Granuloma vs Cyst Histology — MFDS Part 1 MCQ
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Correct answer: A — An epithelium-lined pathological cavity
A radicular cyst is defined histologically by a pathological cavity lined by epithelium, usually non-keratinised stratified squamous epithelium. A periapical granuloma consists predominantly of chronically inflamed granulation or fibrous tissue without an epithelium-lined cavity. Importantly, granulomas may contain proliferating epithelial rests or strands, so the mere presence of epithelial cells is not diagnostic of a cyst. A lymphoplasmacytic infiltrate is common to both lesions. Cholesterol clefts and associated multinucleated giant cells may also occur in either longstanding inflammatory lesion and are not independently distinguishing features. Thus, the architecture of an epithelium-lined cavity makes A the single best answer.
Reference: Schulz M, von Arx T, Altermatt HJ, Bosshardt D. Histology of periapical lesions obtained during apical surgery. Journal of Endodontics. 2009;35(5):634-642. https://pubmed.ncbi.nlm.nih.gov/19410074/