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3 Cards in this Set
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Infections and inflammatory conditions Benign growth eg focal fibrous hyperplasia, pyogenic granuloma, peripheral giant cell granulomas Premalignant lesions eg leukoplakia,erythroplakia, leukoerythroplakia, dysplasia, carcinoma in situ Malignant tumors. eg squamous cell carcinoma Herpes simplex virus infections Present as gingivostomatitis in children and pharyngitis in adults Caused by HSV 1, but also HSV 2 Primary infections in children asymptomatic Latency to trigeminal ganglia Abrupt onset of vesicles and ulceration of oral mucosa Lesions accompanied by lymphadenopathy, fever, anorexia Lesions are small group of vesicles Morphology Intracellular and intercellular edema and acantholysis (split epithelium)create clefts Eosinophilic intranuclear viral inclusion Giant cells Tzanck test diagnose vesicle fluid demonstrate giant cells, moulding Reactivation of latent HSV causes recurrent Oral thrush/ oral candidiasis Candida albicans Most common Pseudomembrane called thrush - gray to white inflammatory base Composed of matted organisms Oral hairy leukoplakia EBV infections Immunocompromised patient Lateral border of tongue Not scrapped of White, confluent patches of fluffy hairy , hyperkeratotic thickening Apthous ulcers Frequent in first two decades of life Recurrent and painful Associated with Celiac disease, inflammatory bowel disease, |
Fibrous hyperplasia Pyogenic granuloma Gingiva of children, young adults and pregnant women Red to purple in color Frequent ulceration Rapid growth Regress or mature into dense fibrous masses Peripheral giant cell granulomas Reactive inflammatory process Intact gingival mucosa Maybe ulcerated Peripheral ossifying fibroma Reactive rather than neoplastic Long standing pyogenic granuloma Nodular, red and ulcerated Peak in young females |
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Leukoplakia, erythroplakia leukoerythroplakia Gross description Squamous proliferation Erythroplakia - high risk of severe dysplasia Leukoplakia White patch or plaque cannot be scrapped of and cannot be characterized clinically as any other disease Common on buccal mucosa, floor of mouth, palate,gingiva Erythroplakia Red and velvety eroded area Risk of malignancy higher Risk- tobacco, Squamous hyperplasia Thickened squamous epithelium, includes acanthosis ( increased thickened of spinous layer) Woven basket appearance Squamous dysplasia Premalignant proliferation of squamous epithelium Loss / arrested maturation Loss polarity Dyskeratosis No invasion of basement membrane Nuclear pleomorphism Hyperchromasia Mitotic figures Can regress or progree to cancer Grading Mild- confined to lower third Moderate- middle third of epithelium Severe- upper third of epithelium Carcinoma in situ - full thickness |
Oral squamous cell carcinoma Most common oral malignancy Risk- smoking, alcohol, radiation, HPV genetic predisposition Disease in adults and elderly - ulcerated lesion with necrotic central area sarrounded by elevated rolled borders HPV 16 more common p16 positive Clinical presentation Mouth pain, bleeding Non healing mouth ulcers Dysphagia, odynophagia Dysarthria Referred otalgia Cervical lymphadenopathy Weight loss History of long standing leukoplakia and erythroplakia Losenig of teeth or ill fitting dentures Diagnosis Clinical history and physical examination Imaging Cytological specimen Biopsy - incisional or excisional Histopathology Broad confluent band or irregular tumor nests, cords, single cells Positive for p16 HPV associated vs non HPV associated Younger. Older Risk factor HPV 16 Smoking tobacco Alcohol Diet- betel liquid HPV associated better prognosis Smoking and alcohol poor prognosis |
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Salivary glands pathology Can be neoplastic or inflammatory eg sialadenitis, sialolithiasis, mucocele Xerostomia Dry mouth from decreased production of saliva 70 yrs of age.
Cause - sjogren syndrome, radiotherapy of head and neck cancer, side effects of drugs Sialadenitis Inflammation to salivary glands due to trauma, viral or bacterial Include mucocele Mucocele Fluctuant lower lip swelling Rupture or blocked salivary glands duct Ranula - epithelial lined cysts when duct has been damaged Sialolithiasis |
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