5. Soft Tissue Developmental Lesions

Question 1

What is the DD of Macroglossia due to Neoplasms and Hamartomas?

Answer 1

He Likes Naked Sexy Models

Hemangioma

Lymphangioma

Neurofibroma (NF)

Schwannoma

MEN 2B/3

Question 2

What is the DD of Macroglossia due to Endocrine?

Answer 2

Myxedema/Cretinism

Acromegaly

Question 3

What is the DD of Macroglossia due to Other Developmental/Genetic?

Answer 3

Coming Home During My Break

Congenital

Hemihypertrophy

Down Syndrome

Mucopolysacharidoses

Beckwith Hypoglycemia Sx

Question 4

What is the DD of Macroglossia due to Acquired Reasons?

Answer 4

Amyloidosis (multiple myeloma)

Physiologic - loss of teeth

Question 5

• Scalloped edges are aquired and due to constant pressure of tongue against lingual surfaces of teeth
• Can cause Burning Mouth

Answer 5

Crenated Tongue

Question 6

What is the major associated factor causing Fissured Tongue?

Answer 6

Geographic Tongue (BMG)

Question 7

Most common site of Geographic Tongue (BMG)

Answer 7

anterior dorsolateral tongue

Question 8

What will the biopsy of BMG yeild histologically?

Answer 8

• Neutrophilic Munro micro-abscesses
• Elongation of rete ridges

Question 9

Besides BMG what else is Fissured Tongue associated with?

Answer 9

Melkersson-Rosenthal Sx

Question 10

What looks like Geograhic Tongue but on the soft palate, and requires presence of typical tongue Geographic Tongue to be dx?

Answer 10

Migratory Stomatitis

Question 11

Red, depapillated patch on midline, posterodorsal tongue (rare site of cancer)?

Answer 11

Median Rhomboid Glossitis

Question 12

What was the theorized etiology of Median Rhomboid Glossitis?

Answer 12

Developmental failure of tuberculum impar to disappear

proven non-developmental (not in children)

Question 13

Some cases of what disease have kissing lesions in soft palate that represent candida or hypersensitivity rxn to candida antigens. CITNIP

Answer 13

Median Rhomboid Glossitis

Question 14

What does the Histology of Median Rhomboid Glossitis Show? (4)

Answer 14

• Absence of papilla
• Chronic inflammation
• Candida in parakeratin
• PEH

Question 15

What is the discoloration of Hairy Tongue from?

Answer 15

• Chromphilic organisms
• Fe sulfide from bact reduction
• Tobacco, coffee, tea

Question 16

What are the Etiologic associations of Hairy Tongue?(6)

Answer 16

The Poor Old Asain Ate Ramen

Tobacco

Poor Oral Hygiene

Oxidizing Mouthwashes

Antacids

Antibiotic

Radiation Rx to Head and Neck

Question 17

Developmental disorder where lingual frenum is too thick, too short, and is attached close to the tip, limiting movement

Answer 17

Ankyloglossia

Question 18

When must you tx Ankyloglossia?

Answer 18

when tongue is fully developed (age 5)

Question 19

Varicose veins of the ventral tongue seen in elderly

Answer 19

Lingual Varices

Question 20

• Ectopic intraoral sebaceous glands in 80% of population
• Appear as soft, yellow granules

Answer 20

Fordyce Granules

Question 21

What are the locations of Fordyce Granules (in order)?

Answer 21

1. Bilateral Buccal Mucosa
2. Upper Lip Mucosa
3. Retromolar Pad
4. Alveolar Mucosa

Question 22

• Generalized white lesion, bilateral buccal mucosa
  
  • ​Not limited to buccal bite line
• Lobulated appearance with veil-like translucency
• Tends to disappear when stretched

Answer 22

Leukoedema

Question 23

What helps in the DD and what is the DD of Leukoedema?

Answer 23

Tends to disappear when stretched

• Lichen planus
• Hereditary Benign Intraepithelial Dyskeratosis
• White Sponge Nevus
• Candidiasis

Question 24

Developmental blind pits or depressions in commissures or on lower vermillion on both sides of midline

Answer 24

Lip Pits

Question 25

Appears as smooth, shiny, red/orange, soft elevations

Answer 25

Reactive Lymphoid Tissue

(Ectopic Lymphoid Tissue)

Question 26

What are the 3 intraoral locations of Reactive Lymphoid Tissue?

Answer 26

1. Posterolateral Tongue (foliate papilla area)
2. Fauces and Soft Palate
3. FOM

Question 27

• Any ectopic lyphoid tissue has surface epithelial infoldings (crypts) that can become entrapped and collect keratin - thus forming a cyst
• Round, soft, opaque, cream colored
• Don’t mistake for Fordyce Granule

Answer 27

Lymphoepithelial Cyst

Question 28

A Branchial Cleft Cyst is a large lymphoepithelial cyst developing in a …

Answer 28

cervical lymph node

MUST BE in the lateral neck

Question 29

• Developmental cystic teratoma from totipotential cells in the midline FOM as a doughy mass growing slowly
• Children and young adults
• Histo - sebaceous glands in wall (sebum –> doughyness)

Answer 29

Dermoid Cyst

Question 30

What are the 3 things a Thyroglossal Duct Cyst must be?

Answer 30

1. Midline
2. Anterior to larynx
3. Elevates when pt swallows or protrudes tongue

Question 31

• Rare cyst located in the alveolar mucosa in the area of the upper lateral and canine
• Raises ala
• Obliterates vestibule

Answer 31

Nasoalveolar (Nasolabial) Duct Cyst

Question 32

Where does the Nasoalveolar Duct Cyst arise from?

Answer 32

Nasolacrimal duct

Question 33

• Present in almost all newborns and disappear spontaneously in several weeks
• Small white line of bumps represent keratin inclusion cysts

Answer 33

Epstein Pearls

Question 34

What are epstein pearls derived from?

Answer 34

entrapped epithelium along midline closure of hard palate

Question 35

• Little areas of keratin forming cysts along edentulous ridges
• Kinda look like baby teeth

Answer 35

Dental Lamina Cyst

Question 36

Bohn’s nodules are similar to Epstein pearls, except …

Answer 36

junction of the hard and soft palate = vibrating line