Ameloblastoma pathophysiology

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Shivali Marketkar, M.B.B.S. [2]

Ameloblastoma Microchapters
Home
Overview
Historical Perspective
Classification
Pathophysiology
Causes
Differentiating Ameloblastoma from other Diseases
Epidemiology and Demographics
Risk Factors
Screening
Natural History, Complications and Prognosis
Diagnosis
Diagnostic Study of Choice
History and Symptoms
Physical Examination
Laboratory Findings
Electrocardiogram
X-Ray
CT
MRI
Echocardiography and Ultrasound
Other Imaging Findings
Other Diagnostic Studies
Treatment
Medical Therapy
Surgery
Primary Prevention
Secondary Prevention
Cost-Effectiveness of Therapy
Future or Investigational Therapies
Case Studies
Case #1
Ameloblastoma pathophysiology On the Web
Most recent articles
Most cited articles
Review articles
CME Programs
Powerpoint slides
Images
American Roentgen Ray Society Images of Ameloblastoma pathophysiology All Images X-rays Echo & Ultrasound CT Images MRI
Ongoing Trials at Clinical Trials.gov
US National Guidelines Clearinghouse
NICE Guidance
FDA on Ameloblastoma pathophysiology
CDC on Ameloblastoma pathophysiology
Ameloblastoma pathophysiology in the news
Blogs on Ameloblastoma pathophysiology
Directions to Hospitals Treating Ameloblastoma
Risk calculators and risk factors for Ameloblastoma pathophysiology

Pathophysiology

Gross

Shown below is the gross specimen of resected left half of mandible initiated at third molar.

Microscopic Pathology

Histopathology will show cells that have the tendency to move the nucleus away from the basement membrane. This process is referred to as "Reverse Polarization". The follicular type will have outer arrangement of columnar or palisaded ameloblast like cells and inner zone of triangular shaped cells resembling stellate reticulum in bell stage. The central cells sometimes degenerate to form central microcysts. The plexiform type has epithelium that proliferates in a "Fish Net Pattern". Shown below is a micrograph of ameloblastoma

The image shows the characteristic features:

• Islands of cells with palisaded nuclei that have reverse polarization.
• Reverse polarization of nuclei = nuclei distant from the basement membrane/nuclei at pole opposite of basement membrane.
• Palisaded nuclei = picket fence appearance; columnar-shaped nuclei with long axis perpendicular to the basement membrane.

• Subnuclear vacuolization in palisading cell - vacuoles at the basement membrane aspect.
• Loose stroma around the islands of cells.
• Star-like cells at the centre of the islands of cells (stellate reticulum).

The six different histopathological variants of ameloblastoma are desmoplastic, granular cell, basal cell, plexiform, follicular, and acanthomatous.

Video

{{#ev:youtube|VW5aSalmyF0}}