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173 Cards in this Set
- Front
- Back
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What are the DD lesions for an anterior tongue mass
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Fibroma and neuro lesions eg tramatic Neuroma, and Granular Cell Tumor.
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what are the 4 differentials for a gingival mass
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1) peripheral fibroma 2) peripheral giant cell granuloma 3) peripheral ossifying fibroma 4) pyogenic granuloma
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What are the four caracteristics of MEN(multiple endocrine neoplasia) III
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(1) multiple mucosal neuromas, (2) adrenal pheochromocytomas, (3) medullary thryroid carcinoma, and (4) a Marfanoid body build w/ muscle wasting of extremities
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What is the most common soft tissue tumor of the oral cavity
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Fibroma
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What is a Vascular malformation
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structural anomalies of blood vessels without endothelial proliferation. They present at birth and persist throughout life. They can present with a PORT WINE stain.
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Which soft tissue oral tumor is a well-defined, smooth-surfaced pink nodule that may be sessile or pedunculated and most are less than 2 cm in dia., but can be considerably larger also more frequent in adults than children
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Fibroma
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What is the treatment for a Vascular Malformation?
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Usually none, but sugical exision on large lesions.
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what is the most common location for an oral fibroma
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buccal mucosa along the bite line
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What is the most common Oral location for Kaposi Sarcoma
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Palate
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What is the histological appearance of a Fibroma
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nodular mass of fibrous connective tissue covered by stratified squamous epithelium. Lesion is not encapsulated. Covering epithelium often exihibits atrophy of the rete ridges and surface may exhibit hyperkeratosis due to secondary trauma
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what is the generic term that can be applied to any tumor of the gingival or alveolar
mucosa |
epulis
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what is an EPULIS FISSURATUM
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reactive hyperplasia of fibrous connective tissue and epithelium that occurs in the alveolar vestibule in association with irritation from poorly fitting denture
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What is the most common location of an epulis fissuratum
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more common in the anterior areas and occur more frequently on the facial of the alveolar ridge than on lingual
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What are some of the pathological findings associated with dentures
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Epulis Fissuratum, Inflamatory papillary hyperplasia.
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What is the most common spot for an Inflamatory papillary hyperplasia lesion
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Palate or alveolar ridge
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What lesion is clinically characterized by multiple, broad-based papillary projections that closely approximate one another and
may be of normal color or erythematous. |
INFLAMMATORY PAPILLARY HYPERPLASIA or DENTURE PAPILLOMATOSIS
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What is the histology of an Inflammatory Papillary Hyperplasia
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may exhibit pseudocarcinomatous hyperplasia and on occasion is misdiagnosed as squamous cell carcinoma
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what is caracterized by a diverse group of locally aggressive fibrous proliferations that occupy a pathologic gray zone btwn benign and malignant tumors
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Fibromatosis
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What if the histology of a Fibromatosis
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cellular proliferation of spindle-shaped cells that are arranged in streaming fascicles and are associated with a variable amount of collagen. They are poorly circumscribed lesion and infiltrate adjacent tissues
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What is the rare condition caracterized by a spindle cell neoplasm that consists of myobibroblasts (cells with both
smooth muscle and fibroblastic features) |
Myofibroma
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When does myofibroma usually present in life
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Occurs most frequently in the first 4 decades of life
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Most common oral location fo a Myofibroma
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Most common oral location is the mandible, followed by the lips, cheek, and tongue
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What is the histological appearance of a Myofibroma
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composed of interlacing bundles of spindle cells with tapered or blunt-ended nuclei and eosinophilic cytoplasm centrally the lesion is often more vascular with a hemangiopericytoma-like appearance
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What is a common reactive, tumorlike growth of the oral cavity that occurs as a result of local irritation and considered to be nonneoplastic in nature
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PYOGENIC GRANULOMA
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What is another name for a pyogenic granuloma
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sometimes termed “pregnancy tumor”
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What is a tumorlike growth exclusively of the gingiva or alveolar ridge. It is similar to the pyogenic granuloma, presenting as a sessile or pedunculated mass, often with an ulcerated surface
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PERIPHERAL GIANT CELL GRANULOMA (GIANT CELL EPULIS)
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What is the histology of a Peripheral Giant Cell Granuloma
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proliferation of multinucleated giant cells within a background of plump ovoid and spindle-shaped mesenchymal cells. A zone of dense fibrous connective tissue usually separates the giant cell proliferation from the mucosal surface
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What is the most common mesenchymal neoplasm
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LIPOMA
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what is a lipoma
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benign tumor of fat that is common in the subcutaneous tissues but relatively uncommon in the oral cavity
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what is the differential diagnosis for a lipoma
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fibroma, mucocele (blue), salivary gland lesions, and neural lesions
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What is the most common type of peripheral nerve neoplasm
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NEUROFIBROMA
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What is a Neurofibroma
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Benign tumor of nerve origin that contains Schwann cells, perineural cells, and neuritis.
May occur as solitary neoplasm or in association with neurofibromatosis |
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What is the most common site for a Neurofibroma
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Tongue and buccal mucosa are the most common intraoral sites
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What is a group of genetic disorders that are characterized by the development of multiple neural tumors, especially neurofibromas
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NEUROFIBROMATOSIS (VON RECKLINGHAUSEN’S DISEASE OF THE SKIN)
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What are Lisch nodules?
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Pigmented spots on the iris associated with Neurofibromatosis type I
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What is an uncommon neoplasm that shows a predilection for oral cavity, esp. the tongue (dorsum) and not as often on the buccal mucosa
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GRANULAR CELL TUMOR
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What is the histology of a Granular Cell Tumor
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composed of large, polygonal cells w/ abundant eosinophilic, granular cytoplasm and small, vesicular nuclei. Cells arranged in sheets, but also may be found in cords and nests
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Rare benign tumor of uncertain histogenesis that occurs on the alveolar ridge of newborn infants, it bears histopathologic resemblance to the granular cell tumor and
90% of reported cases have been females |
CONGENITAL EPULIS
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Common benign tumor of blood vessels that cannot be recognized at birth, but arise subsequently during the first 8 wks of life
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HEMANGIOMA
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benign tumor of lymphatic vessels that arise from lymphatic tissue that fails to communicate normally with the rest of the lymphatic system
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LYMPHANGIOMA
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Malignant neoplasm of fibrous connective tissue that is uncommon in oral cavity
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FIBROSARCOMA
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This disease is defined by malignant skeletal muscle tumors and is one of the most common soft-tissue sarcomas in children. Head and neck most common site for pediatric cases, accounting for 40% of childhood cases
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RHABDOMYOSARCOMA
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What is the most common location of a Pyogenic Granuloma
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Can develop almost anywhere in oral cavity, but gingival is most common site. They are more common on max. gingival than mand. and anterior is preferred over post
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“cupping” of the underlying bone is characteristic of what pathology?
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PERIPHERAL GIANT CELL GRANULOMA
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What are benign tumors of Schwann cell origins that are uncommon in the oral cavity
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NEURILEMOMA
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What is the DD for a GRANULAR CELL TUMOR
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lipoma, neural lesions, and fibroma
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what is the most common location for CONGENITAL EPULIS
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Twice as common on the max. ridge as on the mand. ridge. More Common with Females
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in some cases they are congenital, presenting on the skin as “birthmarks”other cases develop during childhood or later in life
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Hemangioma
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Are Hemangiomas more common in male or female? Black or white?
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Female, White
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What is the most common oral location for Lymphangioma
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Anterior 2/3 of tongue is most common oral location, often resulting in macroglossia
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T/F Prognosis of fibrosarcoma depends on size, location, and histopathologic grade of tumor
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True
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What is the overall 5 yr survival rate for fibrosarcoma
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40-70% and intrabony tumors have worse prognosis than peripheral tumors
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What is the most common site for RHABDOMYOSARCOMA?
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In head and neck region, the orbit is the most common site, followed by the nasal cavity and nasopharynx. Tthe palate is the most common intraoral site
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what is the treatment for Rhabdomyosrcoma?
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tx usually involves a combination of surgery, radiation, and chemotherapy
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What is a fluid filled reactive process to irritation or trama that typically appear as dome-shaped mucosal swellings that can range from 1-2mm to several cm in size
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MUCOCELE
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What is the most common location of a Mucocele
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Lower Lip
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what surrounds the pool of mucin in a mucocele
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Granulation and fibrous CT
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What is a Ranula?
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Similar to a mucodele but on a major salivary gland.
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What is the most common location for a Ranula?
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Always in the floor of the mouth, under the tongue / usually located lateral to the midline (this may help distinguish it from a midline dermoid cyst)
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What is a Plunging Ranula
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the ranula has plunged through the mylohyoid muscle and causes swelling under the mandible into the neck
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What is a MUCUS RETENTION CYST
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It is basically a mucocele of the max sinus. Unlike the more common mucocele, it is a true cyst b/c it is lined by epithelium. Asymptomatic
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What is the treatment for a Mucus Retention Cyst
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None, it ususally resolves independently
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If a pt. presents with pain, usually when eating, due to obstruction of salivary duct and usually, after eating, pain and swelling will subside within an hr or so what is the diagnosis.
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SIALOLITHIASIS
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In SIALOLITHIASIS which glands are most affected
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Submandibular > Parotid
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what is Sialadenitis
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Inflammation of the salivary glands from infectious or noninfectious causes (mumps is the most common viral infection) can result from SIALOLITHIASIS if correction and relief does not occur.
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What is the histology of a BENIGN LYMPHOEPITHELIAL LESION
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involves intense LYMPHOCYTIC INFILTRATE associated with destruction of the salivary acini; ductal epi persists; ductal cells and surrounding myoepi cells become hyperplastic forming EPIMOYOEPITHELIAL ISLANDS throughout the lymphoid proliferation
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what disease is a Benign Lymphoepithelial Lesion associated with?
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Mikulicz Disease
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is Sjogren Syndrome more common in Male or Female?
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80% to 90% of cases occur in females.
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What conditions are more likly to occure with Sjogrens Syndrome?
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Increased tooth decay, Angular Cheilitis, fissured tongue, & Candidiasis
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What is Sjogren Syndrome
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It is a chronic, systemic autoimmune disorder that principally involves the salivary and lacrimal glands, resulting in xerostomia (dry mouth) and xerophthalmia (dry eyes)
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What is NECROTIZING SIALOMETAPLASIA
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Is a benign process tansformation from a more specialized type to a least.
It is a very uncommon locally destructive inflammatory condition of the salivary glands |
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what is the most common location of Necrotizing Sialometaplasia?
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usually the hard palate (75%-post hard palate, 2/3 are unilateral), but uncommon altogether. Fairly asymptomatic
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What is the most common salivary neoplasm
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PLEOMORPHIC ADENOMA (BENIGN MIXED TUMOR) account for 53-77% of parotid tumors, 44-68% of submandibular tumors, and 38-43% of minor gland tumors
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what is the most common location of a PLEOMORPHIC ADENOMA
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Parotid gland
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what is a MONOMORPHIC ADENOMA
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The term is ambiguous or broad, really encompassing basal cell adenoma, canalicular adenoma, Warthin tumor, and oncocytoma as examples. Most common on upper lip.
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What is a PAPILLARY CYSTADENOMA LYMPHOMATOSUM (WARTHIN TUMOR)
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Benign neoplasm that occurs almost exclusively in the parotid gland
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What virus is associated with a Warthin Tumor?
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EBV
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What is the Histology of a Warthin Tumor
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one of the most distinctive patterns of any tumor; composed of a mixture of ductal epi and lymphoid stroma; the epi is oncocytic in nature, forming uniform rows of cells surrounding cystic spaces
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What is the rule of 80's
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80%-Parotid; 80% Benign (pleomorphic adenoma); because of odds, it is better to have the lesion located in the Parotid (the chance of being benign is better) This is for Major Salivary Gland Tumors
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what is MUCOEPIDERMOID CARCINOMA
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CT stroma, Mixture of Mucus-producing cells and squamous (epidermoid) cells; mucus cells vary in shape but contain abundant foamy cytoplasm that stains positively with mucin stains
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What is the most common location of a Mucoepidermoid Carcinoma?
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Parotid Gland
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What is an ADENOID CYSTIC CARCINOMA
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One of the more common and best-recognized salivary malignancies (distinctive histo features). Can occur in any salivary gland site, but approximately 50% develop within minor salivary glands (palate is the most common site for minor salivary gland tumors; the parotid and submandibular comprise the remainder sites, with an almost even distribution rate)
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What are the symptoms for an Adenoid Cystic Carcinoma?
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pain and/or parasthesia
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What is the Rule of 50's
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50%-palate & 50%-malignant for Minor Salivary gland tumors
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What is considered acute lymphoid hyperplasia
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Enlarged, tender, soft, and freely movable
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What is considered chronic lymphoid hyperplasia
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Enlarged, rubbery firm, nontender, and
freely movable |
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What is considered malignant lymphoid hyperplasia
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Hard, indurated, nontender, and fixed
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What is Hemostasis
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A complex interaction of Vessels, Platelets, Plasma coagulation
factors |
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What is the most common type of bleed disorder
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Von Willebrand’s disease 1:800-1000
Hemophilia A (factor VIII) 1:10,000/2 Hemophilia B (factor IX) 1:60,000/2 |
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Which chromosome is associated with hemophilia A
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X-chromosome
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What are the most common symptoms of Hemophilia
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Nose bleeding and GI bleeding
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What is the disease described as a decreased ability to carry oxygen
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Anemia
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What are the signs and symptoms of Anemia
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Signs- Pallor of mucous membranes
Symptoms– Reduced oxygen carrying capacity (tiredness, headache, or lightheadedness) |
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Which factor is associated with Hemophila A? B? Von wildebrands disease
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A=Factor VIII
B=Factor X Von wildebrands disease=factor VIII & platelet function |
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What is THALASSEMIA, One of the most common inherited disease in humans
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Defect of hemoglobin A, Similar to sickle cell anemia but greater spectrum of disease due to multi-gene involvement
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what is a Rare, life threatening, failure of hematopoetic stem cells, that is T cell mediated
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APLASTIC ANEMIA
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What is nuetropenia
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Neutrophils < 1500/mm3 in an adult. Increased susceptibility to infection
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what is agranulocytosis
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Absence of all granulocytic cells
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What is CYCLIC NEUTROPENIA
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Cyclic reduction in neutrophiles for 3-6 days every 21 days
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what are some clinical signs of cyclic neutrocytopenia
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Recurrent episodes of fever, anorexia,cervical lymphadenopathy, malaise,
pharyngitis, and oral ulcerations |
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What is THROMBOCYTOPENIA
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Decreased platelets(<100,000/mm ) caused by Reduced production, Increased destruction, and Sequestration in spleen
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What is IDEOPATHIC THROMBOCYTOPENIC
PURPURA (ITP) |
Childhood illness, often following a viral infection. It usually resolves in 4-6 weeks. 90% recover by 3-6 months
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What is THROBOTIC THROMBOCYTOPENIC PURPURA
(TTP) |
Endothelial damage triggering thrombi in
small blood vessels. Was uniformly fatal, now 70% with plasmapheresis |
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What is POLYCYTHEMIA VERA
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Excessive production of RBC’s and other blood products
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What is the main problem with POLYCYTHEMIA VERA
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Increased viscosity leads to sludging causing Stroke, MI, hypertension, and spleenomegaly. Also produces itching with out a rash
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What is the prognosis of polycythemia Vera
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10-12 year survival with Increased risk of leukemia 2-10%
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What is leukemia
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Malignant transformation of one of the hematopoetic stem cells. Bone marrow moves into the peripheral circulation (myleophthisic anemia)
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What are the classifications of Leukemia?
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Acute or Chronic.
Myeloid or Lymphocytic. |
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What is the most common form of leukemia
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Chronic lymphocytic Leukemia
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What is the treatment for Leukemia?
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Chemotherapy + radiation
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Posterior mandible “teeth floating in air” is a characteristic of which disease
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LANGERHANS CELL
HISTOCYTOSIS |
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What is the treatment for Langerhans Cell Histocytosis?
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Surgical curettage, low level radiation, + chemotherapy, and steroid injection
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What is Hodgkens Lymphoma
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Malignant lymphoproliferative disorder
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What is a Reed-Sternberg cell
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Owl-eye shaped cell associated with hodgkins lymphoma
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What virus is associated with Hodgkins Lymphoma
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EBV
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What is the treatment for Hodgkins Lymphoma
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radiation (stage l-ll); chemotherapy (stage III-lV)
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Which one has the better prognosis Hodgkins or non-hodgkins lymphoma
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Hodgkins Lymphoma has better prognosis
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What is the treatment for non-hodgkins lymphoma
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Low grade=no treatment, High Grade=Chemotherapy and /or radiation (stem cell transplant)
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What is MYCOSIS FUNGOIDES
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Lymphoma of CD4+ lymphocytes
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What are the three stages of Mycosis Fungoides
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Eczematous (erythematous) stage, Plaque stage, Tumor stage
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What is Mycosis Fungoides? (Cutaneous T-cell Lymphoma)
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A t-lymphocyte derived lymphoma
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What is Sezary Syndrome
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An aggrasive expression of Mycosis Fungoides
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What is Burkitts Lymphoma?
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Malignancy of B-cell origins
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What are the two types of Burkitts lymphoma?
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African-Endimic Burkitts Lymphoma
American– Sporatic Burkitts Lymphoma and Immunceficiency-associated |
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What % of endemic Burkits Lymphoma present in the oral cavity?
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50-70%
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What is the disease associated with a Starry-sky histological appearance.
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Burkits Lymphoma
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What is the Prognosis for stage I-II Burkitts Lymphoma?
Atage III-IV? |
I-II, Good Prognosis 85-90% no recurance 3-5 years
III-IV, Good Prognosis 75-85% no recurance 3-5 years |
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What is Multiple Myeloma?
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Relatively uncommon malignancy of plasma cell origin. The cause is unknown.
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How many cases of multiple myeloma are diagnosed each year?
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20,000 in the US
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Who is at higher risk for Multiple myeloma
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Older, Black 2:1, Male2:1
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What is the radiographic appearance of Muliple Myeloma?
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Multiple punched out lesions
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How is Multiple Myeloma diagnosed
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Urine and Serum protein immunoelectrophorysis, bone marrow bx, and skeletal radiograph survey.
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What is the treatment and prognosis for Multiple myeloma?
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Treatment – Chemotherapy, Palliative radiation
Prognosis – Poor: 5 year survival rate 10% |
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What is Plasmacytoma?
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A unifocal, monoclonal neoplastic proliferation of plasma cells that ususally arises within bone.
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Who is most at risk for Plasmacytoma?
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Adult Males 3:1
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What is the treatment and prognosis for Plasmacytoma?
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Treatment-Radiation
Prognosis- Most will eventually develop multiple myeloma, 50% with in 2-3 years. 1/3 survive >10 years |
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What is the most common type of inherited bone disease
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Osteogenisis imperfecta
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What is the most common type of osteogenisis imperfecta?
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Type I is most common and mildest form.
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What is the most Severe form of ostergenisis imperfecta?
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Type II. 90% will dies before 4 weeks age.
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What is the most severe form of osteogenisis imperfecta noted in individuals beyond the perinatal period?
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Type III, exibit moderate to severe bone fragility.
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What is type IV osteogenisis imperfecta?
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Mild to moderatly severe bone fragility.
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What is Cleidocranial displasia?
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Abnormalities of skull and clavicles
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What dental anomalies are associated with Cleidocranial displasia?
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prolonged retention of primary teeth and delayed eruption of permanent teeth; supernumerary teeth
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What is Focal Osteoporotic Marrow Defect
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A non-pathelogical process that leaves a radiolucent spot comprised of marrow where a tooth was extraced.
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What is the prevalance of Focal Osteoporotic Marrow Defect
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75% adult female, 70% posterior mandible
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what is idiopathic osterosclerosis?
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A focal area that exhibits increased radiodensity that is of unknown cause.
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Where does idiopathic osteosclerosis occure most frequently?
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Posterior mandible, 90%
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What is the DD for idiopathic osteosclerosis?
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Focal cemento-osseous dysplasia
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What is Paget's Disease of Bone?
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Abnormal deposition and resorption of the bone resulting in distortion and weakening of the affected bone.
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What is the radiological appearance of Paget's disease of bone?
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Cotton, wool, or frosted glass appearance.
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What disease is caracterized by increased serum alkaline phosphatase
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Paget's disease of bone
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What is the actronym MAC_O_MAC used for?
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Multilocular differential diagnosis.
M - Multilocular cyst (OKC) A - Ameloblastoma C - Central giant cell granuloma (CGCG) O - Ossifying fibroma (COF) M - Myxoma A - Aneurysmal bone cyst (ABC) C - Cherubism |
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What is the mos t common site for a central giant cell granuloma?
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Anterior Mandible.
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What is Cherubism?
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A rare developmental jaw condition. Bilateral expansion of multilocular lesions in the mandible and maxilla.
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What is a simple bone cyst
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A benign, empty, or fluid filled cavity whithin the bone that is devoid of epithelial lining. Unknown cause.
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What is an aneurysmal bone Cyst
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An intraosseus accumulaiton of blood filled spaces surrounded by cellular fibrous connective tissue.
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What is Fibrous Dysplasia
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Condition where bone is replaced by fibrous connective tissue intermixed with bone.
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What gene is associated with Fibrous Dysplasia
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GNSA1
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what is the radiographic appearance of fibrous dysplasia?
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Described as a RO ground glass appearance.
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what is the most common type of fibrous dyplasia?
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Monostotic. 80-85% of all cases, most occuring in the jaw.
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What is Polystotic fibrous dysplasia?
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Fibrous dysplasia in more than one bone.
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What is Jaffe-Lichtenstein symdrome?
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"Coffee with Milk" pigmentation associated with polystotic fibrous dysplasia.
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What is the treatment for fibrous dysplasia
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Resection of mandible, bisphosphoates
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What are the three types of Cemento-osseus dysplasias
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Focal cemento-osseous dysplasia
Periapical cemento-osseous dysplasia Florid cemento-osseous dysplasia |
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What is the most common fibro-osseous lesion encountered
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Focal Cemento-osseous Dysplasia
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Who is most likely to get a Focal Cemento-osseous
Dysplasia |
90% Female, white, posterior mandible, 30-60 y.o.
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What is the radiographic appearance of Focal Cemento-osseous Dysplasia
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Radiolucent, mixed, or radiopaque with well delineated irregular borders.
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Who is most likely to get a PERIAPICAL CEMENTO-OSSEOUS DYSPLASIA (cementoma)
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Black, Female, Lower anterior, 30-50 y.o.
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What is the most common fibro-osseous leason?
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Focal Cemento-osseous Dysplasia
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What are the 4 DD for RO lesions?
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1.Periapical Cemento-osseous Dysplasia (cementoma)
2.Florid Cemento-osseous Dysplasia 3.Idiopathic sclerosis 4.Cementoblastoma |
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What is Familial Gigantiform Cementoma
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Rare Autosomal Dominanat with rapid growth and facial deformity.
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What is an Ossifying Fibroma
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Well defined lesion, can be Unilocular or multilocular and Radiolucent, mixed or target
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How common is osteogenisis imperfecta
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1:8000
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