelium.

fibrous cyst wall

1: The fibrous cyst wall contains (a large amount of) lymphoid tissue and can form lymphoid follicles

Thyroglossal duct cyst (more common in adolescents) (occurs from the residual epithelium of the thyroglossal duct)

clinical

1: Mostly located near the (midline or midline of the neck), anywhere from the blind foramen of the tongue to the thyroid gland

2: There is a sense of fluctuation when touched

pathology

Cyst contents: clear liquid or mucus, which may turn into purulent mucus if secondary infection occurs

lining epithelium

1: It is stratified squamous epithelium or pseudostratified ciliated columnar epithelium, and the transition between the two often coexists.

Cysts near the oral cavity are mostly composed of stratified squamous epithelium

The lower part of the neck is mostly ciliated columnar epithelium

fibrous cyst wall

Visible thyroid or mucous gland tissue

Mucocele (most common soft tissue cyst) caused by rupture of (minor salivary gland) duct)

Mucoceles: soft tissue cysts caused by rupture or obstruction of minor salivary gland ducts, leading to extravasation or retention of mucus.

clinical

1: It is best to occur on the lower lip, and is more common in children and young people.

2: Cysts can disappear on their own but are prone to recurrence.

Extravasation mucocele (common) (no epithelial lining)

It is usually caused by (mechanical trauma) causing the rupture of the salivary gland duct, and the mucus overflows into the connective tissue to form a mucus pool, which is surrounded by inflammatory granulation tissue or fibrous tissue.

Under the microscope: 1: The mucus pool is surrounded by inflammatory granulation tissue or fibrous tissue.

retention mucocele

It is caused by obstruction of the salivary gland ducts and dilation of the ducts due to saliva retention.

More common in the elderly

under the mirror

1: The cyst cavity contains thick mucus material and is lined with epithelium of various types.