Ameloblastoma diagnosis by fine‐needle aspiration cytology supplemented by cell block samples

Abstract

Ameloblastomas are rarely encountered in clinical practice, accounting for only 1% of tumors and cysts of the jaw although they are one of the most common odontogenic neoplasms. The cytological features are described in a few case reports only. The aim of this study was to describe the morphological features of ameloblastoma in fine‐needle aspiration cytology (FNAC) and highlight the contribution of cell blocks in their diagnosis. Three cases of ameloblastoma diagnosed on FNAC (FNAC) with cell block samples were retrieved and evaluated in detail. Radiological correlation was performed in three cases. Follow‐up histopathology of the resected specimen was available in two cases. Cytology smears showed clusters of basaloid cells with high nucleocytoplasmic(N/C) ratio and dense chromatin. Focal squamoid differentiation was present in one case and cystic change predominated in one case. The characteristic morphology of the tumor was better appreciated on cell block section with cribriform and trabecular arrangement of tumor cells with peripheral nuclear palisading with foci of squamoid differentiation and cystic change. Cell blocks from aspirates act as mini‐biopsies and contribute to accurate diagnoses of ameloblastomas of the mandible, thereby emphasizing their contribution to the proper management of these uncommon neoplasms.

Ameloblastoma with adenoid features: Case report with cyto‐histopathologic correlation and molecular findings

“…Only a handful of case reports and series have been published describing the cytologic features of ameloblastomas. [10][11][12][13][14] The ameloblastic (parenchymal) component predominates in smears, and demonstrates irregular, crowded groups of basaloid cells with scant-to-moderate amounts of cytoplasm. 10 Peripheral palisading may be seen.…”

“…10 Peripheral palisading may be seen. 11 The cytoplasmic edges are indistinct, and the nuclei are oval to round, with fine chromatin and indistinct nucleoli. Nuclear molding may be seen.…”

“…The ameloblastic (parenchymal) component predominates in smears, and demonstrates irregular, crowded groups of basaloid cells with scant‐to‐moderate amounts of cytoplasm 10 . Peripheral palisading may be seen 11 . The cytoplasmic edges are indistinct, and the nuclei are oval to round, with fine chromatin and indistinct nucleoli.…”

Fine needle aspiration cytology for two cases of ameloblastoma—Key highlights and diagnostic features

“…The material aspirated represents cellular and stromal elements of the lesion—including degeneration, myxoid change, or hyalinisation, thus enabling comprehensive evaluation for an accurate diagnosis. However, in case of ameloblastoma, the intrabony localisation makes the use of aspiration cytology challenging 1–3 . In this regard, wide‐bore needles help obtain representative content from these lesions.…”

“…Granular, acanthomatous, and other cellular changes in ameloblastomas have also been documented using FNAC 5,6 . FNAC features that help rule out the diagnosis of ameloblastoma include the presence of cholesterol crystals, keratin, and a background rich in inflammatory cells 2,3 …”