Abstract
Radicular cysts are the most common inflammatory odontogenic cystic lesions. It originates from epithelial residues in periodontal ligaments secondary to inflammation. The pathogenesis involves the activation of epithelial cell rests of Malaseez after physical, chemical or bacterial injury. Microscopically, the cyst is thin with smooth or corrugated inner surface. The most common epithelial lining is stratified squamous; with Rushton's hyaline bodies in 10% of the reported cases. Slow accumulation and deposition of cholesterol during the inflammatory process leads to the formation of "clefts" with acute and chronic inflammatory cells in the proliferating epithelium and connective tissue, respectively. The presence of hemosiderin usually indicates a previous micro-hemorrhage event. While the presence of lipid-laden macrophages or foam cells indicate the presence of cholesterol-removing mechanism from the lesion. We report a rare case of 38-year-old Mediterranean female presented with throbbing right maxillary pain. The diagnosis of radicular cyst was confirmed by the presence of atrophic non-keratinized stratified squamous epithelium. The radicular cyst was associated with hemosiderin, foam cells, subepithelial fibrosis and root canal dystrophic calcification. They represent uncommon synchronous histopathological features.
Highlights
Radicular cysts are the most common inflammatory odontogenic cystic lesions
The diagnosis of radicular cyst was confirmed by the presence of atrophic non-keratinized stratified squamous epithelium
The radicular cyst was associated with hemosiderin, foam cells, subepithelial fibrosis and root canal dystrophic calcification
Summary
Radicular cysts are the most common inflammatory odontogenic cystic lesions. It originates from epithelial residues in periodontal ligaments secondary to inflammation. Cases Journal 2009, 2:9067 http://casesjournal.com/casesjournal/article/view/9067 cysts cause swelling and bony expansion followed by erosion and fluctuation of the overlying soft tissue; this is usually associated with pain and infection with a discharging sinus They appear as round or ovoid radiolucent areas surrounded by a narrow radioopaque margin, extending from the lamina dura of the involved tooth [1,2,3]. While the presence of lipid-laden macrophages or foam cells indicate the presence of cholesterol-removing mechanism from the lesion [7] This mechanism has been described in atherosclerotic patients suffering from ischaemic heart disease [8], but has not been evaluated in radicular cyst lamina propria. We report a rare case of radicular cyst associated with hemosiderin, foam cells, subepithelial fibrosis and root canal dystrophic calcification. Pigmentation (Figure 5) were identified in the chorium of the radicular cyst
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