2014 Volume 5 Issue 2 Pages 88-92
Cholesterol crystals are a precipitated product of lipid degeneration. These crystals have also been observed in common jawbone lesions of radicular and residual cysts and radicular granulomas, but the pathogenesis and biological significance have yet to be fully clarified. The purpose of this study was to verify the morphological characteristics of cholesterol crystals in radicular cysts, residual cysts, and radicular granulomas under optical and polarization microscopy. Histopathologically, granulation tissues and fibrous tissues formed in these lesions involved various amounts of needle-shaped clefts surrounded by multinucleated giant cells. Accumulation of lipid-laden foamy macrophages was also observed around the clefts in some cases. In addition, cyst fluid aspirated from radicular cysts involved some shimmering, golden crystals. Imprint specimens of the fluid showed some rectangular crystals with notched corners. The crystals also emitted blue and yellow light under polarization microscopy. These findings suggest that the pathogenesis of cholesterol crystals is associated with precipitation of lipids, and accumulation of lipid-laden macrophages and multinucleated giant cells against a background of inflammation and foreign body reactions. Furthermore, since characteristic features of cholesterol crystals could be clarified using optic and polarization microscopy, we recommend microsurgery for useful technique for completely removing the lesions with cholesterol crystals.
