Pathology · single question
Aspiration of a jaw lesion yields a thick, milky-white, cheesy material. What is the MOST likely diagnosis?
Show answer and explanation
Correct answer: A. Odontogenic keratocyst
- A. Correct. The thick, creamy, cheese-like aspirate is KERATIN, and it is essentially diagnostic of an ODONTOGENIC KERATOCYST. The aspirate has a soluble protein content below 4 g/dL, which is the classic laboratory discriminator. OKCs are aggressive, have a high recurrence rate because of daughter cysts and a friable lining, and multiple OKCs should prompt evaluation for Gorlin-Goltz syndrome.
- B. A radicular cyst yields thin amber fluid, often with cholesterol crystals that shimmer.
- C. A dentigerous cyst yields thin, straw-coloured serous fluid.
- D. A central giant cell granuloma is a solid vascular lesion — aspiration yields blood, not keratin.