PMC5588404_01
Cropped panoramic radiographs showing the affected mandible at different times. a Initial panoramic radiograph. b 9 months after tooth removal and marsupialization of the lesion. c 2 years after initial treatment. d 4 months after surgical enucleation of the lesion.
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F1
On the panoramic radiograph, an extensive cystic-appearing lesion was visualized (fig. 1).
a The microscopic analysis exhibited a cystic lesion of inflammatory origin. x10. b After 2 years of follow-up, the cystic lesion associated with convoluted hyalinized rings and foreign body-type multinucleated giant cells. x10. Inset Cellular details are shown. c At low magnification, numerous hyalinized rings and vegetable matter supported by fibrous stroma. x5. d Vegetable particle closely associated with foreign body-type multinucleated giant cells. x20. e Dark organic material and granulomatous foreign body response. x10. f High-power view showing convoluted hyalinized rings containing calcified basophilic granules. x40. a-f H&E.
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F2
The clinicopathological correlation led to the diagnosis of a paradental cyst (fig. 2a). The cyst was marsupialized again, and microscopically revealed an association with focal HRG reaction (fig. 2b). The histopathological analysis of the entire tissue blocks showed an exuberant HRG reaction (75% of the surgical specimen) supported by fibrous stroma (fig. 2c-f).