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Actions	Mandible showing Chloroma Remove from selection Add to selection Object numberGC.10751 TitleMandible showing Chloroma Creator David Eric Cameron (1902-1989) Mekie DescriptionChloroma - mandible. From a male Teochew aged fourteen years. A swelling of the jaw first appeared three months previously and was associated with “toothache”. He was treated in the Dental department of the General Hospital, Singapore and there a biopsy was carried out. The pathological report was a “reticulum cell sarcoma” and for this radiotherapy was advised. The boy, however, did not report for treatment for a further period of three months, by which time the swelling had, increased in size and the radiological picture had altered from being that of a purely osteolytic tumour to that more suggestive of an osteogenic sarcoma. In view of this finding, because of the equivocal character of the pathological report and in order to eliminate the discomfort locally caused by the tumour, a hemisection of the mandible was performed. When the examination of the specimen revealed the true diagnosis further investigations were carried out. Preparative routine blood examinations had been essentially within normal limits and intensive further examinations both of the peripheral blood, and by sternal puncture, failed to establish the presence of a leukaemia. On one occasion only, was a single abnormal cell — apparently a myoloblast - observed. Subsequent to operation, secondary lesions were demonstrated in the skull and spine. He died one year later from paraplegia and ascending urinary infection. The specimen consists of the left half of the mandible which hag been sectioned at the raid-line and. at the base of the condylar process. This portion of the bone is surrounded eccentrically by tumour growth which extended almost from the one line of section to the other. The major portion of the tumour lies below and lateral to the mandible forming a globular or ovoid mass with a regular almost smooth wall. The tumour has a false capsule of condensed fibrous tissue to which muscle fibres remain adherent. On the medial aspect of the specimen the lateral incisor, the canine and the first premolar teeth are visible. Behind the premolar lies an area of ulcerating buccal mucosa (the site of the original biopsy). The removal of a large wedge of tissue on the superior and lateral surface of the tumour reveals the internal structure of the growth, When first sectioned this surface was a bright grassy green colour but this colour faded rapidly. It has been restored with hydrosulphite. Immediately below the capsule there would appear to be a “cortical” gone of homogeneous tissue deep to which the tumour is of somewhat lighter colour and broken up into lobules by radiating striations in which minute blood vessels are observed. Here and there haemorrhages have occurred into the substance of the tumour. Microscopical examination. The tissue consists of highly cellular tumour covered by .a variable mixture of fibrous tissue, skeletal muscle and squamous mucous membrane. The neoplastic cells are of various types. One variety is fairly large and round and made up of moderately abundant, feebly acidophile cytoplasm and a relatively large, finely granular nucleus. Another type is distinctly smaller than the foregoing. It is round, oval or polyhedral and grades up to about three times as large as the smallest examples of the group. Its characteristically eccentric nucleus is usually rather densely stained and pyknotic, but shows a cart-wheel structure in the better preserved regions superficially. The nuclei are occasionally double, one nucleus being then sometimes distinctly larger than the other. The cytoplasm is basophile and, not infrequently characterised by a perinuclear zone of pallor. Other varieties are structurally intermediate between the foregoing. The large and. small types are regarded as reticulo-endothelial and. plasma cells respectively, while the others are interpretable as immature plasma forms. Some parts of the tumour consist wholly of undifferentiated reticulo-endothelial or mature plasma-cells whereas others are made up of a mixture of cells ranging in maturity between those extremes. Mitotic figures are fairly numerous, especially among the reticulo-endothelial cells, while the framework is scanty and vascular. The growth has invaded the fibrous end muscular parts of the specimen and spread up to the deep margin of the rete malpighii of the mucosa. The findings indicate a plasmacytoma with local reticuloendothelial features. Specimen and Histological Glass Slides x4 Production date 1954 Production periodTwentieth century, mid Object nameBONE, mandible Object categoryAnatomical, specimen, HISTOLOGY Dimensions Slide Length: 7 cm Slide Width: 2.5 cm

Object numberGC.10751

TitleMandible showing Chloroma

Creator David Eric Cameron (1902-1989) Mekie

DescriptionChloroma - mandible. From a male Teochew aged fourteen years. A swelling of the jaw first appeared three months previously and was associated with “toothache”. He was treated in the Dental department of the General Hospital, Singapore and there a biopsy was carried out. The pathological report was a “reticulum cell sarcoma” and for this radiotherapy was advised. The boy, however, did not report for treatment for a further period of three months, by which time the swelling had, increased in size and the radiological picture had altered from being that of a purely osteolytic tumour to that more suggestive of an osteogenic sarcoma. In view of this finding, because of the equivocal character of the pathological report and in order to eliminate the discomfort locally caused by the tumour, a hemisection of the mandible was performed. When the examination of the specimen revealed the true diagnosis further investigations were carried out. Preparative routine blood examinations had been essentially within normal limits and intensive further examinations both of the peripheral blood, and by sternal puncture, failed to establish the presence of a leukaemia. On one occasion only, was a single abnormal cell — apparently a myoloblast - observed. Subsequent to operation, secondary lesions were demonstrated in the skull and spine. He died one year later from paraplegia and ascending urinary infection. The specimen consists of the left half of the mandible which hag been sectioned at the raid-line and. at the base of the condylar process. This portion of the bone is surrounded eccentrically by tumour growth which extended almost from the one line of section to the other. The major portion of the tumour lies below and lateral to the mandible forming a globular or ovoid mass with a regular almost smooth wall. The tumour has a false capsule of condensed fibrous tissue to which muscle fibres remain adherent. On the medial aspect of the specimen the lateral incisor, the canine and the first premolar teeth are visible. Behind the premolar lies an area of ulcerating buccal mucosa (the site of the original biopsy). The removal of a large wedge of tissue on the superior and lateral surface of the tumour reveals the internal structure of the growth, When first sectioned this surface was a bright grassy green colour but this colour faded rapidly. It has been restored with hydrosulphite. Immediately below the capsule there would appear to be a “cortical” gone of homogeneous tissue deep to which the tumour is of somewhat lighter colour and broken up into lobules by radiating striations in which minute blood vessels are observed. Here and there haemorrhages have occurred into the substance of the tumour. Microscopical examination. The tissue consists of highly cellular tumour covered by .a variable mixture of fibrous tissue, skeletal muscle and squamous mucous membrane. The neoplastic cells are of various types. One variety is fairly large and round and made up of moderately abundant, feebly acidophile cytoplasm and a relatively large, finely granular nucleus. Another type is distinctly smaller than the foregoing. It is round, oval or polyhedral and grades up to about three times as large as the smallest examples of the group. Its characteristically eccentric nucleus is usually rather densely stained and pyknotic, but shows a cart-wheel structure in the better preserved regions superficially. The nuclei are occasionally double, one nucleus being then sometimes distinctly larger than the other. The cytoplasm is basophile and, not infrequently characterised by a perinuclear zone of pallor. Other varieties are structurally intermediate between the foregoing. The large and. small types are regarded as reticulo-endothelial and. plasma cells respectively, while the others are interpretable as immature plasma forms. Some parts of the tumour consist wholly of undifferentiated reticulo-endothelial or mature plasma-cells whereas others are made up of a mixture of cells ranging in maturity between those extremes. Mitotic figures are fairly numerous, especially among the reticulo-endothelial cells, while the framework is scanty and vascular. The growth has invaded the fibrous end muscular parts of the specimen and spread up to the deep margin of the rete malpighii of the mucosa. The findings indicate a plasmacytoma with local reticuloendothelial features. Specimen and Histological Glass Slides x4

Production date 1954

Production periodTwentieth century, mid

Object nameBONE, mandible

Object categoryAnatomical, specimen, HISTOLOGY

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