Incisional and excisional biopsy

Histologic evaluation revealed multiple small and decalcified pieces of hard and soft tissue made up of a combined benign odontogenic tumor and a pigmented odontogenic cyst (Figure 3).  The cystic portion of this lesion is made up of lining epithelium of odontogenic origin containing clusters of epithelial ghost cells, melanin pigment and calcified material (Figure 4).  Most of the latter is calcified ghost cells.  Iron stain is negative for hemosiderin.  The tumor is of mixed origin made up of primitive connective tissue with epithelial islands and areas of haylinized connective tissue and dysplastic dentin and cementum (Figure 5). 

Figure 3. Low power (x100) histology shows a combined cyst and benign odontogenic tumor.  The latter is of mixed epithelial and mesenchymal origin.


Figure 4. High power (x200) histology of the cystic structure shows odontogenic epithelial lining, ghost cells, connective tissue wall and melanin pigment.


Figure 5. High power (x200) histology of the odontogenic tumor made up of primitive connective tissue stroma, epithelial islands and cords and dysplastic odontogenic hard tissue.