A Radiographic Features Of Oral Malignancy

B D F (1) F (3)

Histopathological Key Of Malignant Jaw Lisions C E F (2) F (4)

A, Ill-defined
01 Primary Malignant Tumors
invasive borders
01 Malignant Odontogenic Tumors followed by bone
destruction. C, Tumor invasion along E, Bone destruction
01 Malignant Vascular Tumors
the periodontal ligament around teeth,
02 Malignant Maxillofacial Bone and Cartilage Tumors space (PDLS) causing “floating teeth”
B, Destruction of the irregular thickening. in space. F, Four types of effects on cortical bone and periosteal reaction:
03 Malignant Neural Intraosseous Tumors
cortical boundary
(floor of maxillary (2) laminated "onion-skin“ (3) destruction of cortical
04 Tumors of Haematopoietic and Lymphoid Tissues D, Multifocal lesions located at root apices (1) cortical bone (4) a spiculated or sunray
bone with periosteal
antrum. and in the papilla of a developing tooth destruction without periosteal reaction with “hair-on-end” type of
reaction at the periphery
destroying the crypt cortex and displacing periosteal reaction. destruction of the cortical periosteal reaction.
07 Metastatic Carcinomas bone and the new forming Codman’s
the developing tooth in an occlusal direction. triangles.
periosteal bone.

Early Stage Late Stage

Solitary Multifocal Solitary Multifocal
Unilocular Unilocular Unilocular Unilocular Unilocular Multilocular Teeth Associated No Teeth Association
Teeth Associated No Teeth Association Multilocular No Teeth Association
Teeth Associated No Teeth Association
Radiolucent Mixed

Primary Intraosseous Primary Intraosseous Primary Intraosseous

Carcinoma, NOS Carcinoma, NOS Carcinoma, NOS Leukemia
Primary Odontogenic Sarcomas Chondrosarcoma
Intraosseous
Mucoepidermoid
Intraosseous
Mucoepidermoid
Multiple Myeloma Intraosseous Metastatic Carcinomas Primary Intraosseous Hepatosplenomegaly Multiple Myeloma
Carcinoma Carcinoma Carcinoma, NOS Osteosarcoma Carcinoma, NOS Lymphadenopathy
+ve CKs
Mesenchymal Any one or more of the
Metastatic Primary Intraosseous Chondrosarcoma
Ameloblastic Carcinoma Ameloblastic Carcinoma
Carcinomas Intraosseous Intraosseous following: CRAB,
Mucoepidermoid Carcinoma, NOS
Osteolytic, Mixed or Mucoepidermoid Foci of leukemic Widening of the Clonal bone marrow
Solitary Carcinoma Carcinoma cells (chloromas) PDLS plasma cell ≥10-60%,
Intraosseous Plasmacytoma Osteoblastic: Intraosseous Ewing Sarcoma
Mucoepidermoid +ve CD38 Mucoepidermoid Carcinoma Destruction of bone crypts of Abnormal serum free
Carcinoma
+ve CD138
• Breast • Lung Ameloblastic Charcterized by laminar periosteal
developing teeth. light chain ratio, >1 focal
Premature loss of deciduous
+ve Kappa • Prostate • Thyroid Carcinoma "onion-skin" new bone formation. widening of the
PDLS
“sunray” spicules
or “hair-on-end”
Unheald tooth Floating Teeth Ameloblastic Carcinoma teeth. lesions on MRI (at least
OR Lambda • Kidney Ameloblastic Carcinoma Burkitt’s Lymphoma socket
5mm in size).
+ve Alcian blue Soft tissue mass.
+ve Mucicarmine Low-Grade Osteosarcoma Ghost Cell Angiosarcoma Analysis
Chondrosarcoma Widening of the
of
Odontogenic Carcinoma PDLS +ve CD31
ALL AML
(Atypical blasts) (Anisopoikilocytosis)
Characterized by: +ve FLI 1 Cyto-
+ve CD99 +ve CD34
arcs and whorls of Chondrosarcoma osteoid matrix formation Chondroblastic osteosarcoma
+ve FLI-1
genetics
calcification Clear Cell Destruction of bone crypts
with radiolucent
Odontogenic Carcinoma of developing teeth.
+ve Factor VIII
CLL
centers
-ve HHV-8 CML
Ameloblastic Carcinoma
Premature loss of Chondrosarcoma -ve GLUT-1
(Smudge cells)
Leukemia deciduous teeth.
+ve S100 +ve CK14/CK19 Angiosarcoma Lymphoma
+ve S0X9
+ve EMA Soft tissue mass and Mesenchymal
Lymphoma +ve PAS
nodal involvement. Chondrosarcoma Widening of the PDLS +ve CD38
+ve CD138
Metastatic -ve S100 Kaposi Sarcoma Biphasic malignant tumour (small round +ve Kappa
Carcinomas blue cells and islands of differentiated Spindle Epithelioid OR Lambda
Metastatic hyaline cartilage) Soft tissue mass and nodal
Sclerosing Odontogenic Starry sky pattern
Carcinomas Soft tissue mass. involvement.
Carcinoma +ve LCA
The malignant cells Perineural +ve LCA B cell markers:
+ve CD20 Slit-like spaces +ve SOX9 +ve CD20
form single-file line invasion +ve c-MYC +ve CD31 T cell markers: Metastatic
+ve CD34 HEY1- NCOA2 +ve CD3
Carcinomas
+ve Factor VIII
+ve Podoplanin fusions +ve CD5
+ve HHV8
Malignant Peripheral
+ve CK19 Nerve Sheeth Tumor Epithelioid Metastatic Carcinomas
Presented by: +ve CK5/6
Hemangioendothelioma References:
Safaa Mohammed El-Baz Odontogenic
Carcinosarcoma
Spindle cells
+/-herring bone
Ghost Cell
Odontogenic Carcinoma 1-El-Naggar AK et al (2017) WHO Classification of Head and Neck Tumours.
A s s is t a n t Le c tu re r, B UE pattern
+ve CD31
+ve CD34
+ve FLI1 2-Koenig, Lisa, Tamimi, Dania, Petriko, G. (2018) Diagnostic imaging oral and
P hD C an d i d at e , C airo Un ive r s it y -ve GLUT1 maxillofacial. second ed. Manitoba: Elsevier.
+ve P53 3-White, S. C. and Pharoah, M. J. (2014) Oral Radiology: Principles and Interpretation.
Under Subervision of:
+ve Ki-67
(Both markers are Epithelioid cells
7th ed. Mosby: Elsevier.
4-http://www.pathologyoutlines.com
Dr. Amal Hassan Abdelrahman
positive in both
epithelial and
connective tissue Odontogenic Sarcomas 5-https://librepathology.org
components)
Pro fe s s o r O f Oral Pat h o lo gy, C airo U niversity 6-https://www.medscape.com