Benign Fibroproliferative Lesions Flashcards
In general firm and pink lesions are made of? Soft and red?
Dense fibrous connective tissue
Granulation tissue
Localized hyperplasias are typically in response to?
Trauma or repeated irritation
Describe the appearance of a pyogenic granuloma in terms of color, pedunculated or sessile, growth rate.
Fiery red nodule that can be pedunculated or sessile. Tends to grow very quickly
Where can pyogenic granulomas occur and what may cover them?
Anywhere in the mouth. Can be covered by a fibropurulent pseudomembrane
What can pyogenic granulomas become as they mature?
Irritation fibromas
What tissues are seen in a pyogenic granuloma? Describe the appearance of the overlying SSE
Granulation tissue with acute or chronic inflammatory cells
The overlying SSE is typically atrophic and or ulcerated
What is the classification for the particularly prominent areas of gingival enlargement seen in hyper plastic gingivitis?
Localized hyperplastic gingivitis. They can resemble pyogenic granulomas
What is a pregnancy tumor and what causes them?
A pyogenic granuloma that appears during pregnancy. The hormone changes causes an increased response to local irritants
What can trigger a post-extraction granuloma, i.e. epulis granulomatosum? What is the ddx?
Fragments of alveolar bone in the empty socket. These can also be aggressive tumors
What color is a typical irritation fibroma?
usually normal colored or slightly paler than the surrounding mucosa
Are irritation fibromas sessile or pedunculated? Attached or unattached?
Usually sessile more often than pedunculated. They are attached to the connective tissue
What tissues make up an irritation fibroma? The SSE covering the lesion can be described as?
Dense fibrous connective tissue. The covering is hyper plastic and sometimes keratinized
What is another name for denture hyperplasia?
Epulis fissuratum
What is an epulis fissuratum lesion composed of?
Collagenous fibrous connective tissue with areas of granulation tissue
Most cases of palatal papillary hyperplasia occur due to?
Upper denture use
What are causes of palatal papillary hyperplasia in non-denture wearers?
Local predisposing factors and being immunocompromised
Palatal papillary hyperplasia gives the palate a ____ appearance?
Cobblestone
What tissues are seen in palatal papillary hyperplasia?
Proliferating epithelium covering inflamed granulation tissue. Candidal hyphae are sometimes seen
Where is peripheral ossifying fibroma typically seen?
On the interdental gingiva
What does the lesion look like?
Typically a firm, well-defined, red or pink nodule
How can an ossifying fibroma be distinguished radiographically from irritation fibroma?
The extensive calcified tissue may cause irregular opacities to appear
What is seen histologically that allows one to make the diagnosis of peripheral ossifying fibroma?
Fibrous connective tissue containing osteoid, bone, or cementum
Why do peripheral ossifying fibromas have a higher recurrence rate than irritation fibromas and PGs?
they arise from deeper tissues like the PDL or alveolar crest
What is parulis?
Abscess in the gingiva derived from an acute infection of a non-vital tooth
Where is a parulis typically seen and what color is it?
Red or yellow and forms at the mucogingival junction
What is non-specific inflammatory gingival hyperplasia?
Associated with plaque, scurvy, or hormonal imbalance. Tend to be red
What is non-specific fibrous gingival hyperplasia?
Associated with drugs and inherited abnormalities leading to enlargement without local irritants. Pink and firm enlargement
Foreign body reactions present as?
Sessile nodules
When viewed under polarized light the foreign substance may appear?
Birefringent
What tissues are seen in foreign body reactions?
Inflamed granulation tissue with giant cells
What are pseudo sarcomatous reactive hyperplasias? What are they often mistaken for?
Rapidly growing ill-defined enlargements
Often mistaken for malignancies, initial microscopic investigation suggests sarcoma
Herniated sinus lining occurs where?
At the site of recent tooth extraction
Foliate papillitis is what structure? They contain what kind of tissue?
Vestigial lingual papillae. They contain lymphoid tissue
Transient lingual papillitis presents as? Is it painful?
One to several small red or yellow papule on the anterior surface of the tongue. Moderately painful
What is the name of a blood blister which only lasts a few minutes and then spontaneously ruptures?
Angina bullosa hemorrhagica
Fibromatoses typically affect who?
Juveniles or young adults
What is seen histologically in fibromatoses?
Proliferation of bland spindle cells with variable amounts of collagen
How do you treat fibromatoses?
Wide excision
Giant cell lesions are sessile or pedunculate?
Either
New PGCLs are what color and consistency? Older ones?
Violet to dark red and soft, old lesions are pink and firm
What can a PGCL cause on an edentulous ridge?
Cuffing of bone
