Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Oral Pathology Exam 3 > 7. Giant Cell Lesions > Flashcards

7. Giant Cell Lesions Flashcards

1
Q

What is the common denominator of Giant Cell Lesions?

A

Similar histology

  • Cellular mononuclear round and spindly cell stroma studded by clusters of foreign body-type giant cells (big cell with lots of nuclei, that looks like osteoclasts
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What is the most common Giant Cell Lesion?

A

Central Giant Cell Granuloma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What is the pathogenesis of the Central Giant Cell Granuloma?

A

Reactive lesion, but we aren’t sure what it is reacting to.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What population is affected by Central Giant Cell Granulomas?

A
  • 10 - 20 yrs, rare after age 25
  • Female 2:1
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Where can a Central Giant Cell Lesion occur, and which location is the most common? (4)

A

ONLY in jaws

  • Anterior Mandible most common
  • Can be almost anywhere
  • Rare posterior to 2nd molars
  • Won’t be seen in the 3rd molar or ramus area
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What is the radiographic appearance of the Central Giant Cell Granuloma?

A
  • Ill-defined multilocular, periapical RL causing root resorption, and destroying crestal bone
    • Always RL, no RO
  • No respect for midline
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What is the gross appearance of the Cental Giant Cell Granuloma?

A

Brown, liver-like curetting’s

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What is the standard treatment for the Central Giant Cell Granuloma? (2)

A
  • Curretage is standard treatment that makes alot of them go away
  • Must get serum calcium test to rule out Giant Cell Lesion of Hyperparathyroidism, especially if they are over age 25
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What is the treatment for the large, fast growing or recurrent lesions of Central Giant Cell Granuloma? (4)

A
  • Shrink the lesions then curettage
    • Steroid injections and Calcitonin to shrink
  • Bisphosphonates
  • Alpha interferon, but it has risky side effects = Lupus Erythematous
  • If non-responsive to curretage then Block Excision
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What is the prognosis for Central Giant Cell Granuloma?

A
  • Overall recurrence rate = 15-20%
    • 50% for aggressive lesions
  • 2 year follow-up, it will not recur after 2 years
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What makes a Central Giant Cell Granuloma more likely to be aggressive? (6)

A
  • > 3cm
  • Ramus, even though not expected here
  • Very young children (2-3 yrs old)
  • Resorb roots, displace teeth or perforate bone
    • already being aggressive
  • Pain
  • Rapid growth
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What is the single most important histologic predictor of aggressiveness in Central Giant Cell Granulomas?

A

No osteoid formation

The formation of osteoid on the perimeter of the lesion is a good sign, that indicates that it is trying to heal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What is the pathogenesis of the Aneurysmal Bone Cyst?

A
  • Not a true cyst
  • A metabolic condition caused by hyperparathyroidism
    • Excess PTH mobilizes calcium out of bone
    • Replaced by a mass of vascular granulation tissue containing osteoclastic giant cells
  • Often associated with other lesions:
    • Might represent a Giant Cell Granuloma that has maintained vascular channels, allowing it to continue to grow
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What is the behavior of the Aneurysmal Bone Cyst?

A
  • Crazy fast growing (within a week)
  • Painful, tender swelling, causing deformity simulating infection or malignancy
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Where do Aneurysmal Bone Cysts occur?

A

Long Bones, rare in jaws

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Who is affected by Aneurysmal Bone Cysts?

A
  • Most cases in children and young adults
  • Equal M:F
17
Q

What is the radiographic appearance of the Aneurysmal Bone Cyst?

A
  • Unilocular or multilocular BLOWOUT of affected bone
18
Q

What are the surgical findings of the Aneurysmal Bone Cyst?

A
  • At surgery a blood-filled honeycombed mass is found and curetted out
  • Care is needed to identify any associated lesion (fibro-osseous lesion)
  • Follow-up for 50% recurrence
19
Q

What are the other names for Osteitis Fibrosa Cystica?

A
  • von Recklinghausen Disease of Bone
  • Brown Tumor of Hyperparathyroidism
20
Q

What is the radiographic appearance of Osteitis Fibrosa Cystica?

A
  • Unilocular RL destroying bone
21
Q

What is the histology of Osteitis Fibrosa Cystica?

A
  • Same as CGCG so differentiate with calcium levels
22
Q

What population does Osteitis Fibrosa Cystica affect?

A

Adult Females

23
Q

What are the typical presenting symptoms of Osteitis Fibrosa Cystica?

A
  • Hyperparathyroidism
  • Elevated serum calcium
24
Q

What is the gross appearance of Osteitis Fibrosa Cystica?

A

Red in the mouth, turns brown in formalin

25
Q

What is the etiology of Cherubism?

A

Autosomal Dominant

100% penetrance in males

50-75% penetrance in females

26
Q

What age group is affected by Cherubism?

A

Begins in childhood > 2 yrs, continuing until puberty “chipmunck cheeks”

Stabalizing, then regressing until it disappears by age 30

27
Q

What is the clinical presentation of Cherubism?

A
  • Slow, painless, symmetrical, bilateral jaw expansion
  • Severe cases destroy tooth buds and interefere with speech, swallowing, and breathing
28
Q

What is the classic radiographic presentation of Cherubism?

A
  • Bilateral, multilocular RL
  • Always begins in the posterior mandible continuing towards the midline
    • May continue anteriorly to affect the entire mandible with multilocular lesions
  • Always bilateral in posterior mandible and ramus
    • Condyles are spared
29
Q

What is the radiographic presentation of Cherubism if the maxilla is affected? (3)

A
  • Starts in the posterior and moves anteriorly
  • Bilaterally affects maxillary tuberosity, palate and orbits
  • Raises cheeks and causes eyes to gaze upward toward heaven
30
Q

What is the treatment for Cherubism?

A
  • Do nothing - it resolves spontaneously
  • Genetic Counseling
  • In severe cosmetic, malfunctioned or life threatening cases, surgery can be performed
    • Surgery = rapid regrowth of grotesque deformity
31
Q

What treatment is contraindicated in pts with Cherubism?

A

Radiation contraindication, it can cause sarcomatous transformation

32
Q

What is the other name for the True Giant Cell Tumor?

A

Osteoclastoma

33
Q

Where do True Giant Cell Tumors occur?

A

Low grade malignancy of the long bones

NOT IN JAWS

34
Q

How do True Giant Cell Tumors present in the extremely rare case that they present in the jaws?

A

In the mandibular symphysis and may be associated with Paget’s Disease

35
Q

What population do True Giant Cell Tumors affect?

A

Young adults, > 20 yrs old

CGCG is rare in pts > 25, and prefers females

36
Q

What is the prognosis for a pt with True Giant Cell Tumors?

A

50% recurrence with surgery - hard to remove

10% metastasize

Oral Pathology Exam 3 (8 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions