This 44 year old female was treated over a course of one year for a
symptomatic mandibular left second bicuspid. Due to extensive bone loss
and severe mobility of the tooth, a biopsy was performed along with
extraction of the involved tooth.
Differential Diagnosis:
- Eosinophilic Granuloma
- Squamous Odontogenic Tumor
- Ameloblastoma
- Calcifying Odontogenic Cyst
Although the lesion is fairly well demarcated, there is no clear cut delineation, such as a sclerotic border, from the adjacent bone. Also note that this is predominantly an alveolar bone process.
Histology:
Slide 1 (medium power, H&E). This slide shows a dense cellular infiltrate. The cells contain lightly staining cytoplasm and uniform round or indented nuclei.
Slide 2 (high power, H&E). This slide demonstrates collections of cells with granular eosinophilic cytoplasm and bilobed nuclei. Although difficult to see, these eosinophils are found within a background of the larger mononuclear cells.
Diagnosis: Eosinophilic Granuloma
Note: any form of Langerhans cell disease (Histiocytosis X) could have this type of histology.
|