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Rushton Bodies — MFDS Part 1 MCQ

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HardOral PathologyRushton BodiesMFDS Part 1

A 46-year-old patient has a well-circumscribed periapical radiolucency associated with a maxillary lateral incisor that does not respond to pulp sensibility testing. Histological examination shows a non-keratinised stratified squamous epithelial lining, chronic inflammation, cholesterol clefts and curved or hairpin-shaped eosinophilic hyaline structures within the epithelium. Which cyst is the most likely diagnosis?

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Correct answer: E — Radicular cyst

The diagnosis is a radicular cyst. Its periapical relationship to a non-vital tooth and its inflamed, non-keratinised stratified squamous lining are decisive. The curved or hairpin-shaped eosinophilic structures are Rushton bodies. Although classically associated with radicular cysts, they are not exclusive to them and may occur in dentigerous cysts or odontogenic keratocysts; they must therefore be interpreted with the clinical and other histological findings. An odontogenic keratocyst ordinarily has a parakeratinised corrugated lining, while a dentigerous cyst is attached to the crown of an unerupted tooth. A nasopalatine duct cyst is centred in the incisive canal, and a lateral periodontal cyst usually occurs beside a vital mandibular canine or premolar.

Reference: Virkkunen S et al. Ex vivo detection of lipopolysaccharide immunopositivity in Rushton bodies. Histology and Histopathology. 2023;38(8):889-892. https://pubmed.ncbi.nlm.nih.gov/36880590/