As the lesion progress , the calcifications increases and that gives the appearance of driven snow to the lesion ( old lesions appear radio-opaque not radiolucent as the new lesions ).
Associated with impacted teeth
So the presence of a radio-opacity will exclude the ameloblastoma and the keratocyst from the diagnosis
Unlike the ameloblastoma , this tumor is formed by sheets of large polyhedral epithelial Cells abundant eosinophilic cytoplasm.
Prominent intercellular bridges ( connections between the cells)
It contains features that could be misleading ( looks like a malignancy ) :
(Pleomorphism, multinucleation, hyperchromatism )of the nuclei
Inside the lesion we could find amorphous amyloid-like material deposited from epithelial cells , the presence of the amyloid can be confirmed by the histopathologist by using the" congo red stain" , this lesion is +ve for this stain so this test is a good diagnostic tool for this tumor .
The amayloid-like material can be calcified forming Spherical calcifications( by time the no. of calcifications inside the lesion increases )
Adenomatoid odontogenic tumour
Start at the 2nd decade of life ( young patients mainly children )
On radiograph it may be misdiagnosed as a dentigerous cyst as in this age many teeth could still be impacted ( like the canines )
The difference between this tumour and the dentigerous cyst, is that its extended below the CEJ surrounding the crown and part of the root .
loose cellular fibromyxoid connective tissue ( looks like the dental papilla or the immature pulp tissue )
The stellate reticulum is less abundant unlike the ameloblastoma( which has stellate reticulum in the center and its epithelium is surrounded by fibrous tissue) where as in this lesion the epithelium is surrounded by cellular tissue.
Peripheral layer of cuboidal or columnar Cells enclosing Stellate Reticulum which is like what's found in the ameloblastoma
This tumor is different than the ameloblasoma in ( the prognosis , the surrounding tissue , the abundance of stellate reticulum )
As Ameloblastic fibroma contains dental pulp like structures + ameloblasts , formation of dentin like material could happen so its then called Ameloblastic Fibrodentinoma.
Sometimes , the process continues to form enamel , dentin and cementum so odontome complex forms , so its called ameloblastic fibro-odontoma
Prognosis : all types of this tumor are not aggressive , the local recurrence rate is low , and it's not an invasive tumor.
Can be compared with the previously mentioned ameloblastic fibro-odontoma .
This tumor is basically like an ameloblastoma which contain an odontoma
Its behavior is like the ameloblastoma (invasive and has high local recurrence rate ) so its more dangerous than the ameloblastic fibro-odontoma .
Calcifying cystic odontogenic tumour/cyst
The Solid form of it: Dentinogenic Ghost cell tumour