Radicular cyst with unique presentation of hyaline bodies – Case report and review of literature

Hyaline bodies or Rushton bodies are peculiar eosinophilic, linear, curved, lamellated, glassy structures, sometimes with a granular center. They appear to be restricted to small areas of the epithelium rather than being present throughout. There is no consistent difference between different types of odontogenic cysts but are predominantly reported in radicular and dentigerous cysts. Radicular cysts are the most common inflammatory cysts found at the apices of the involved teeth and these bodies are found in approximately 10% of radicular cysts. Numerous pathogenic mechanisms regarding their origin, structure, and composition have been proposed, of which two endogenous theories gained importance, which are epithelial and hematogenous origins. Recently, β-pleated conversion of keratins as well as hemoglobin has been proposed. Majority of the hyaline bodies appear to be localized in the cystic lining, but few reports have demonstrated these bodies in the connective tissue wall, and others reported them to be straddled within basement membrane. We present a case of radicular cyst with extensive aggregation of these structures within the cystic lumen and occupying two-thirds of the thickness of cystic epithelium in a 42-year-old male patient with a review of these enigmatic structures.