case_images: PMC5406800_01
case_images: Clinical photograph shows a diffuse solitary swelling on the left side of the face, involving the angle of mandible
case_images: JOMFP-21-158-g001.jpg
case_images: PMC5406800_01_JOMFP-21-158-g001.jpg
case_images: F1
case_images: A 27-year-old female patient presented with a history of swelling in mandibular left posterior region for 1 year and pain for 1 month [Figure 1].
case_images: (a) Orthopantomograph showing multilocular radiolucency in the mandibular body-ramus area on the left side. (b) Cone beam computed tomography image showing buccal expansion due to the lesion
case_images: JOMFP-21-158-g002.jpg
case_images: PMC5406800_01_JOMFP-21-158-g002.jpg
case_images: F2
case_images: The radiographic examination revealed a multilocular radiolucency involving left mandibular region [Figure 2a and b].
case_images: (a) Photomicrograph demonstrating follicles of ameloblastoma in mature fibrous stroma (H&E, x10). (b) Foreign body and associated granulomas (H&E, x10). (c) Multinucleated giant cells phagocytosing hyaline ring-like foreign particles (H&E, x40). (d) The foreign body demonstrating periodic acid-Schiff positivity (periodic acid-Schiff, x10)
case_images: JOMFP-21-158-g003.jpg
case_images: PMC5406800_01_JOMFP-21-158-g003.jpg
case_images: F3
case_images: Microscopic examination of the excised tissue specimen revealed follicles of ameloblastoma of varying sizes [Figure 3a]. The stroma was mature, collagenous and it demonstrated foreign body granulomas with numerous multinucleated giant cells [Figure 3b and c]. On careful examination, it was evident that these foreign body granulomas were associated with multiple, amorphous, eosinophilic masses enclosed in densely hyalinized eosinophilic matrix/rings [Figure 3b and c]. The hyaline rings were periodic acid-Schiff positive [Figure 3d].
case_images: (a) Foreign body showing peripheral smaller rectangular cells (demonstrated by arrowhead) and arrow pointing larger more angular cells in the center enclosing amorphous eosinophilic material (H&E, x40). (b) Processed pulse showing structure similar to the foreign body (H&E, x40)
case_images: JOMFP-21-158-g004.jpg
case_images: PMC5406800_01_JOMFP-21-158-g004.jpg
case_images: F4
case_images: We observed that a section of a legume [Figure 4b] bore a striking resemblance, to the foreign body we encountered.
case_images: (a and b) Photomicrographs showing the features of irregular foreign body particles in light microscopy and polarizing microscopy, respectively (H&E, x40). (c and d) Foreign body giant cells with ingested material which shows birefringence and hence is evident on polarizing microscopy (H&E, x40)
case_images: JOMFP-21-158-g005.jpg
case_images: PMC5406800_01_JOMFP-21-158-g005.jpg
case_images: F5
case_images: When viewed under polarized light, the hyaline structures exhibited birefringence [Figure 5a and b] and the fragments of material similar to hyaline rings were noted within the giant cells [Figure 5c and d].