Opath Soft Tissue Lesions

Front 1

Fibroma

Back 1

Exophytic, nodular mass, dense, fibrous CT covered by SSE, NOT encapsulated, pedunculated, response to local irritation or trauma, fibrous maturation of a preexisting pyogenic granuloma

Front 2

Giant Cell Fibroma

Back 2

Retrocuspid papilla, vascular, fibrous CT, multi-nucleated, stellate fibroblasts within superficial CT, Rete ridges narrow and elongated

Front 3

Peripheral Ossifying Fibroma

Back 3

Exclusively on gingiva, interdental papillae, formation of mineralized product (central bone formation), pyogenic granuloma (ddx)

Front 4

Pyogenic Granuloma

Back 4

Response to local irritation or trauma, pedunculated, highly vascular, endothelium-lined channels engorged with RBCs, lobular aggregates of vessels

Front 5

Peripheral Giant Cell Granuloma

Back 5

Response to local irritation or trauma, exclusively on gingiva, nodular proliferation of multi-nucleated giant cells within the gingiva, highly vascularized, RBCs

Front 6

Traumatic Neuroma
(Amputation Neuroma)

Back 6

Haphazard proliferation of mature, myelinated and unmyelinated nerve bundles, reactive proliferation after local trauma to a nerve, regeneration pathology

Front 7

Neurilemoma (Schwannoma)

Back 7

Schwann cell origin, Antoni A/B, palasaded arrangement around the central, acellular eosinophilic areas (Verocay Bodies)àReduplicated BM and cytoplasmic processes, S100 protein +

Front 8

Granular Cell Tumor

Back 8

Benign, derived from Schwann or neuroendocrine cells, tongue, large polygonal cells, NOT encapsulated (but benign), S100+, acanthosis, PEH

Front 9

Neurofibroma

Back 9

Peripheral nerve neoplasm, solitary or part of neurofibromatosis, skin, interlacing bundles of spindle-shaped cells, wavy nuclei, mast cells

Front 10

Neurofibromatosis

Back 10

NF1 gene, Von Recklinghausen’s Disease, Plexiform variant (bag of worms), Café-au-lait (6+), Axillary Freckling (Crowe’s Sign), Lisch Nodules, optic glioma, neurofibromas, enlargement of fungiform papillae, mandibular foramen, and increased bone density

Front 11

Paraganglioma

Back 11

Paraganglia (tissues from NCCs), carotid body tumor

Front 12

Multiple Endocrine Neoplasia Type 2B

Back 12

Marfanoid body build, Pheochromocytomas (increased catecholamines), leads to medullary thyroid carcinoma, increased VMA and Epi:NorEpi

Front 13

Melanotic Neuroectodermal Tumor of Infancy

Back 13

NCC origin, Maxilla, pigmented neoplasm, high urinary levels of VMA, benign, despite rapid growth and potential to destroy bone

Front 14

Inflammatory Papillary Hyperplasia (Denture Papillomatosis)

Back 14

Ill-fitting dentures, hard palate, mouth breathers, high palatal vault, hyperplastic SSE, PEH, sclerosing sialadenitis if salivary glands present, loose and edematous to densely collagenized CT, chronic inflammatory cell infiltrate

Front 15

Epulis Fissuratum

Back 15

Ill-Fitting Dentures, Fibroepithelial polyp/leaf-like fibroma, hard palate, pedunculated, hyperkeratotic overlying epithelium, irregular hyperplasic rete ridges

Front 16

Congenital Epulis

Back 16

Soft tissue tumor, alveolar ridges of newborns, polypoid mass

Front 17

Hemangioma

Back 17

Benign tumors of infancy, endothelial proliferation, circumscribed cellular mass of vascular endothelial cells, strawberry hemangioma (bright red, superficial), deeper hemangiomas are bluish due to Tyndall Effect

Front 18

Vascular Malformations

Back 18

NO endothelial proliferation, Port Wine Stains (face, along CNV), excessive numbers of dilated blood vessels in the middle and deep dermis

Front 19

Sturge-Weber Angiomatosis

Back 19

Hamartomatous vascular proliferation involving tissues of brain and face, port wine stain or nevus flammeus, leptomenigial angiomas, gyriform “tramline” calcifications in the brain, glaucoma, vascular dilation of oral lesions, vascular hyperplasia of gums

Front 20

Lymphangioma

Back 20

Hamartomatous tumors of lymphathic vessels, dilated lymphatic vessels beneath the atrophic surface epithelium and in the deeper CT (Cavernous Lymphangioma), Cystic Hygroma, pebbly and vesicle apper.

Front 21

Leiomyoma

Back 21

Benign tumor of smooth muscle, Masson Trichome stain shows SM bundles with normal collagen

Front 22

Rhabdomyoma

Back 22

Benign neoplasm of skeletal muscle, rounded and polygonal cells with focal vacuolization (spider web appearance) granular eosinophilic cytoplasm, PTAH=focal cross striations

Front 23

Lipoma

Back 23

Benign tumor of mature fat cells, yellow-nodular masses, sessile or pedunculated, thin fibrous capsule

Front 24

Osseus and Cartilagionous Choristomas

Back 24

Microscopically NORMAL tissue in an ABNORMAL location, bone and/or cartilage in the TONGUE, mass of dense lamellar bone beneath surface epithelium

Front 25

Fibrosarcoma

Back 25

Malignant tumor of fibroblasts, spindle-shaped cells with mild pleomorphism

Front 26

Liposarcoma

Back 26

Malignant tumor of fatty cell origin, well-differentiated/atypical lipomatous tumor (most common)

Front 27

Leiomyosarcoma

Back 27

Malignant tumor of smooth muscle origin, uterine wall and GI tract, RARE in oral cavity

Front 28

Rhabdomyosarcoma

Back 28

Malignant tumor of skeletal muscle origin, infiltrative mass that grows rapidly, head and neck common

Front 29

Malignant Peripheral Nerve Sheath Tumor

Back 29

50% of NF1 gene + people get this (Neurofibromatosis)

Front 30

Kaposi’s Sarcoma

Back 30

Vascular neoplasm caused by HHV8 and KSHV, propensity in HIV+, lesion arises in endothelial cells

Front 31

Metastasis to Oral Soft Tissues

Back 31

Uncommon, Batson’s Plexus allows metastasis, gingiva and tongue most common, lung>kidney>melanoma>prostate>breast cancer for metastasis to oral cavity