Granuloma vs Cyst Radiographic Limitation — NDEB AFK MCQ
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Correct answer: B — They cannot be reliably differentiated by radiographic appearance alone
Periapical granulomas and periapical (radicular) cysts CANNOT be reliably differentiated by radiographic appearance alone. Both present as well-defined periapical radiolucencies, often with a corticated border in chronic cases. While some older literature suggested that larger lesions (>1.5-2 cm) are more likely cysts, this is unreliable — small cysts and large granulomas exist. Definitive differentiation requires histopathological examination of the excised tissue (looking for an epithelial lining in a cyst). This is why all periapical surgical specimens should be submitted for histopathology.
Reference: White & Pharoah – Oral Radiology, 8th ed., 2019; Neville – Oral and Maxillofacial Pathology, 4th ed., 2016