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36 Cards in this Set
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What is described as Firm, Asymtomatic nodules covered by epithelium unless secondarily tramatized. Occur along line of occlusion in the lower lip or buccal mucosa most frequently. Reactive hyperplasia (not true neoplasm).
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Tramatic or irritation fibroma
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May irritation fibromas undergo malignant transformation?
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No
(fibromas are the most common benign oral lesion in the opinion of some, but some people feel that leukoplakia is the most common benign oral lesion) |
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What is described as asymptomatic, sessile or pedunculated papules < 1 cm. Often have papillary surface, although may have smooth surface. Female < 30. Occurs on gingiva 50% and mandible is most common site. True neoplasm.
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Giant Cell Fibroma
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愛想
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/(n) civility/courtesy/compliments/sociability/graces/(P)/
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[あいそう]
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What has clinical features that include Tumor-like hyperplasia of fibrous connective tissue associate with denture flange. Manifests as two folds with flange seated in between. Firm & fibrous, but may show erythema and ulceration. Facial aspect on anterior of mandibular jaw. > 50 year old Women.
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Epulis Fissuratum (Denture Injury Tumor, Inflammatory Fibrous Hyperplasia, Denture Epulis)
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Will an epulis Fissuratum come back if it is surgically removed?
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Yes if the denture is not remade or relined
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What has clinical features that include Reactive tissue growth that usually, but not always develops beneath a denture. Painless, papillomatous, "Cobblestone" lesion of hard palate although occasionally it occurs on the edentulous mandibular ridge or in association w/epulis fissuratum. The lesion is usually asymptomatic and red due to inflammation.
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Papillary Hyperplasia (Inflammatory papillary hyperplasia, palatal papillomatosis, denture papillomatosis)
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Is papillary hyperplasia a premalignant condition?
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No
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What are a diverse group of tumors tha exhibit both fibroblastic and histiocytic differentiation. They can occur anywhere in the body, but those of the skin are most common and called dermatofibromas. They are uncommon in the oral/perioral region, with the buccal mucosa being the most common intraoral site. > 50 years old. Appears as painless nodular masses and can range in size, with deep tumors being larger.
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Fibrous Histiocytoma (Dermatofibroma, Sclerosing Hemangioma, Fibroxanthoma, Nodular Subepidermal Fibrosis)
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What are a broad group of fibrous proliferations with a biological behavior ranging from benign to malignant?
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Fibromatoses
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What presents as a firm painless mass, which may grow rapidly or slowly. 8-11 years old. Paramandibular soft tissues. Lesions can grow to a large size and destroy bone.
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Fibromatosis
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Where are Myofibromatosis most commonly seen?
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Neonates and infants. Firm mass in the dermis or subcutaneous tissues of the head and neck.
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What is noteworthy about treatment of fibromatosis?
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Wide surgical excision because these lesions are locally aggressive
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What uncommon oral tumor-like mass is believed to be the oral counterpart of cutaneous focal mucinosis or a cutaneous myxoid cyst. The tissue is widely separated and has a myxominous look to it -- loose connective tissue. Mucinous tissue seen in these lesions is said to be hyaluronic acid. Occurs most commonly in young adults with a female gender predilection and occurs most commonly on the gingiva. Typically smooth, non0ulcerated nodular mass may be lobular or more dome shaped. Solitary, sessile, painless and the same color as the surrounding tissue.
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Oral Focal Mucinosis
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Is a Pyogenic Granuloma (pregnancy tumor) pyogenic?
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No
Means pus-producing It is not unusual for these to be covered by a pseudomembrane. For many years, it was thought that this pseudomembrane was pus, but it is not |
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Is a Pyogenic Granuloma (pregnancy tumor) a granuloma?
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No
A pyogenic granuloma is really made up of chronically inflammed granulation tissue. Granuloma: macrophages, epithloid cells (transformed histeocytes and macrophages), multinucleated giant cells, lymphocytes and a few plasma cells. Granulation tissue: fibroblasts, collagen, acute inflammatory cells and lots of blood vessels. Angiogenesis is occuring |
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This common oral tumor usually appears as an asymptomatic, red tumescence, which may be secondarily ulcerated. The site predilection is the gingiva but may be seen anywhere in the oral cavity (and body for that matter). The pyogenic granuloma can exhibit rapid growth and many early lesions bleed easily. (these features often create alarm in both the patient and dentist)
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Pyogenic Granuloma (Pregnancy Tumor)
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What is meant if something is truly peripheral?
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Peripheral = It is in the Soft Tissue, outside of bone
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What is meant if something is said to be central?
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Central = It is inside bone
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What appears as an asymptomatic red tumescence of the gingiva composed of fibroblasts and multinucleated giant cells. (this means that it can grossly appear like a pyogenic granuloma, so in a differential diagnosis, you would have to include both a pyogenic granuloma and a peripheral giant cell granuloma. Occurs in adults in the former areas of the primary teeth. Soft tissue overlying bone. However, PGCGs may produce a cupping radiolucency of the bone (eroding) superficially particularly in edentulous areas of the jaw. This is a reactive lesion associated with chronic trauma or irritation. Looks like a pyogenic granuloma, but this is an uncommon lesion.
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Peripheral Giant Cell Granuloma (Giant Cell Epulis)
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What is a reactive gingival growth that occurs Exclussively on the Gingiva. Nodular mass usually arising from the interdental papilla area. Red to pink color and often ulcerated. (Very similar to pyogenic granuloma and peripheral giant cell granuloma). Common in young adults and females, maxilla and anterior region of the jaws.
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Peripheral Ossifying Fibroma (POF) (Ossifying Fibroid Epulis, Peripheral Fibroma with Calcification, Calcifying Fibroblastic Granuloma)
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What is the treatment for POF (Peripheral Ossifying Fibroma)?
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Local surgical excision down to the periosteum to prevent recurrence.
The adjacent teeth should be scaled to eliminate irritants such as calculus. |
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What appears as asymptomatic, slow-growing, well-circumscribed, and if they are superficial enough, they may have a yellow to yellow white benign neoplasm of fat. Common elsewhere in the body, lipomas are Uncommon intraorally
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Lipoma
Benign tumor of adipose tissue |
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What is a reactive proliferation of neural tissue following transection or damage to the nerve bundle. (the nerve tries to reconnect and the nerve bundles proliferate along with scar tissue and it does so in a haphazard way, so you end up with a nodule that is smooth and typically non-ulcerated.
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Traumatic Neuroma
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What has the clinical features as smooth, non-ulcerated nodules. Predilection sites include: mental foramen, tongue, and lip. Often a Hx of trauma (possibly ill-fitting denture). May produce a radiolucent defect if bone is involved. > 50 Females. Only 25-33% are reported as painful.
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Traumatic Neuroma (Amputation Neuroma)
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What does palisade mean?
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Palisade = row, lined up
Palisaded Encapsulated Neuroma is a row of nuclei |
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What manifests as a solitary, smooth, painless, dome-shaped papule or nodule (Not a fibroma). Common in adults with NO gender predilection. Commonly involves the face, palate, and lip. Histologically well-circumscribed and encapsulated. Interlacing fascicles of spindle cells, which are probably Schwann cells. Palisading, but NO Verocay bodies of Antoni A tissue.
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Palisaded Encapsulated Neuroma
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What is a benign neural neoplasm of Schwann cell origin?
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Neurilemoma (Schwannoma)
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What are the clinical features of a Neurilemoma (Schwannoma)?
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The neurilomoma is a slow-growing, encapsulated tumor associated with the nerve trunk.
Usually asymptomatic but pain may occur Young to middle aged adults Tongue is Most Common Site May occur in bone where it may cause expansion, radiolucency, pain or paresthesia |
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What are the Histological Features of a Neurilemoma (Schwannoma)?
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1. Antoni A & B tissue (Antoni A tissue apears as streaming fascicles (palisaded) of spindle-shaped Schwann cells, these cells often form a palisades around an acellular eosinophilic area known as a Verocay body. Verocay bodies represent reduplicated basement membrane and cytoplasmic processes. Antoni B tissue is less cellular and less well organized.
Neurites Can NOT be demonstrated within the mass. They grow adjacent ot the nerve trunk. |
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Can Neurilemomas be malignant?
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Yes Extremely rare malignant transformation
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What condition has the clinical features of soft, single or multiple, asymptomatic nodules covered by epithelium. Intraorally, they may appear as the same color as or lighter in color than the surrounding mucosa. Most frequently they are found on the tongue, buccal mucosa and vestibule but may occur anywhere. No Age or Gender Predilection.
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Neurofibroma/Neurofibromatosis
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What condition is inherited as an autosomal dominant trait, but 50% of patients have no family Hx. Causes mutations toa specific gene located on chromosome 17q11.2 that is responsible for suppressor protein known as Neurofibromin?
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Neurofibroma
mutation is in NF1 (neurofibrosis I; von Recklinghausen disease of skin) |
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When is the diagnostic criteria met for Neurofibromatosis Type I?
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if a patient has two or more of the following features:
1) Six or more Cafe au Lait macules over 5 mm in diameter for prepubertal persons and over 15 mm in pospubertal persons. 2. Two or more neurofibromas of any type or one plexiform neurofibroma 3. Freckling in the axial or inguinal regions 4. Optic glioma 5. Two or more Lisch nodules (irish hamartomas) 6. A distinctive osseous lesion such as sphenoid dysplasia or thinning of long bone cortex with or without pseudoarthrosis 7. A first degree relative with neurofibromatosis type I |
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What is one of the most feared complications of neurofibromatosis?
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Development of cancer (neurofibrosarcoma or malignant schwannoma), which has been reported in up to 5% of the cases
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What are these clinical features indicative of? Multiple neuromas more common on the lips, tongue and buccal mucosa. Oral neuromas present as soft, painless papules or nodules. Patients have marfanoid features. lips thick because of proliferation of nerve bundles. Of greatest significance is the development of Medullary Carcinoma of the Thyroid. May develop a pheochromocytoma and an associated hypertensive problem.
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Multiple Endocrine Neoplasia Type 2B (MEN Type 2B or III) (Multiple Endocrine Neoplasia Type III, Multiple Mucosal Neuroma Syndrome)
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