Implications of cholesterol crystals in odontogenic cysts. Factors related to cholesterol formation in cysts and granulomas. Mcqs on odontogenic cysts and tumors oral pathology part 2. Odontogenic cyst and non odontogenic cyst epithelium. Pathogenesis develops between enamel epithelium and tooth after odontogenesis is completed. Occasionally dentigerous cysts contain rushtons hyaline bodies. Bilateral or multiple dentigerous cysts are usually associated with the maroteauxlamy mucopolysaccharidosis, type vi syndrome 16 and cleidocranial dysplasia. Owing to its clinical characteristics similar to other more commonly occurring lesions in the oral cavity, differential diagnosis should include dentigerous cyst. Developmental odontogenic cysts 1 dentigerous cyst a cyst that forms around the crown of an unerupted tooth.
Odontogenic cysts are largely classified based on their location, viability of the associated tooth and clinical setting the principal exception to this is the odontogenic keratocyst, which can occur in any site or setting unlike most of the other cysts, it has aggressive potential. Odontogenic cysts, tumors, and related jaw lesions ento key. Rushton bodies scattered mucous, or ciliated or sebaceous cells uncommon but possible occasional dystrophic calcifications odontogenic epithelial rests, small, inactive appearing. Inflammatory odontogenic cysts are benign osteolytic asymptomatic lesions, but that.
The relationship between cholesterol crystals, foamy macrophages. It is a consequence to pulp necrosis of carious teeth. Radicular cyst is the most common inflammatory odontogenic cyst. They are most frequently encountered in radicular cysts and dentigerous cysts, but they also may develop in odontogenic keratocysts. Rushton bodies rb or hyaline bodies in odontogenic cysts feature as eosinophilic, straight or curved, irregular or rounded structures within the epithelial lining of odontogenic cysts. Introduction a cyst is an epithelium lined sac containing fluid or semifluid material the epithelial cells first proliferate and later undergo degeneration and liquefaction grow by expansion, causing displacement of adjacent teeth 3. These cysts show variable features and some lie on a cysttumour interface, making classification and diagnosis difficult. Although widely investigated, the exact pathogenesis and histogenesis of rbs is still an enigma. Rushton bodies, spongiosis, ciliated cells, necrosis, microabscesses and russel bodies, cholesterol crystals, hemosiderin and inflammatory. Epidemiology most common odontogenic cyst is periapical.
Ectopic production of hair keratin constitutes rushtons. Rushton bodies definition of rushton bodies by medical. It has two different histomorphological appearances. The most common inflammatory odontogenic cyst is the radicular cyst. A rushtons hyaline body hb is a concretion occasionally found in odontogenic cysts. Hyaline bodies of rushton are peculiar microscopic structures found. Fibrous to fibromyxoid connective tissue no rete ridges, flat interface. Though these are restrictedly expressed in odontogenic cysts, one case of plexiform ameloblastoma was. Apoptosis and rushton body formation apoptosis and rushton body formation pesce, c. The aim of this case is to illustrate that the clinician should consider that an apparent benign dentigerous cyst can suffer malignant transformation and that all material removed from a patient must be evaluated histologically. We have examined a series of rushton bodies seen in. The origin and nature of rb have been hotly debated. Odontogenic keratocyst because of its behavior, many oral pathologists now consider the okc an odontogenic tumor that has a cystic form 2005 classi.
A number of published studies have been carried out on large series table 1 relative frequency of 470 odontogenic cysts included in a study in the college of dentistry, king saud university, riyadh. Syndrome composed of multiple odontogenic keratocysts, bifid ribs, frontal bossing and multiple nevoid basal cell carcinomas in the patient. Rushton bodies may be seen as irregular structures on the surface epithelium of odontogenic cysts. Rushton bodies are characterized by a glassy pink hyalinized appearance in. Bilateral dentigerous cysts report of an unusual case. Rushton bodies hyaline are observed occasionally, and these are described as cuticular or keratinlike products of odontogenic epithelium. Odontogenic cysts are jaw lesions that may be misdiagnosed due to lack of complete data. Giant radicular cyst of the maxilla bmj case reports. Odontogenic cyst are a group of jaw cysts that are formed from tissues involved in odontogenesis tooth development. Odontogenic cysts and tumors ppt linkedin slideshare. Rushton bodies are believed to be a secretory product of the odontogenic epithelium due to the fact that they are usually found within the epithelial lining of various odontogenic cysts, such as.
Histopathological study of radicular cysts diagnosed in a. Rushton bodies rbs are one of the characteristic features seen in the epithelial lining of odontogenic cysts mainly radicular, dentigerous and odontogenic. Rushton bodies are seen exclusively in odontogenic cysts and are most commonly observed in radicular cysts with a reported frequency of 10% followed by dentigerous cysts 410% and odontogenic keratocysts okc 7% 1,2. Odontogenic epithelial rest was noted in one case 0. Rushton bodies or hyaline bodies in radicular cyst a morphologic curiosity. Although unique to odontogenic cysts, the biologic significance of rushton bodies is unknown. Primary intraosseous carcinoma of the jaws pioscc might arise from odontogenic epithelium, more commonly from a previous odontogenic cyst. Dentigerous cyst is a developmental odontogenic cyst that is formed by expansion of dental follicle and therefore always attached to the neck of an impacted or unerupted tooth.
Oralsurgery 548 dentalupdate julyaugust 2015 odontogenic cysts an overview abstract. Histologic or microscopic features of dentigerous cyst. Apoptosis and rushton body formation, histopathology 10. Results 115 cases with 20% quiescent epithelium fig. Rushton bodies rbs are one of the characteristic features seen in the epithelial lining of odontogenic cysts mainly radicular, dentigerous and odontogenic keratocyst. Calcifying odontogenic cysts have a wide age distribution that peaks at 10 to. Rushton bodies rb or hyaline bodies in odontogenic cysts feature as eosinophilic, straight or curved, irregular or rounded structures within. Rushtons hyaline bodies are found in odontogenic cysts, in particular in radicular cysts, as amorphous or lamellar concretions. Odontogenic cysts are closed sacs, and have a distinct membrane derived from rests of odontogenic epithelium. Cysts that derive their epithelium from tissues involved in tooth formation are classed odontogenic and can be inflammatory or developmental in origin. Distribution of morphological alterations observed in radicular cysts from. Data from published studies suggest an overall incidence of about 8%. Electron microscopic investigation of hyaline bodies in. Theory of rushton bodies formation one theory is that hyaline bodies are particular products of odontogenie epithelium wertheimer et al.
The cystic lumen will frequently contain necrotic cellular debris. Other types of epithelial lining were also observed, including simple table 1. Though these are restrictedly expressed in odontogenic cysts, one case of plexiform ameloblastoma was reported, by takeda et al. In this case report, we present a rare case of radicular cyst with rushton bodies in a 42 years male patient. Rushton bodies are seen exclusively in odontogenic cysts and are most commonly observed in radicular cysts with a reported frequency of 10% followed by. Most of these lesions involve the apex of offending tooth and appear as welldefined radiolucencies. Extremely rare examples have even been reported in a glandular odontogenic cyst and in an ameloblastoma. This article aims to discuss the clinical features, radiological assessment, histopathology and management of a variety of odontogenic cysts. Calcifying odontogenic cyst also called gorlin cyst as a cystic neoplasm. Odontogenic cysts and tumors are uncommon lesions and should be included in the differential diagnosis of gnathic bone pathoses. Comparison of components of cystic fluid in odontogenic keratocyst, dentigerous cyst, and radicular cyst.
Clinicopathological analysis of 232 radicular cysts of the jawbone in. Cysts of the jaw and soft tissues cairo university. Initially this lesion is asymptomatic, other than a clinically missing tooth. The contents of odontogenic cysts are variable from clear yellow liquid to a semisolid cheeselike mass. Rushton bodies are hyalinized structures that may be observed within the epithelial lining of odontogenic cysts.
We present a rare case of a radicular cyst showing rushton bodies in a 47yearold male patient. Dentigerous cysts account for about 20% of all odontogenic cysts, developing duringa peakage of 10to 30years,witha male predilection3. Rushton bodies are seen exclusively in odontogenic cysts and are most commonly observed in radicular cysts with a reported frequency of. It also highlights the reclassification of odontogenic keratocysts to keratocystic odontogenic tumours. Although cysts are common in the jaws, most are radicular cysts of in. A small percentage of radicular cysts have crescentshaped hyaline rushton bodies within the epithelial lining. Comparison of components of odontogenic cyst fluids. If the cyst not lined by epithelium it is pseudo cyst. Oral cavity cysts oral cavity cysts exist in jaw bones and soft tissue, gingiva odontogenic. Calcifying odontogenic cyst calcifying odontogenic cyst. Discussion although dentigerous cysts are common developmental cysts, reported bilateral dentigerous cysts are extremely rare. Exclusive occurrence of hyaline bodies in odontogenic cysts and the restricted presence within the epithelial lining suggest.
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