Treatment

Under local anesthesia, this small nodule was completely surgically removed.  The area healed without any complications.

Incisional Biopsy

Histologic examination of the H & E section revealed a small piece of soft tissue covered by keratinized epithelium and supported by dense connective tissue containing a neoplasm of odontogenic origin (Figure 2).  This neoplasm occupied the bulk of the specimen and was made up of epithelial islands of variable shapes and sizes (Figure 3).  These islands were lined by one layer of palisaded and polarized columnar and cuboidal epithelial cells (Figure 4).  The center of the islands were filled with stellate-reticulum type epithelial cells and squamoid epithelial cells.  Focal areas of cystic degeneration were also present in one or two of the neoplastic islands.

Figure 2 Low power (x40) H & E histology shows gingival covered by surface epithelium and connective tissue containing a neoplasm of odontogenic epithelial origin. This neoplasm is made up of epithelial islands of variable shapes and sizes.

 

Figure 3 Higher power (x100) H & E histology taking a closer look at the epithelial islands with palisaded columnar/basaloid epithelial cells at the periphery and stellate reticulum type epithelium in the center of some of the islands and squamoid epithelium in other islands.

 

Figure 4 High power (x200) higher power H & E histology taking an even closer magnification of the epithelial islands with palisaded columnar/basaloid epithelial cells at the periphery and stellate reticulum type epithelium in the center.