Granular cell ameloblastoma of jaw: report of a case with an emphasis on its characterization

Ameloblastoma is a neoplasm of odontogenic epithelium, especially of enamel organ-type tissue that has not under gone differentiation to the point of hard tissue formation. It accounts for approximately 10% of all tumors originating from gnathic bones. It exhibits diverse microscopic patterns which occurs either singly or in combination with other patterns. Granular cell ameloblastoma is a rare condition, accounting for 3.5% of all ameloblastoma cases that shows marked transformation in the cytoplasm of tumor cells, which are usually stellate reticulum like cells. The transformed cells possess very coarse, granular, eosinophilic cytoplasm. The 'granular change' is thought to be due to a dysfunctional status of neoplastic cells, and the pathogenesis of this tumour seems to be age-related. Ultrastructural, histochemical, and immunohitochemical studies have revealed that cytoplasmic granularity is caused by overload; however the mechanism ivolved remains poorly understood. This article describes a case of granular cell variant of ameloblastoma affecting a 55-year old femal

Granular cell ameloblastoma: Case report of a particular ameloblastoma histologically resembling oncocytoma

Granular cell ameloblastoma is classified as a histological subtype of solid/multicystic ameloblastoma. Usual granular cell ameloblastoma is histologically characterized by granular changes of stellate-like cells located in the inner portion of the epithelial follicles. Here we report a case of another type of granular cell ameloblastoma, showing predominant anastomosing double-stranded trabeculae of granular cells. This type of granular cell ameloblastoma is extremely rare, and the World Health Organization classification does not contain the entity. We tentatively termed it \u27anastomosing granular cell ameloblastoma\u27 in this report. The present case suggests the importance of differential diagnosis because the histology of \u27anastomosing granular cell ameloblastoma\u27 resembles that of salivary gland oncocytoma rather than that of usual granular cell ameloblastoma. The trabeculae observed in our case continued to the peripheral cells of a small amount of epithelial sheets of plexiform ameloblastoma, and the tumor cells were positive for CK19, which is regarded as an immunohistochemical marker of odontogenic epithelium. Similar to usual granular cell ameloblastoma, the tumor cells had CD68-positive granules. For precise diagnosis of this condition, immunohistochemistry using CK19 and CD68, as well as detailed histological observation, are recommended

Comparative Study of Tzanakis Score in effective diagnosis of acute appendicitis

Background:Appendicitis is a common surgical problem. The diagnosis of appendicitis at right point helps in early treatment of the disease. A number of scoring systems have developed in order to diagnose the appendicitis. This study was mainly undertaken to study the efficacy of Tzanakis score in diagnosing Acute appendicitis.Material and Methods:An observational study was undertaken in a tertiary care setting. A total of 30 cases of acute appendicitis constituted the sample size. All the patients were subjected for detailed clinical history and clinical examination, laboratory work up along with Tzanakis scoring and Alvarado scoring. The operative decision was made by experienced surgeon based on overall clinical judgement. Results:About 53.3% of the study subjects belonged to 21 – 30 years of age group. About 80% of the patients were males. About 46% of the patients presented 6 – 24 hours after onset of symptoms. Pain was the most common symptom of the study group followed by Anorexia, Nausea/ Vomiting and fever. The sensitivity for Alvarado scoring was 90%, specificity was 80%, positive predictive value was 90% and Negative predictive value was 90%. The Tzanaki’s score had shown that, the sensitivity was 95.7%, specificity was 85.7%, positive predictive value was 95.7% and negative predictive value was 85.7%.Conclusion:TheTzanakis scoring was a good tool in diagnosis of acute appendicitis

Pigmented intramucosal nevus of gingiva with a special insight on its pathophysiology: Report of a rare entity

Oral melanotic nevi can be characterized as developmental malformations or melanocytic tumors. Nevi are benign in nature originating from proliferating malfunctioning melanoblasts of the neural crest cells either in the epithelium or in connective tissue. It is an infrequent oral lesion triggering focal pigmentation. Considerable debate exists in the literature with respect to their origin, development, maturation, and their association to oral melanocytes. Nevi present in the mucous membrane have been documented to ensure the risk of malignant transformation. Hence, it is appropriate to cautiously diagnose all pigmented lesions of the oral cavity. Here, we report a case of intramucosal nevus with unusually large size in maxillary anterior gingival mucosa

Nevoid basal cell carcinoma syndrome: A case report

Nevoid basal cell carcinoma syndrome (NBCCS) is an autosomal dominant inherited condition that exhibits high penetrance and variable expressivity. The syndrome is caused by mutations in patch (PTCH), a tumor suppressor gene that has been mapped to chromosome 9q22.3-q31. NBCCS is characterized by basal cell carcinomas (BCCs), odontogenic keratocysts of the jaws, pits of the palms and soles, ectopic calcification particularly of the falx cerebri, and skeletal anomalies. Other features, including ovarian fibromas, medulloblastoma, ocular anomalies, and neurological defects, are also associated with this syndrome. It arises in all races with equal sexual predilection. It is a rare syndrome and incidence rate is 5%. In this report, we present a case of NBCCS in a 30-year-old male patient

Granular cell type of ameloblastoma

Ameloblastoma is a locally invasive tumor derived from odontogenic epithelium. An uncommon variant of ameloblastoma is granular cell type, which cannot distinguish from other ameloblastoma subtypes by clinical and radiographic findings alone. Only review of it's microscopic features allows distinction from other subtypes. The purpose of this article is to present a case of granular cell ameloblastoma. This subtype should be distinguished from the other histopathologic subtypes because of it's higher recurrence rate and more aggressive biological behavior. Radiographic and histologic findings as well as treatment are also discussed. © 2018 Dental Research Journal | Published by Wolters Kluwer - Medknow