Lecture 7 Giant cell lesions .

Peripheral giant cell granuloma. Nodular reddish-purple mass of the maxillary gingiva.

Peripheral giant cell granuloma. ulcerated mass of the mandibular gingiva.

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Pyogenic granuloma. Erythematous, hemorrhagic mass arising from the maxillary anterior gingiva.

Pyogenic granul oma. Ulcerated and lobulated mass on the dorsum of the tongue.

Peripheral giant cell granu loma. low-power view showing a nodular proliferation of multinucleated giant cells within the gingiva.

Periph eral giant cell granuloma . High-powerview showing scattered multinucleated giant cellswithin a hemorrhagicbackground of ovoid and spindle-shaped mesenchymal cells.

Central giant cell granuloma. A, A bluish-purple mass is present on the anterior alveolar ridge of this 4-year-old white boy. B, The occlusal radiograph shows a radiolucent lesion with cort ical expansion.

Central giant cell granuloma. A, A bluish-purple mass is present on the anterior alveolar ridge ofthis 4-year-old white boy. B, The occlusal radiograph shows a radiolucent lesion with cortical expansion.

Central giant cell granuloma. Panoramic radio graph showing a large,expansile radiolucent lesion in the anterior mandible.

Central giant cell granuloma.

Central giant cell granuloma. Numerous multinucleated giant cells within a background of plump proliferating mesenchymal cells. Note extensive red blood cell extravasation.

Giant cell tumor. This photomicrograph shows large giant cells that are distributed in a cellular mesenchymal tissue. This specimen was from an aggressive lesion that had destroyed most of the maxilla.

Cherubism

Cherubism. A, Panoramic radiograph of a 7-year-old white male. Bilateral multilocularradiolucencies can be seen in the posterior mandible. B, Same patient 6 years later. The lesionsi n the mandibular rami demonstrate significant resolution, but areas of involvement are still presentin the body of the mandible.

Cherubism. Photomicrograph showing scattered giant cells within abackground of cellular, hemorrhagic mesenchymal tissue. The inset demonstrates perivascular eosinophilic cuffing.

Aneurysmal bone cyst . A large multilocular radiolucent lesion involves most ofthe ascending ramus in a 5-yearold white boy.

Simple bone cyst. Panoramic film showing a large multilocular simple bone cyst of the mandible in a 16-year-old white male.

Simple bone cyst. Panoramic film showing a large simple bone cyst of the mandible in a 12-year-old girl. The scalloping superior aspect of the cyst between the roots of the teeth is highly suggestive of, but not diagnostic for, a simple bone cyst.

Simple bone cyst. Periapical radiograph showing a radiolucent area in the apical region of the anterior mandible. The incisor teeth responded normally to vitality testing, and no restorationsare present.

Aneurysmal bone cyst. Photomicrograph showing a blood-filled space surrounded by fibroblastic connective tissue. Scattered multinucleated giant cells are seen adjacent to the vascular space.

Simple bone cyst. Photomicrograph of the bony wall of a simple bone cyst. A thin. vascular connective tissue membrane is adjacent to the bone and no epithelial lining is identified.

Hyperparathyroidism. Thisperiapical radiograph reveals the "ground glass" appearance of the trabeculae and loss of lamina dura in a patient with secondary hyperparathyroidism.

Hyperparathyroidism. This occlusal radiograph of the edentulous maxillary anteriorregion shows a multilocular radiolucency characteristic of a brown tumor of primary hyperparathyroidism.

Hyperparathyroidism. Palatal enlargement is characteristic of the renal osteodystrophy associated with secondary hyperparathyroidism.

Hyperparathyroidism. This high-power photomicrograph of a brown tumor of hyperparathyroidism shows scattered multinucleated giant cells within a vascular and proliferative fibroblastic background.

Hyperparathyroidism. This low-power photomicrograph shows delicate, interconnecting trabeculae of woven bone within a background of cellular fibrous connective tissue.