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18 Cards in this Set
- Front
- Back
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Mucosal Smear
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examine the cells that can be collected by scraping the surface of a lesion
Involves taking sample from surface of epithelium Used for diagnosis of Oral candidiasis and herpetic lesions only |
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Oral candidiasis
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a superficial proliferation of a fungal organism that is a component of the oral microflora
Mucosal smear used for diagnosis Can be erythematous or white |
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Herpetic lesions-
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ulcers usually located on fixed, keratinized mucosa, caused by the herpes simplex virus
Mucosal smear used for diagnosis |
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Positive mucosal smear for candidiasis
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Consists of epithelial cells invaded by fungal hypae
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A biopsy shows neutrophils that form abscesses in the superficial epithelium and rough, keratinized epithelium - what is the diagnosis?
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Candidiasis infection
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What are the most common places for hepetic lesions?
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On fixed, keratinized lesions like gingiva, palate, and alveolar ridge
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Clinical observation shows a crop of irregularly shaped ulcers on the palate? What is the differential diagnosis?
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Herpetic ulcers
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A biopsy shows large multinucleated tzanck cells. What is the diagnosis?
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Herpes Simplex Virus infection
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Positive mucosal smear for herpetic lesions
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See scattered multinucleated tzanck cells
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Brush biopsy
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collects cells from all the layers of the epithelium, from the basal cells to the surface keratin layer.
clinician thinks flat white lesion is due to hyperkeratosis, but wants to make certain there's no premalignant changes in the epithelium |
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Why don't you brush biopsy ulcerated areas?
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Because there is no epithelium
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Incisional Biopsy
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A small sample of the lesion is taken and submmitted for microscopic exam
allows the pathologist to see the relationship between the cells and tissues of the lesion |
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Excisional Biopsy
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Entire lesion is removed and submitted for microscopic exam
allows the pathologist to see the relationship between the cells and tissues of the lesion |
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How do you know when to perform an incisional biopsy
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If the lesion is greater than 1cm
If access to the lesion is difficult If lesion is close to vital structures If the lesion is very suspicious |
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Hod do you know when to perform an excisional biopsy
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If the lesion is less than 1cm
If access to lesion is easy and it is not near vital structures If lesion is not suspicious such as pedunculated lesions |
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You have a lesion which you suspect is due to hyperkeratosis but you want to be more sure. What biopsy technique should you use?
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Brush biopsy
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You have a red lesion on the lateral border of the tongue and the patient is high risk behavior. What type of biopsy should you perform?
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Incisional biopsy because if malignant, you leave margins for surgeon to make excision
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If you have a firm, well defined, exophytic sessile lesion, what type of biopsy would you perform?
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Excisional biopsy
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