Unilocular Lucent Lesions
Terms in this set (116)
unilocular odontogenic lucenices can present in this way......
this type of lucency is present pericoronal to an unerupted/impacted tooth
this type of lucency presents inter-radicular or apical (may or may not be tooth related)
- nasopalatine duct cyst
- central giant cell granuloma
- traumatic bone cavity
- primary or metastatic malignancy
these are unilocular radiolucencies that are non-odontogenic
- histiocytosis-X (langerhans cell disease)
- multiple myeloma
these are examples of unilocular diffuse/multiple radiolucencies that are non-odontogenic
- dentigerous cyst
- unicystic ameloblastoma
examples of pericoronal odontogenic unilocular lucencies
- lateral periodontal cyst
examples of radicular unilocular odontogenic radicular lucencies
dentigerous cyst and eruption cyst
this is a developmental odontogenic cyst surrounding an impacted tooth; develops from fluid accumulation between follicle and crown of impacted tooth
dentigerous and eruption cysts remain attached to the _____________________ of the tooth
- mandibular and maxillary 3rd molars
- maxillary cuspids
- mandibular second premolar
these teeth are associated with dentigerous cysts (in a descending order)
dentigerous cyst with pericornitis
laterally positioned dentigerous cyst
dentigerous cyst (pericoronal)
simple, conservative enucleation
how are dentigerous and eruption cysts treated?
what is the recurrence rate of dentigerous and eruption cysts?
yes: ameloblastoma, SCC, mucoepidermoid carcinoma
are there reports of neoplastic transformation reported with dentigerous and eruption cysts?
denitgerous cyst attached to CEJ
what type of epithelium is found lining the inside of a dentigerous cyst?
what is the arrow pointing to on the right?
- follicular space/hyperplastic dental follicle
- dentigerous cyst
what are the possible differential diagnoses for periocoronal unilocular radiolucencies?
follicular space/hyperplastic dental follicle
eruption cyst (aka eruption hematoma)
this is a dentigerous cyst in soft tissue; surrounding the crown of a tooth which erupted through bone, but not the overlying soft tissue
pigmental neuroectodermal tumor of infancy
an eruption cyst may appear as this soft tissue tumor and should be included in your differential diagnosis
pre- and post-functional dental lamina rests
OKCs develop from........
what is the rate of recurrence for OKC?
nevoid basal cell carcinoma syndrome
multiple OKCs are associated with......
uni- or multi-locular, w/ or w/out impacted tooth, scalloped borders
how do OKCs appear radiographically?
this is when an OKC develops in placed of a tooth
keratinized lining epithelium w/ nuclear palisading, "daughter cysts" and thin capsule
how do OKCs appear microscopically?
primordial cyst (OKC)
OKC w/ daughter cysts
surgical enucleation/curettage followed by chemical or surgical ablation
how are small cases of OKCs treated?
surgical resection (en bloc or segmental)
how are large cases of OKCs treated?
marsupialization followed by enucleation
this technique is used in some cases of OKCs
OKCs are reported to recur in ______________% of cases in 5 and 10 year follow up series
long term radiologic follow up
this is recommended in patients with OKCs
nevoid basal cell carcinoma syndrome (gorlin-goltz syndrome)
this is inherited as an autosomal dominant condition patched (PTCH) gene mutation (9q22.3-q31)
multiple BCCs in gorlin goltz
multiple OKCs in gorlin goltz
multiple epidermoid cysts in gorlin goltz
calcification of the falx cerebri in gorlin goltz
bifid ribs in gorlin goltz
short fourth metacarpal in gorlin goltz
cardiac fibroma in gorlin goltz
palmar pits in gorlin goltz
plantar pits in gorlin goltz
this lesion appears unilocular radiographically, intraoperatively and microscopically and resembles a DC when associated with impacted tooth
young, teen age < 20 years
what age group does unicystic ameloblastoma present?
this is significant in the treatment of a unicystic ameloblastoma
what are the histologic subtypes of unicystic ameloblastomas?
plexiform nodules in the lumen
what is the arrow pointing to?
luminal unicystic AB
unicystic ameloblastoma w/ mural invasion
lateral periodontal cyst
this is derived from one or more of the dental lamina rests, typically present between the roots of mandibular bicuspids and between maxillary lateral and cuspid
what is the treatment for lateral periodontal cyst?
what is the recurrence rate for lateral periodontal cysts?
non- keratinized lining epithelium w/ plaque
what is the lining of a lateral periodontal cyst?
traumatic bone cyst (simple bone cyst, idiopathic bone cavity)
this is a hollow cavity within bone that is common in children, usually non-expansile
is there an epithelial lining in a traumatic bone cyst?
this may be found in a traumatic bone cyst
long bones (unicameral bone cyst)
where are traumatic bone cysts found?
host bone line by fibrovascular tissue w/o lining epithelium
what is the pathology of a traumatic bone cyst?
unknown, trauma reported in ~50%
what is the etiology of a traumatic bone cyst?
metaphysis of proximal regions of humerus or femur and jaw bones
these are the most common locations for traumatic bone cysts
what is the predilection for traumatic bone cysts?
traumatic bone cysts affects people in this age range
surgery of a traumatic bone cyst reveals ____________________
routine x-ray (festooning between roots)
how are traumatic bone cysts in the oral cavity found?
diagnosis of traumatic bone cysts should be made on these findings
curettage and establish fresh hemorrhage
how are traumatic bone cysts treated?
____________________ of the jaws is much more common
what percent of cancers metastasize to the jaw?
this cancer is women most commonly metastasizes to the jaws
this cancer in men most commonly metastasizes to the jaws
these are other cancers (from most to least common) that can metastasize to the jaws
jaw metastasis is the first evidence of cancer in _______% of cases
"moth-eaten" lucency, occasionally opaque, root resorption
how does metastatic carcinoma of the jaws appear radiographically?
primary carcinoma of the jaws
this type of malignant lesion in the jaws is rare
poorly differentiated carcinoma c/w metastatic breast carcinoma
poorly differentiated carcinoma c/w metastatic lung carcinoma
this is a metabolic disorder characterized by excessive production production of parathyroid hormone and hypercalcemia
this type of lesion is due to a functional tumor in one parathyroid gland
this type of lesion is to hyperplasia of all parathyroid glands in renal failure (end stage kidney disease)
- generalized osteopenia
- loss of lamina dura around teeth
- Lucent lesions (uni or multilocular)
what are radiographic characteristics of hyperparathyroidism?
- elevated PT hormone
- elevated serum calcium
what are the lab findings of hyperparathyroidism?
ground glass and loss of lamina dura in hyperparathyroidism
langerhans cell disease (histiocytosis-x)
this is a proliferative disorder of histiocyte-like cells derived from monocytes and exhibit differentiation of langerhans cells
birbeck granules in langerhans cells
this is a solitary LCD bone lesion
chronic disseminated LCD in bone, viscera, and skin is associated with........
LCD + exophthalmia + DI
what is the Hand-Schuller-Christian disease triad?
acute disseminated LCD
this type of LCD presents as numerous bone lesions with visceral and cutaneous involvement
in cases of acute disseminated LCD, multiple organ involvement besides bone is known as........
chronic disseminated in Hand-Schuller-Christian disease
Langerhans cell disease (histiocytosis-x)
this is a malignancy of bone marrow based B lymphocyte
monoclonal malignant plasma
multiple myeloma is characterized by _____________________ cell proliferation throughout skeleton and jaws
what is the acronym that characterizes the multifocal neoplastic process of multiple myeloma?
- skeletal destruction w/ osteolytic lesions
- pathologic fractures
- bone pain
what are some characteristics of multiple myeloma?
C= calcium elevation in blood (hypercalcemia)
R= renal impairment (^BUN, creatinine)
A= anemia (myelophthisic)
B= bone lytic lesions of MM, fractures
what does CRAB stand for?
serum monoclonal protein (gamma protein)
these lab findings are detected by electrophoresis in MM cases
- amyloid deposition in tissues
- Bence-Jones protein in urine
this is also detected in MM cases
MM with "punched out" lesions
graph showing elevated gamma protein in MM
neoplastic plasma cell infiltrate in marrow (MM)