PMC3362824_01
Panoramic radiographs of the patient. (a) Taken at the first visit. No bone alterations can be seen in the area of the lesion; (b) Nine-year follow-up: no change worthy of note.
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fig1
Radiographs showed normal bone appearance (Figure 1(a)). In the nine-year follow-up, he was clinically and radiographically normal (Figure 1(b)).
(a) Nondysplastic hyperkeratotic oral epithelium (magnified in the box, H&E, 10x) and the submucous odontogenic epithelial cell islands (H&E, 2,5x); (b) Less mature odontogenic island with vacuolated oval to polyhedric cells (H&E, 40x); (c) ameloblastomatous nest composed by peripheral palisading columnar and central polyhedric cells (H&E, 20x); (d) budding projection in an ameloblastomatous island (circle) (H&E, 20x).
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fig2
Microscopically, the oral squamous epithelium was hyperplastic and hyperkeratotic but without dysplastic alterations (Figure 2(a)). In the deep portion of oral submucosa there were numerous islands of odontogenic epithelial cells scattered in a fibrous stroma (Figure 2(a)). Few nests were predominantly composed by polyhedric cells (Figure 2(b)). The outer cells presented more basophilic staining than that inner ones (Figure 2(c)). In few larger islands, it was possible to see evident budding projections (Figure 2(d)).
(a) Cystic formations in an ameloblastomatous nest (H&E, 20x); (b) squamous metaplasia seen in an ameloblastomatous nest (H&E, 20x). (c)Stroma surrounding the odontogenic epithelial islands with a more fibrous arrangement than that outer connective tissue (H&E, 10x).
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fig3
Semiserial section of the lesion exhibited epithelial islands with squamous metaplasia and incipient cystic formation (Figures 3(a) and 3(b)). Another interesting microscopical feature was the presence of connective tissue surrounding the islands of odontogenic epithelial cells with looser arrangement than adjacent collagenous tissue not involved with the lesion (Figure 3(c)).