1 Non-odontogenic Cysts Dr. Ioannis G. Koutlas Division of Oral Pathology All pictures are intellectu al property o f the Division o f Oral and Maxillofacia l Pathology or its Faculty. Duplicatio n or any unauthorized use is prohibited. Developmental Cysts • a.k. a. fi ssur al cysts • Exact pa thogene sis of some of them uncert ain • Generally, sl ow increase • May be i dentif ied incident ally Palatal and gingival cysts of newborns • Common (more than ha lf of neonate s) • Small, occasionally in clusters • Embr yog enesi s – Entrapped epithe lium during formation of 2 º palate – Epithelial remnants of salivary g lands • Epst ein pearl s: mid line • Bohn’s nodule s: ha rd/soft palate • Gingiva l cy sts: keratin filled • No tr eatment , spo ntaneou s rupt ure Nasopalatine duct cyst • a.k. a. inci sive canal cys t, naso pala tal cyst • Most common non-odon togeni c cyst • Embr yog enesis – Remnants of nasopalatine duct – Incisive canals exit via a common fo ramen – Rarely two foramina = can als of Scarpa
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• Review thyroid develoment• Remnants of the thyroglossal duct epithelium
• Have been described in families
• Midline (foramen cecumsuprasternal notch)
– Except if they are located in the area of thyroid cartilage
• More frequently below the hyoid
• ! Base of tongueairway obstruction
• Clue: If it maintains attachment to hyoid bone ortongue it will move vertically during swallowing orprotrusion of the tongue; can cause fistulous tract
• Thyroid tissue may be absent histologically
Branchial cleft cyst
• a.k.a. cervical lymphoepithelial cyst
• From branchial clefts (2nd arch), or cystic change of parotid
gland epithelium entrapped in upper cervical lymph nodes
(not valid)
• Lateral upper neck along the anterior border of the
sternocleidomastoid muscle
• Young adults, fluctuant, between 1-10 cm, more frequently
on the left
• Occasionally a fistula
• Contain lymphoid tissue (occasionally not though)
• Rare examples of malignant transformation
Oral lymphoepithelial cyst• Invaginations of epithelium resulting in pouches or
crypts that may fill with keratin debris
• Salivary gland or surface epithelium that becomes