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Pindborg Tumour — MFDS Part 1 MCQ

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HardOral PathologyPindborg TumourMFDS Part 1

A 42-year-old patient has a slowly enlarging, mixed radiolucent–radiopaque lesion in the posterior mandible. Biopsy shows sheets and islands of polyhedral epithelial cells with prominent intercellular bridges. There is abundant extracellular eosinophilic material that is Congo-red positive and displays apple-green birefringence under polarised light, together with concentric lamellar calcifications. Which odontogenic tumour is the most likely diagnosis?

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Correct answer: B — Calcifying epithelial odontogenic tumour

The diagnosis is a calcifying epithelial odontogenic tumour (Pindborg tumour). Its defining combination is sheets or islands of polyhedral epithelial cells with intercellular bridges, extracellular amyloid-like material and concentric calcifications known as Liesegang rings. The amyloid-like material is Congo-red positive and demonstrates apple-green birefringence. Ameloblastoma instead typically shows peripheral palisading, reverse nuclear polarity and stellate-reticulum-like cells. Ameloblastic fibroma is biphasic, containing odontogenic epithelium in primitive ectomesenchyme. Adenomatoid odontogenic tumour may contain calcifications but shows duct-like or rosette-like epithelial structures rather than amyloid deposits. Squamous odontogenic tumour consists of islands of mature squamous epithelium and lacks this characteristic amyloid–calcification combination.

Reference: Burman S et al. An Unusual Variant of a Calcifying Epithelial Odontogenic Tumor in the Maxilla: A Case Report. Cureus. 2025;17:e98686. https://pubmed.ncbi.nlm.nih.gov/41510447/