This study surveys twenty acceptable cases of granularcell ameloblastoma from the files of the armed forces institute of pathology. The periphery of the islands consists of non granular tall columnar cells. Cyst formation within the epithelial islands of the follicular type is common. The ohio state university wexner medical center columbus, ohio u.
When this granular cell change is extensive in an ameloblastoma, the designation of granular cell ameloblastoma is appropriate. The most widely accepted hypothesis is that granular cell tumor arises from the altered. Clinicopathological analysis of histological variants of ameloblastoma in a suburban nigerian population. In the largest series of granular cell ameloblastomas retrieved from the files of the armed forces institute of pathology, granular cell. Ameloblastoma can affect all ages, but is mainly found in the 2050 years old range, with an average age of 27 years. Expression of reck and matrix metalloproteinase2 in ameloblastoma. Later, these cases were grouped as dentinogenic ghost cell. Oral granular cell tumor in a brazilian population. Desmoplastic variant is composed of the dense collagen stroma, which appears hypocellular and hyalinized. Ameloblastoma has been classified into several histologic subtypes including follicular, cystic, acanthomatous, plexiform, basal cell and granular cell. Expression of reck and matrix metalloproteinase2 in. Ameloblastoma is a locally aggressive benign tumor derived from the odontogenic epithelial tissues. Department of pathology, brigham and womens hospital, boston massachusetts. Granular cell tumor is an uncommon neoplasm that can occur in any part of the body, including the orofacial region.
Histopathological features displayed a follicular type of ameloblastoma with an accumulation of granular cells residing within the tumor follicles. Pdf a 42yearfemale patient presented with a swelling on the left side of the face for the past 10 years. Comparison of proliferating cell nuclear antigen expression in odontogenic. Granular cell ameloblastoma is a rare condition, accounting for 3. Desmoplastic ameloblastoma of maxilla a case report. Basal cell type, the epithelial tumor cells are less columnar and arranged in sheets. Many a times it is similar to a fibroosseous lesion due to. These granular cells are seen in several physiological and pathological conditions and the granularity in gca is due to lysosomal aggregates. Granular cell ameloblastoma of jaw med oral patol oral cir bucal. However, there is some evidence, at least anecdotal, that the most recent variant to have been described, the. Usual granular cell ameloblastoma is histologically characterized by granular changes of stellate. The tumor is usually benign, but there are reports of cases in which the tumor shows a locally aggressive behavior, malignancy, and distant metastases.
Headneck cytopathology miscellaneous lesions 24th annual seminar in pathology pittsburgh, april 2017 p. Areas of osseous metaplasia with active osteoblasts were also noted figure 4. A wide spectrum of histological patterns have been described for ameloblastoma 11. Granular cell ameloblastoma is characterized by the presence of granular cells, which measures about 1 m in size 10 giant the occurrence of granular cells in developing enamel organ of granular cells are up to 30 m and rarely seen. Of the 8 cases with no reactivity 5 were follicular ameloblastomas two acanthomatous ameloblastomas and a case of granular cell ameloblastoma. A unicystic ameloblastoma with late recurrence as follicular ameloblastoma aggressive ameloblastoma treated with radiotherapy, surgical ablation and reconstruction pigmented hemosiderotic granular cell ameloblastoma. Cytologic findings in granular cell tumors, with emphasis on the diagnosis of malignant granular cell tumor by fine. There are several histological subtypes, including plexiform, follicular, acanthomatous, basaloid, granular cell, cystic and desmoplastic forms.
Headneck cytopathology miscellaneous lesions topics. They are also classified as multicystic versus unicyst ic in which former is more aggressive and recurs more frequently than does later. Cytologic findings in granular cell tumors, with emphasis. It is a also well known fact that the granular cell variant and ameloblastoma exhibiting clear cell differentiation which were not seen in our series. There was no occurrence of the granular or basal cell histopathological type of. Granular cell ameloblastoma is a rare histological subtype of ameloblastoma accounting for less than 5% of the total. Provisional diagnosis of this tumor is based on clinical and radiological features. Clinicopathological analysis of histological variants of. To our knowledge, this is the first description of the ultrastructure of the granular cell ameloblastoma, an odontogenic tumor.
Below are the links to the authors original submitted files for images. The purpose of this article is to present a case of unusual variant of ameloblastoma and highlighting its unique microscopic features that allow its distinction from other jaw tumors with a granular cell consistency. The characteristic microscopic features of granular cells are attributed to. On a radiograph, this lesion rarely suggests the diagnosis ameloblastoma. All fresh tissues were immediately stored in liquid nitrogen for further analysis. The incidence of ameloblastoma is similar between males and females. The characteristic microscopic features of granular cells are attributed to the increased presence of lysosomes in the cytoplasm of the. Here we report a case of another type of granular cell ameloblastoma, showing predominant anastomosing double. Topics nonlymphoid small cell cytoplasmicpoor nonlymphoid large cell cytoplasmicrich cystic spindle cell when it comes to fna. Granular cell tumors gcts are extremely rare lesions of the urinary bladder with only nine cases being reported in world literature of which one was malignant. Aggressive granular cell ameloblastoma pdf free download. A threeyear retrospective study ramesh tatapudi, shaik abdul samad. The majority of these tumors arise in the mandible 80%. Doctoral thesis summary university of medicine and.
In 80s and 90s scientific manuscripts, a number of them were reported containing ghost cells and dysplastic dentin, what were renamed using several descriptive terms. Ameloblastoma, mandibular, with a periphery of dark palisading columnar cells arrow typical of ameloblasts. Histologically ameloblastoma epithelium resembles that of the enamel organ of the developing tooth. The tumor has a slight increased preponderance in females and is mainly diagnosed in the third or fourth decade of life2, 3. Pdf ameloblastoma is a benign, slowgrowing neoplasm of odontogenic. Investigation of basement membrane proteins in a case of granular. Ameloblastoma is a benign locally aggressive type of odontogenic tumor derived exclusively from the epithelium. Ameloblastoma prevalently occurs in the ramus and the angulus of the mandible, and. In granular cell ameloblastoma, cytoplasm of stellate reticulumlike cells appear coarse granular and eosinophilic. The most frequent primary site is the angle of the mandible.
This study surveys twenty acceptable cases of granularcell ameloblxstoma from the files of the armed forces institute of pathology. The granular cell ameloblastoma gca is one of the rarest entities and accounts for only 5% of all ameloblastomas 5. Case report extragingival peripheral ameloblastoma of the. Of the many types, granular cell ameloblastoma gca is an uncommon variant that possesses distinctive features. Here the central area of the cell nest looks squamoid triangles. Research article ameloblastoma containing marcelo macedo.
Under general anesthesia, the spec imen was taken out, and the defect was covered by a cellular allograft dermal matrix membrane. These variations include follicular, plexiform, acanthomatous, granular cell, basal cell, unicystic, desmoplastic, and malignant types. Granularcell ameloblastoma a survey of twenty cases from the armed forces institute of pathology kenton s. Granular cell ameloblastoma is classified as a histological subtype of solidmulticystic ameloblastoma. Ultrastructure of granular cell ameloblastoma ultrastructure of granular cell ameloblastoma navarrete, antonio r smith, marilyn 19710401 00. In most instances, it occurs as an admixture with other histo. A case of massive granular cell ameloblastoma in a 44yearold thai female is reported. The granular cells usually form the central mass of the epithelial tumor islands and cords. It is also considered an aggressive variant of the ameloblastoma with potential recurrence and malignant transformation.
The origin of the granular cells appears to be epithelial, and recent ultrastructural studies have indicated that the cytoplasmic granules probably represent lysosomal aggregates. Pdf granularity in granular cell ameloblastoma yoithap. Plagiarism is copying another persons text or ideas and passing the copied material as your own work. Granular cell ameloblastoma austin publishing group. The tumor originates from the epithelium involved in tooth formation, the enamel organ, epithelial cell rests of malassez, reduced enamel epithelium, and epithelial lining of odontogenic cysts with special reference to dentigerous cysts 1, 2. The nuclear crowding and hypercellularity of basal cell ameloblastoma always raises a concern for malignancy but by itself is not diagnostic of malignancy. Hartman, lieutenant colonel, usaf dc dental and oral pathology division, armed forces institute of pathology ameloblastoma is an uncommon odcmtogenic tumor that may on occasion demonstrate the presence of granular cells. Ameloblastomas may be divided histologically into follicular, plexiform, cystic, acanthomatous, desmoplastic, granular cell, basal cell and unicystic. Growing papule on the right shoulder of an elderly man. To the best of our knowledge, there have been no previous reports on the cytologic. Wizdent ameloblastoma showing multilocular radilolucency. Extragingival peripheral ameloblastoma 12631 int j clin exp med 2017.
Proliferating cell nuclear antigen pcna and p53 protein. Desmoplastic ameloblastoma is an aggressive variant of ameloblastoma which needs special attention by the clinician, owing to its locally destructive nature. With the granular cell variety, some or all of the cell can show granular cell change, often complicating diagnosis. Considering the rarity of the lesion, we report here an interesting and unique case of basal cell ameloblastoma of. Granular cell ameloblastoma gca is one of the rare histological variants of ameloblastoma 1.
There was no occurrence of a granular or basal cell histopathological type of ameloblastoma. Immunoreactivity for p53 was present in 11 of the 19 cases of ameloblastoma investigated 57. The average age at diagnosis of patients with ameloblastoma is 34 years with a range of five to 74 years. Ultrastructure of granular cell ameloblastoma, cancer 10.
Desmoplastic ameloblastoma with osteoplasia savithri, et al. Subclassification of ameloblastoma has not proven practical, however, since it has been determined that 2 or more histologic types may be observed in the same tumor, and. Generally believed to be of neural origin based on histochemical, immunohistochemical, and ultrastructural studies. Metastatic ameloblastoma responding to combination. Other rare histological variants, including basal cell ameloblastoma, desmoplas tic ameloblastoma and kerato ameloblastoma, have also been described. Ameloblastoma is a mostly benign, locally invasive odontogenic neoplasm arising in the jaws. Granular cell ameloblastomas have histologic features and staining. When this granular cell change is extensive in an ameloblastoma, the designation of granular cell ameloblastoma is appropriate 1.
We conclude that the granular cell ameloblastoma and the granular cell myoblastoma, probably along with the granular cell amelo blastic fibroma and the congenital epulis. Granular cell ameloblastoma is a variant of ameloblastoma that. Basal cell ameloblastoma is a rarest entity till date, only few cases of basal cell ameloblastoma have been reported in the literature. The characteristic microscopic features of granular cells are attributed to the increased presence of lysosomes in the cytoplasm of the tumour cells. The landscape of genetic alterations in ameloblastomas. They include acanthomatous, granular cell, basal cell and keratopapillary ameloblastomas, although these are usually superimposed on one of the two main patterns and none appears to convey or re. Granular cell ameloblastoma is a rare odontogenic tumor, accounting for 3. Investigation of basement membrane proteins in a case of.
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