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Atypical lymphocytes and cellular cannibalism in chronic periapical lesions: A first insight with possible implications
Abhishek Singh Nayyar1, Ketki P. Kalele2, Kaustubh P. Patil3
1Reader cum PG Guide, Department of Oral Medicine and Radiology, Saraswati-Dhanwantari Dental College& Hospital& Post-Graduate Research Institute, Parbhani, Maharashtra, India.
2Senior Academician, Department of Oral and Maxillofacial Pathology and Microbiology, V.Y.W.S Dental College & Hospital, Amravati, Maharashtra, India.
3Department of Periodontics and Oral Implantology, Dr. D.Y. Patil Dental College & Hospital, Pune, Maharashtra, India.

Article ID: 100005P03AN2016
doi:10.5348/P03-2016-5-OA-1

Address correspondence to:
Dr. Abhishek Singh Nayyar
H.No.44, Behind Singla Nursing Home, New Friends' Colony, Model Town
Panipat-132 103
Haryana
India

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How to cite this article
Nayyar AS, Kalele KP, Patil KP. Atypical lymphocytes and cellular cannibalism in chronic periapical lesions: A first insight with possible implications. Edorium J Pathol 2016;3:1–6.


Abstract
Aims: Atypical lymphocyte refers to an unusual structure of lymphocytes that are a part of the cell mediated immune system of the body. Also referred to as reactive lymphocytes, atypical lymphocytes have larger than normal size, attributed to antigen stimulation. Cellular Cannibalism is defined as a large cell enclosing a slightly smaller one within its cytoplasm. Previously, this feature was noted only in cases of malignant tumors. The objectives of this study were to determine the proportion of atypical lymphocytes in chronic periapical lesions; to determine the proportionate cellular cannibalism in these lesions; and to correlate the proportion of the atypical cells and cannibalistic cells with the clinical behavior of the lesions.
Methods and Material: Hematoxylin and eosin stained 30 slides of chronic periapical granulomas and 20 slides of cysts reported in the year 2014–15 and the clinical proformas of the patients were retrieved. These slides were evaluated by three experts to determine the presence of atypical lymphocytes and cellular cannibalism under high power magnification (400X).
Results: Out of the 30 slides of chronic periapical granulomas, about 12 slides (40%) revealed presence of atypical lymphocytes. Four out of the 20 slides (20%) of chronic periapical cysts examined histopathologically showed presence of atypical lymphocytes. Cannibalistic cells were present in 12 out of the 30 slides of chronic periapical granulomas (40%). None of the cysts, however, revealed cannibalistic cells (0%).
Conclusion: In the present study, an observation on the unique cellular composition in histopathological sections of chronic periapical lesions has been highlighted. The question arises that whether presence of such atypical cells in these lesions denotes an aggressive clinical behavior as seen in malignant tumors and should be given a due consideration in deciding the treatment protocols in such patients.

Keywords: Atypical lymphocytes, Cellular cannibalism, Chronic periapical lesions


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Author Contributions:
Abhishek Singh Nayyar – Substantial contributions to conception and design, Acquisition of data, Analysis and interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
Ketki P. Kalele – Analysis and interpretation of data, Revising it critically for important intellectual content, Final approval of the version to be published
Kaustubh P. Patil – Analysis and interpretation of data, Revising it critically for important intellectual content, Final approval of the version to be published
Guarantor of submission
The corresponding author is the guarantor of submission.
Source of support
None
Conflict of interest
Authors declare no conflict of interest.
Copyright
© 2016 Abhishek Singh Nayyar et al. This article is distributed under the terms of Creative Commons Attribution License which permits unrestricted use, distribution and reproduction in any medium provided the original author(s) and original publisher are properly credited. Please see the copyright policy on the journal website for more information.