Benign Mesenchymal Tumors - part I Flashcards

1
Q

tissue of mesoderm origin

A
  1. fibrous
  2. adipose
  3. nerve
  4. blood
  5. lymph
  6. muscle
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2
Q

fibrous benign mesenchymal tumors

A
  1. fibroma
  2. inflammatory fibrous hyperplasia
  3. inflammatory papillary hyperplasia
  4. pyogenic granuloma
  5. peripheral giant cell granuloma
  6. peripheral ossifying fibroma
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3
Q

what causes fibroma (irritation fibroma)?

A

collagen deposition secondary to trauma

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4
Q

T/F: true fibromas are neoplasms, but controversy as to whether irritation fibromas are

A

true

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5
Q

what are considered fibromas?

A
  1. frenal tag

2. retrocuspid papilla

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6
Q

where does fibromas affect?

A

buccal mucosa and tongue (but potentially any mucosal surface)

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7
Q

clinical features of fibroma

A
  1. smooth or slightly papillary surface
  2. dome-shaped
  3. sessile or pedunculated
  4. most 1.5 cm or less
  5. may ulcerate if traumatized
  6. asymptomatic unless traumatized
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8
Q

frental tag

A

small, innocuous growth easily diagnosed clinically

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9
Q

tx for frenal tag

A

none necessary

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10
Q

retrocuspid papilla

A

bilateral papular lesions on the gingiva lingual to the mandibular canines

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11
Q

histopathologic features of fibroma

A

nodular mass of dense fibrous CT

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12
Q

tx of fibroma

A

conservative excision

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13
Q

T/F: recurrence of fibroma is rare

A

true

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14
Q

what is inflammatory fibrous hyperplasia (IFH) also known as?

A
  1. denture epulis
  2. epulis fissuratum
  3. denture-induced fibrous hyperplasia
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15
Q

clinical features of IFH

A
  1. flange of ill-fitting denture

2. may have central fissure/ulcer

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16
Q

histopathologic features of IFH

A

fibrovascular CT covered by stratified squamous epithelium

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17
Q

tx of IFH

A
  1. conservative excision

2. remake denture

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18
Q

prognosis of IFH

A

excellent if appropriately treated

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19
Q

what is inflammatory papillary hyperplasia (IPH) also known as?

A

denture papillomatosis - may have superficial candidiasis

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20
Q

what causes IPH?

A
  1. ill-fitting maxillary denture
  2. poor denture hygiene
  3. wearing denture 24/7
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21
Q

clinical features of IPH

A
  1. numerous asymptomatic red/erythematous papules

2. central region of hard palatal mucosa

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22
Q

IPH affects the central region of hard palatal mucosa due to what?

A
  1. maxillary denture
  2. high palatal vault
  3. habitual mouth breathers
23
Q

histopathologic features of IPH

A
  1. papillary surface

2. edema (accumulation of fluid in the extracellular spaces of a tissue)

24
Q

tx of IPH

A
  1. topical or systemic antifungal therapy
  2. removal of the denture may allow the erythema and edema to subside
  3. excise hyperplastic tissue before fabricating a new denture
25
Q

prognosis of IPH

A

good after tx if pt keeps denture out and keeps it clean

26
Q

reactive lesion

A

exuberant response to local irritation or trauma (hyperplastic granulation tissue)

27
Q

T/F: pyogenic granuloma is a reactive lesion

A

true

28
Q

when does pyogenic granuloma frequently occur?

A

during pregnancy “pregnancy tumor”

29
Q

T/F: pyogenic granuloma is neither “pyogenic” nor a “granuloma”

A

true

30
Q

T/F: pyogenic granuloma is unrelated to an infection

A

true

31
Q

T/F: pyogenic granuloma is not a true granuloma

A

true

32
Q

clinical features of pyogenic granuloma

A
  1. rapid growth
  2. painless
  3. red
  4. often ulcerated
  5. any body surface
  6. bleeds easily
33
Q

what are the most common intraoral sites for pyogenic granuloma?

A

gingiva

34
Q

what are the intraoral sites for pyogenic granuloma?

A
  1. gingiva
  2. lips
  3. tongue
35
Q

if something is growing out of a socket, what are the 3 options?

A
  1. epulis granulomatosa
  2. lymphoma
  3. metastatic disease
36
Q

what is epulis granulomatosa also known as?

A

liver clot

37
Q

histopathologic features of pyogenic granuloma

A

vascular granulation tissue

38
Q

vascular granulation tissue histopathologically

A

proliferation of fibroblasts and new thin-walled capillaries and inflammatory cells (plasma cells, lymphocytes) in a loose extracellular matrix

39
Q

tx of pyogenic granuloma

A

excise, remove irritants

40
Q

T/F: pyogenic granuloma recurs

A

true (15% recur)

41
Q

T/F: peripheral giant cell granuloma is a reactive lesion

A

true

42
Q

clinical features of peripheral giant cell granuloma

A
  1. painless

2. dusky purple-red

43
Q

where does peripheral giant cell granuloma only affect?

A

only on gingiva of alveolar ridge, including edentulous ridge

44
Q

radiographic features of peripheral giant cell granuloma

A

cupping of underlying bone sometimes is seen

45
Q

histopathologic features of peripheral giant cell granuloma

A

granulation tissue with numerous benign multinucleated giant cells

46
Q

tx of peripheral giant cell granuloma

A

excise, remove irritants

47
Q

T/F: peripheral giant cell granuloma will recur

A

true, 15% recur

48
Q

T/F: peripheral ossifying fibroma is a reactive lesion

A

true

49
Q

clinical features of peripheral ossifying fibroma

A
  1. painless
  2. firm
  3. coral-pink
  4. may be ulcerated
50
Q

where does peripheral ossifying fibroma occur?

A

found only on the gingiva

51
Q

histopathologic features of peripheral ossifying fibroma

A
  1. cellular fibrous CT

2. variable amounts of calcification

52
Q

tx of peripheral ossifying fibroma

A

excise, remove irritants

53
Q

T/F: peripheral ossifying fibroma recurs

A

true, 15% recur

54
Q

which fibrous lesions are “bumps on the gums”?

A

“3 P’s”

  1. pyogenic granuloma
  2. peripheral giant cell granuloma
  3. peripheral ossifying fibroma