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Case Reports
. 2012 Sep-Oct;32(5):537-40.
doi: 10.5144/0256-4947.2012.30.5.1342.

Granular cell ameloblastoma showing desmoplasia

Suchitra Gupta  1 , Harshaminder Grewal, Kunal Sah
Affiliations
Case Reports

Granular cell ameloblastoma showing desmoplasia

Suchitra Gupta et al. Ann Saudi Med. 2012 Sep-Oct.

Abstract

Our case of ameloblastoma had a surprisingly long 25 year history, with abnormally large dimensions, a multilocular diffuse-mixed radiographic picture, and was histopathologically diagnosed as granular cell ameloblastoma with desmoplasia. To the best of our knowledge, this is the first ameloblastoma ever reported, that has shown combined features of granular cells, desmoplasia, ameloblastic follicles, plexiform, and acanthomatous patterns. The nature of granular cells in this type of tumor and the significance of their presence have also been reviewed. From the studies on ameloblastomas to date, it seems that the old belief that granular cell ameloblastoma is the most aggressive variant of ameloblastoma is a myth, and in all probability, granular cells are just a transitional or matured phase in the life cycle of ameloblastomas, starting with normal stellate reticulum-like cells, leading to a production of granules and finally leading to degeneration and formation of cystic areas.

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Figures

Figure 1
Figure 1
Extra-oral front view of a single, large, multilobulated swelling of the mandible, extending from the right parasymphysis to the left angle region.
Figure 2
Figure 2
Orthopantomograph showing a mixed radiolucentradiopaque multilocular lesion, extending from the right parasymphysis to the left angle region of the mandible, with welldefined, sclerotic, scalloped borders. Also notice displacement of teeth 31 and 32 and root resorption of 41, 32, 37 and 38.
Figure 3
Figure 3
Photomicrograph showing ameloblastic epithelium arranged in interconnecting strands or follicles, some of them showing cystic degeneration, squamous metaplasia and keratin formation (HE stain, 20×).
Figure 4
Figure 4
Photomicrograph showing granular cells filled with coarse eosinophilic granules, eccentric nucleus and an inconspicuous cytoplasmic membrane, so that the adjacent cells seem to be merging with each other (HE stain, 20×).
Figure 5
Figure 5
Photomicrograph showing granular cell changes in the stellate reticulum-like cells of the ameloblastic follicles and compressed odontogenic strands and cords in a dense fibrous stroma (HE stain, 4×)
See this image and copyright information in PMC

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