Ameloblastoma. Light and electron microscopic study.

Light and electron microscopic studies of ameloblastoma were reviewed. The 21 cases of ameloblastoma examined were classified into 12 cases of the plexiform type and nine of the follicular type. The average age of the patients with the plexiform type was 25.3 years, while that of those with the follicular type was 54.4 years. Histologically, in the follicular type, the tumor cells consisted of two cell types, central polyhedral and star-shaped cells resembling the stellate reticulum and peripheral cuboidal and columnar cells similar to the inner enamel epithelium. The resemblance between the tumor follicle and enamel organ was confirmed electron microscopically. In the plexiform type, however the tumor cells did not show two cell types, but resembled squamous epithelium. Electron microscopically, all cells of the tumor strands had relatively numerous bundles of tonofilaments and were joined together by desmosomes. Differentiation of tumor cells to squamous epithelium less evident than in normal surface epithelium. We speculate that these histological differences between plexiform and follicular types represent the differentiation tendency of the remnant of the dental lamina at the time of neoplastic transformation. What decides the histological pattern is unknown but age may be a factor. Central epidermization with keratinization or microcytic changes was frequently seen in the follicular type. Keratinization and microcystic changes rarely occurred in the plexiform type. We do not believe that these changes are a form of involution or result from multipotentiality of the tumor cells.