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Ameloblastomas display a wide variety of architectural patterns under the microscope, including follicular, plexiform, acanthomatous, basaloid, granular cell, and desmoplastic. Follicular and plexiform patterns are the most common. Multiple patterns often coexist and they have no clinical significance.
Follicular pattern: This pattern consists of round, oval, or irregular islands of epithelium that try to mimic enamel organ epithelium. The nests and islands show peripheral palisading of columnar cells with reverse polarity i.e. their nuclei are polarized away from the basement membrane. The central portion of the islands consists of angulated cells resembling stellate reticulum of the developing tooth germ. The nests are separated by mature fibrous connective tissue stroma.
Follicular pattern: This pattern consists of round, oval, or irregular islands of epithelium that try to mimic enamel organ epithelium. The nests and islands show peripheral palisading of columnar cells with reverse polarity i.e. their nuclei are polarized away from the basement membrane. The central portion of the islands consists of angulated cells resembling stellate reticulum of the developing tooth germ. The nests are separated by mature fibrous connective tissue stroma.