PMC2964905_01
A nontender, persistent swelling in the region of lower left posterior region.
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fig1
Clinical examination disclosed a swelling measuring about 5 mm in diameter in the region of lower left premolars which was non tender, and the over lying mucosa was normal in color. Clinically, a provisional diagnosis of epulis was made (Figure 1).
Solid wellcircumscribed encapsulated mass (a) showing ameloblastomatous islands of odontogenic epithelium (b) and ghost cells (c) with overlying epithelium (d) [Hematoxylin and Eosin, x4].
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fig2
Histological examination revealed a solid well-circumscribed, encapsulated soft tissue mass surrounded by a dense fibrous connective tissue covered by stratified squamous epithelium (Figure 2).
Ameloblastomatous island of odontogenic epithelium with columnar basal cells (a) enclosing stellate reticulum like cells (b) [Hemataoxylin and Eosin, x40].
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fig3
The tumor mass revealed islands of odontogenic epithelium resembling follicles of ameloblastoma, consisting of columnar cells enclosing stellate reticulum like cells (Figure 3).
Ghost cells (a) and surrounding dentinoid-like material (b) [Hemataoxylin and Eosin, x20].
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fig4
These elements were associated with numerous pale, eosinophilic ghost cells with granular eosinophilic cytoplasm and faint nuclear outline (Figure 4).
Irregular foci of dentine/osteo-dentine-like material (a) and calcifying ghost cells (b) and giant cells (c) [Hemataoxylin and Eosin, x40].
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fig5
Irregular foci of tissue resembling dentin were observed surrounding the odontogenic epithelial islands, and these areas were atubular and at places showed cellular inclusions (Figure 5).
Van Gieson stains showing ghost cells staining yellow (a) and surrounding dentinoid-like material staining pink (b) [Van Gieson stain, x40].
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fig6
Van Gieson special stain was carried out to examine the nature of the dentinoid-like material (Figure 6).