PMC3303502_01
MRI showing the tumor in the right mandible
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F1
MRI [Figure 1] revealed a lesion in the right mandible involving the body and ramus.
Photomicrograph showing polygonal epithelial cells amidst amyloid-like material; note the absence of calcification (a) (H and E, x100). Cells showing pseudoglandular pattern (b) (hematoxylin and eosin; x200). Higher magnification of amyloid-like material (c) (H and E, x400). Congo red staining showing green birefringence of amyloid (d) (polarizing microscop, x200)
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F2
An incisional biopsy performed from the lesion revealed an epithelial odontogenic neoplasm composed of nests and islands of polygonal cells having centrally-placed nuclei and eosinophilic cytoplasm [Figure 2a]. Occasionally the cells formed a pseudoglandular pattern [Figure 2b]. The nuclei were vesicular and had inconspicuous nucleoli [Figure 2b]. Interspersed amidst the tumor cells was amorphous, acellular, eosinophilic, amyloid-like material, which showed metachromasia with crystal violet and green birefringence on Congo red staining [Figures 2c and 2d].
Photomicrograph showing immunopositivity of epithelial cells for cytokeratin (immunoperoxidase, x200)
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F3
On immunohistochemical evaluation, the tumor cells showed positivity for cytokeratin [Figure 3].