10 Epithelial Pathologies Flashcards
What is this?
acquired melanocytic nevus
What is this?
basal cell carcinoma
What results from UV radiation and is most common of all cancers?
Basal cell carcinoma
What is a common pathology in elderly that presents as flat tan to brown macules?
Seborrheic keratosis
What is this?
Amalgam tattoo (ha! and you thought it was oral melanoacanthoma)
What is this?
erythroplakia
What is technical term for a birth mark?
congenital melanocytic nevus
A cousin of the ephilis, what is this?
oral melanotic macule
An ephilis on the vermillion border.
What is a Labial melanotic macule?
What are risk factors for melanoma?
- fair complexion
- light hair
- sunburns easily
- blistering sunburns as child
- hx of melanoma
- hx of congenital nevus
What is this?
Seborrheic keratosis
What is this?
basal cell carcinoma
What could this be?
Heck’s disease (multifocal epithelial hyperplasia)
Which five types of HPV mostly cause condylomas?
HPV 6, 11, 16, 18, 31
What mostly causes oral melanoacanthoma and where is it typically found in the mouth?
trauma, found on buccal mucosa
What viruses causes Squamous papilloma?
HPV 6, 11
Give a differential diagnosis.
- Squamous papillom
- Veruccous vulgaris
- Condyloma accuminatum
- Verucciform xanthoma
Define stage 2 SCCA.
tumor is more than 2cm but less than 4cm across, no infected nodes or mets
What is this? What features might give it away?
Basal cell carcinoma. Rolled borders and telangiectatic blood vessels.
What are six etiologies of leukoplakia?
- tobacco
- alcohol
- sanguinaria
- UV radiation
- microorganisms
- trauma
Biopsy shows it’s caused by HPV 2, 4 & 40. What is this?
Verruca vulgaris
If there are scattered red patches that cannot be removed or identified, what is this termed?
erythroplakia
Sudden appearance of many seborrheic keratosis and pruritis is associated with what other finding?
internal malignancies (condition called Leser-Trélat sign)
What is this? What increases your risk for this in childhood?
Basal cell carcinoma. Frequent sunburns and freckles increases risk
What is this?
Actinic cheilosis
An oral melanotic macule looks like ________, so if you can’t confidently identify it you should biopsy the site.
OMM looks like early melanoma (don’t be fooled!)
Give a differential diagnosis.
- squamous papilloma
- verruca vulgaris
- condyloma acuminatum
- verruciform xanthoma
How do you define leukoplakia?
An intraoral white plaque that cannot be wiped off and cannot be identified as any well known entity.
These don’t get darker with sun exposure. What are they?
Actinic lentigo
Define a stage 1 SCCA.
tumor size is 2cm or less, and there aren’t any infected lymph nodes or metasteses
What would you ask this person?
Do you use smokeless tobacco?
What type(s) of HPV cause Mulitfocal Epithelial Hyperplasia?
HPV 13, 32
Doesn’t darken with sun exposure. Is there risk for malignant transformation?
No. Actinic lentigo has no risk of malignant transformation
What is this?
(Smokeless) tobacco pouch keratosis
Occurred after pregnancy. What is this called?
Melasma
What is the real name for snuff dipper’s cancer?
Verrucous carcinoma
What type(s) of HPV cause Condyloma Acuminatum?
Most commonly HPV 6, 11. High risk for HPV 16, 18, 31
These get darker with sun exposure. What are they?
Ephilis (freckles)
It’s black so what do you think it is?
Melanoma
Define stage 3 SCCA.
Tumor is more than 4cm across; OR the tumor is any size and a lymph node is involved
Mostly affecting the mandibular vestibule and gingiva. What is this?
Verrucous carcinoma
If this could be wiped off, what could it be?
- materia alba
- chemical burn
- thermal burn
- pseudomembranous candidiasis
- sloughing from toothpaste
What is this?
nicotine stomatitis
Similar to seborrheic keratosis, what is this?
Dermatosis papulosa nigra
What is this?
melanoma
What likely causes verucciform xanthoma?
trauma (NOT a virus)
Not an amalgam tattoo. Where do these lesions typically occur?
Blue nevi typical on the palate
What system do you use to help identify melanoma?
ABCDE: asymmetry, border irregularity, color variation, diameter >6mm, and evolving lesions
Your patient is concerned about this turnign into cancer. What do you tell her?
Melasma has no risk of malignant transformation
What is the diagnosis? What are the red spots?
Nicotine stomatitis, red spots are inflamed minor salivary glands
What are 12 possible contributing factors to squamous cell carcinoma?
- tobacco
- alcohol
- betel quid
- phenolic agents
- radiation
- iron deficiency
- vitamin-A deficiency
- syphilis
- oncogenic viruses
- immunosuppression
- oncogenes, and tumor suppressor genes
- 13.
Where are the two most common sites for squamous cell carcinoma?
Tongue and floor of mouth
What causes melasma?
Hormonally-driven hyperpigmentation of the sun exposed areas of the face
What is caused by HPV 13 and 32?
Multifocal epithelial hyperplasia (heck’s disease)
What causes this?
Long-term UV exposure
An acquired melanocytic nevus is a proliferation of cells from what?
The neural crest
Cannot be wiped off. What is it?
leukoplakia
This pt chews betel quid. What is this pathology?
oral submucous fibrosis
How long should it take for this to resolve if habit is ceased?
2 weeks
Caused by HPV 16, 18, 31. What is it?
condyloma accuminatum
What are the two directional growth patterns of melanoma?
Radical and vertical
What three sites are most common to find this?
Floor of mouth, ventral tongue, soft palate
Define stage 4 SCCA
Any tumor >4cm, any tumor in a node >6cm, and mets present
What type(s) of HPV cause Verruca Vulgaris?
HPV 2, 4, 6, 40
This man cannot open his mouth any further than what is shown because his tissue isn’t elastic enough. What is his condition?
oral submucous fibrosis
What is this?
Basal cell carcinoma
If not melanoma, what could this be?
Oral melanoacanthoma
What are some pathologies most likely to progress into verrucous carcinoma?
- Proliferative verrucous leukoplakia
- nicotine stomatitis
- erythroplakia
- oral submucous fibrosis
- erythroleukoplakia
- granular leukoplakia
- actinic cheilosis
Pt smokes tobacco. Based on location, what do you think this is?
Squamous cell carcinoma (tongue is most common place to find it)
On the hard palate. What could this be?
Blue nevus
(less likely an amalgam tattoo)
Biopsy shows it’s caused by HPV 6 & 11. What is this?
Squamous papilloma
What is the major causative factor for melanoma?
Acute UV radiation exposure
