KNOW THIS FIELD
|Year : 2009 | Volume
| Issue : 2 | Page : 61
Know this field
N Lavanya, Elizabeth Joshua, KM Umadevi, K Ranganathan
Department of Oral and Maxillofacial Pathology, Ragas Dental College and Hospital, Chennai, India
|Date of Web Publication||10-Nov-2009|
Department of Oral and Maxillofacial Pathology, Ragas Dental College and Hospital, Chennai
Source of Support: None, Conflict of Interest: None
|How to cite this article:|
Lavanya N, Joshua E, Umadevi K M, Ranganathan K. Know this field. J Oral Maxillofac Pathol 2009;13:61
| Case Details|| |
Site - Intraorally left retromolar region
- 35 year old female
- Pain and swelling in left lower face past twenty days.
- H/o swelling after extraction of left lower back tooth one month back
- Swelling subsides on taking antibiotics and re-occurs
- Swelling is warm, very tender, diffuse, cystic in nature, soft in consistency over the left angle of mandible
- Intra orally 38 missing. A localised swelling, tender in retromolar region behind 38
- Provisional diagnosis:
- Submassetric space infection
- Excisional biopsy
| Histopathology|| |
Nodule of fibrovascular connective tissue exhibiting
- Necrotic areas, Foci of mixed inflammatory cell infiltrate, nerve bundles [Figure 1] adipose tissue and clusters of squamous like epithelial cells areas depicted in the adjacent six photomicrographs.
- All these cliusters of squamous like epithelial cells interspersed with clear cells were adjacent to bundles of nerve tissue [Figure 2],[Figure 3],[Figure 4],[Figure 5],[Figure 6]
| Differential Diagnosis|| |
01) Malignant squamous epithelial islands - Squamous cell carcinoma 2) Mucoepidermoid carcinoma 3) Adenocarcinoma 4) Metastatic deposits 5) Perineural invasion by carcinoma 6. Odontogenic tumours (Squamous Odontogenic Tumour, Adenomatoid odontogenic tumour, Ameloblastoma) 7) Normal findings like Odontogenic rests in the tissue or Organ of Chevitz.
| Diagnosis|| |
Chronic granulation tissue (associated with space infection) with Juxta Oral Organ Of Chevitz in the tissue
| Juxta Oral Organ of Chevitz|| |
These are a cluster of squamous epithelial cells, some times interspersed with clear cells and duct like appearance found microscopially in the tissue taken from the site where inferior alveolar nerve block is given i.e. medial to mandibular internal oblique ridge and pterygomandibular raphe. These are closely associated with myelinated nerve bundles and are suggested to be neuroepithelial structures with a neuroendocrine function.
| Points to Remember|| |
- Site of biopsy.
- Characteristic histopathological appearance, PAS positive intact basement membrane
- Clinical presentation of the lesion.
| References|| |
- Juxtaoral Organ(Chevitz Organ): Morphology and Clinical aspects. Baltimore, Urban and Schwarzberg, 1982 (Monograph)
- The juxtaoral organ of Chievitz . Int J Surg Pathol. 2003 Jan; 11(1):37.
[Figure 1], [Figure 2], [Figure 3], [Figure 4], [Figure 5], [Figure 6]