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133 Cards in this Set
- Front
- Back
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most common benign epithelial neoplasm intraorally
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squamous papilloma
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finger like fronds of epithelium with varying degree of keratinization
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squamous papilloma
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verruca vulgaris
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caused by hpv .... found on fingers and feet ... can be perioral
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condyloma acuminatum
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venereal warts.... hpv.... multiple clustered, sessile pink lesions with a cauliflower like surface
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recurrance rate in condyloma acuminatum
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30% in genital regions
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most common neoplasm of humans
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seborrheic keratosis
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stuck on tan or brown plaques
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seborrheic keratosis
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dermatosis papulosa nigra is a variant of ....
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seborrheic keratosis
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seborrheic keratosis is premalignant
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FALSE removal for cosmetic purposes only
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yellowish umbilicated papules
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sebaceous hyperplasia
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most common leukemia in mouth
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AML
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how do you figure out what type of leukemia
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immunohistochemical and cytogenic studies
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rubber firm enlargin NON TENDER lymph node
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hodgkin lymphoma
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reed sternburg cell
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hodgkin lymphoma
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numb chin
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usually a malignancy in the mandible
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superficial talengetic vessels
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usually indicate malignancy
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most common lymphoma in the mouth
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usually shows up on the hard palate
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"good lymphoma"
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hodgkin - 95% 10 year survival
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where do you find dermatosis papulosa nigra
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1-2 mm brown to black papules of periorbital skin
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yellowish umbilicated papules of the facial skin
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sebaceous hyperplasia
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careful not to confuse sebaceous hyperplasia with
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basal cell carcinoma
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how do you differentiate between sebacous hyperplasia and bcc
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Sebaceous hyperplasia can express sebum from central pit
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rapidly growing and self healing
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keratoacanthoma
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leaves a very ugly scar when it heals
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keratoacanthoma
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conroversial but thought to be benign, despite rapid growth - sometimes thought to be a branch of SCC
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keratoacanthoma
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differentiate candidiasis from leukoplakia
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candidiasis will scrape off
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white patch of oral mucosa that cannot be scraped off and cannot be diagnosed clinically or microscopically as any other condition
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leukoplakia
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leukoplakia treatment
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moderate epithelial dysplasia or worse should be removed completely
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which location is most likely to have luekoplakia turn into something signimicant
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floor of the mouth
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erythroplakia is worse than leukoplakia
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TRUE erythroplakia is much worse!!
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velvety patch of red well demarcated on lateral tongue, floor of mouth, or soft palate.
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erythroplakia
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90% are severe epithelial dyspplasia or worsae at time of biopsy
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erythroplakia
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scaly plaque of sandpaper texture
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actinic keratosis
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actinic chelosis
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actinic keratosis of lower lip
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treatment of actinic keratosis
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liquid nitrogen, topical imiquimod, topical 5-FU
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cause of actinic keratosis
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chronic UV light exposure
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most common skin malignancy
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BCC
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can look like a scar
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sclerosing BCC
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can look like sebaceous hyperplasia
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nodular BCC .... malignancies will not have hair
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mistaken for a nevus
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pigmented bcc
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bcc prognosis
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good - 95% cure rate on first excision
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90% of oral cancers are
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SCC
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where do you find SCC
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lower vermilion zone
intraorally |
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where does SCC metastisize to
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regional lymph nodes
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"grade" of SCC
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how closely lesion tissue resembles normal squamous epithelium
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stage scc is at when found in mouth
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usually III or IV
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clinical scc
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firm, irregular, red, white, ulcerated
exophytic or endophytic |
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increased nuclear /cytoplasmic ratio
nuclear and cellular pleomorphism |
scc
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smokeless tobacco is most frequent cause for this squamous cell variation
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verrucous carcinoma
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treatment for verrucous carcinoma
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WIDE surgical excision
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microscopic appearance of verrucous carcinoma
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very bland and non-malignant; diagnosis based on architecture of the lesion
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freckle
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epheis
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tan to brown macular lesions
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actinic lentigo
increased melanin w/ slight elongation of rete ridges |
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tan to dark brown macule on vermilion zone of lip or on oral mucosa
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oral melanotic macule
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malignant potential of oral malignant macule
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none, but ususally biopsied to rule out
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2 types of melanocytic nevi
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acquired - 6-8 months of age
congenital |
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stages of nevi
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junctional, compound, intradermal
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flat dark brown - nevus cells at tips of rete ridges, at junction of epidermis and dermis
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stage 1- junctional
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hair shows up in nevus; nevus cells in both epidermis and dermis
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compound
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nevus cells completely in dermis
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intradermal
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how big is a small congenital nevus
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10-15 CENTIMETERS
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covers large area of skin with dark brown to black, thick plaque
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large congenital nevus
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blue nevus
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melanin pigment is deep in the tissue so it only reflects blue pigment
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most deaths due to skin cancer
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melanoma
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ABCDs
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assymetry, border irregularities, color variegaition, diameter greater than 6 mm
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prognosis of melanoma
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based on the depth of the lesion
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melanoma that shows up on soles of the feet and palms of the hands
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acral lentiginous melanoma - often in darked skinned individuals
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benign tumor of adipose tissue
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lipoma, soft and encapsulated
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nerve injury due to sectioning
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traumatic neuroma
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smooth surface, domed shaped papule, tender on palpation
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truamatic neroma
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benign tumor of schwann cell origin
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neruilemoma
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solitary, encapsulated, rubbery firm, NON tender noduule
lips tongue and buccal mucosa |
neurilemoma
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microscopic appearance shows antoni A and Antoni B patterns
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neurolemoma
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soft dom shaped superficial nodule
well demarcated UNENCAPSULATED NON TENDER |
neurofibroma
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large range of presentations
cafe au laite spots (6 or more) neurofibromas, axillary freckling |
neurofibromatosis
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wavy fibroblastic cells in a background of fine collegan fibers
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neurofibroma
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x ray floating tooth
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melanotic neuroectodermal tumor of infancy
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anterior maxilla developing rapidly and appearing as a ass that expands bone
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MNTOI
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biphasic proliferation of neuroectodermal cells and larger epithelioid cells with the capability to produce melanin.
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MNTOI
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slow growing, well demarcated though unencapsulated, submucosal lesion, often on dorsal tongue. non tender
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granular cell tumor
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mesenchymal cells habing a finely granular-appearing ctoplasm
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granular cell tumor
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lesional cells intermingle with healthy tissue
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neurofibroma and granular cell tumor
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pseudoepithelial hyperplasia in 30% of cases .... sometimes leading to inappropriate diagnosis
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granular cell tumor
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maxillary alveolar ridge of girl babies
smooth surface - pedunculated |
congenital epulis
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most common tumor of childhood
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hemangioma
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treatment of hemangioma
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delayed until at leats age 6, becuase most will regress
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port wine stain, found to the distribution of CN V - typically opthalmic division
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encephalotrigeminal angiomatosis
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tramline calcifications
calcified walls of abnormal blood vessels |
encephalotrigeminal angiomatosis
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frog egg or tapioca pudding appearance on surface of the lesion,
usually on tongue |
lymphangioma
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proliferation of spindle shaped cells with abundant eosinophilic cytoplasm, often surrounding thick walled vascular spaces
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leiomyoma
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most arise in cardiac muscle and are associated with syndrome called tuberous sclerosis
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rhabdomyoma
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usually an adult patient with a submucosal or subcutaneous mass in submandibular region
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rhabdomoyoma
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large polygonal cells that superficially resemble skeletal muscle
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rhabdomyoma
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fibrosarcoma
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mesenchymal malignancy that differentiates along the lines of a fibroblast
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densly cellular proliferation of spindle shaped cells resembling fibroblasts that invade normal tissue
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fibrosarcoma
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soft tissue - ill defined subcutaneous or submucosal nodule
intrabony - expansion of bone with rugged radioleucent margins |
fibrosarcoma
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malignant peripheral nerve sheath tumor - clinical
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bulky tumor mass with infiltrative borders
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densely cellular proliferation of spindle shaped cells resemble the wavy cells of peripheral nerve tissue
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malignant peripheral nerve sheath tumor
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kaposi's sarcoma caused by
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HHV-8
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where does "classic" kaposi's show up
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skin of legs
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blue/purple macule, like a bruise initially ..... develops into more of a plaque
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kaposi's sarcoma
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children and teenagers
"bunch of grapes" skeletal muscle |
rhabdomyosarcoma
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fatigue, paleness, easy bruising....
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leukemia
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which leukemia mostly affects children
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ALL
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which leukemia is most common in the oral cavity
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AML
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diffuse gingival enlargement
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myelomonocytic leukemias
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paresthesia of mental nerve
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potential SE of non hodgkins
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reed sturnberg cells
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hodgkins disease
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multiple enlarged non tender lymph nodes
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lymphoma
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lymphoma in teenagers and young adults
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hodgkins
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well circumscribed radioleucency that tends to scallop around roots
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traumatic bone cyst
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treat by entering the cavity to induce bleeding
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traumatic bone cyst
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well circumscribed radiolucency below the mandibular canal
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lingual mandibular salivary gland depression
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asymptomatc radioleucancy with no evidence of expansion and ill defined borders
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focal osteoporotic bone marrow defect
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RX show very radiopaque lesion, usually mandibular body,
everything else is good |
idiopathic osteosclerosis
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bilateral swelling on posterior mandible... significant tooth displacement has been noted
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cherubism
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blue sclera
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OI ... maybe DI as well
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lack of osteoclastic activity - excess bone fills in marrow spaces
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osteopetrosis
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blindness, slow tooth eruption
severe pancytopenia |
osteopetrosis
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frontal bossing, retained primary teeth
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cleidocrainial dysplasia
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alkaline phosphatase is markedly raised, mosaic pattern of bone
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pagets
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bowing of legs, maxillary enlargement,
xrays show cotton wool appearance |
pagets
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activate mutation of alpha subuint of stimulatory gene
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fibrous dysplasia
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asymptomatc radioleucancy with no evidence of expansion and ill defined borders
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focal osteoporotic bone marrow defect
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RX show very radiopaque lesion, usually mandibular body,
everything else is good |
idiopathic osteosclerosis
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bilateral swelling on posterior mandible... significant tooth displacement has been noted
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cherubism
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blue sclera
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OI ... maybe DI as well
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lack of osteoclastic activity - excess bone fills in marrow spaces
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osteopetrosis
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blindness, slow tooth eruption
severe pancytopenia |
osteopetrosis
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frontal bossing, retained primary teeth
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cleidocrainial dysplasia
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alkaline phosphatase is markedly raised, mosaic pattern of bone
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pagets
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bowing of legs, maxillary enlargement,
xrays show cotton wool appearance |
pagets
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activate mutation of alpha subuint of stimulatory gene
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fibrous dysplasia
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