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Oral Disease - Soft tissue > Benign neoplasms and inflammatory lumps > Flashcards

Benign neoplasms and inflammatory lumps Flashcards

1
Q

List some inflammatory lumps that can arise in the oral cavity

A
  • Fibroepithelial polyp
  • Fibrous epulis (and ossifying fibrous epulis)
  • Denture induced fibroepithelial hyperplasia
  • Pyogenic granuloma
  • Giant cell epulis
  • Mucocele
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2
Q

List the benign neoplasms and hamartomas that may arise in the oral cavity

A
  • Papilloma
  • Lipoma
  • Nerve sheath tumours
  • Granular cell tumour
  • Haemangioma
  • Lymphangioma
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3
Q

Define hamartoma

A

Benign, tumour-like malformation made of an abnormal mixture of cells and tissues found in areas of the body where it grows

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4
Q

What is a fibroepithelial polyp?

A

Most common benign epithelial tumour associated with minor trauma

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5
Q

Describe the presentation of the fibroepithelial polyp

A

Firm, pink and painless swelling
The surface may be white due to frictional keratosis
Most commonly found on the buccal mucosa (level with occlusal plane), lips or tongue
Superficial (above the muscle)

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6
Q

Tx of fibroepithelial polyp and fibrous epulis

A

Excision with a base of normal tissue

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7
Q

What is a fibrous epulis?

A

Fibroepithelial polpy located on the GINGIVA due to hyperplasia

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8
Q

Describe the presentation of fibrous epulis

A

Painless, firm, pink

Located on the interdental papilla of anterior teeth

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9
Q

Aetiology of fibrous epulis

A

Trauma and chronic irritation e.g. subgingival calculus

Drug induced

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10
Q

How do inflammatory hyperplasias develop?

A

Encourages by increased capillaries, ulceration, collagen

With less blood vessels, more collagen and intact epithelium a polyp generally forms

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11
Q

What is ossifying fibrous epulis

A

Lesion composed of cellular fibroblastic granulation tissue but contains bone or cementum-like mineralisations (fibrous epulis with bone formation)

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12
Q

What is denture-associated hyperplasia?

A

Formation of hyperplastic tissue associated with the margin of an ill fitting denture

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13
Q

Describe the presentation of denture-induced hyperplasia

A
  • Vary in size and shape
  • Firm consistency (firbous) without gross inflammation
  • May be ulcerated where the flange sits
  • May appear like a flat leaf in the palate
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14
Q

Tx of denture-induced hyperplasia

A
  • Denture hygiene

- Tx of superimposed candida infection if present

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15
Q

What is a pyogenic granuloma

A

Ulcerated nodule of granulation tissue

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16
Q

Describe the presentation of a pyogenic granuloma

A
  • Found on the gingiva, tongue, BM due to trauma

- Red with yellow slough (ulceration) and white margin due to keratinisation

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17
Q

Aetiology of pyogenic granuloma

A

OCP
Pregnancy
Puberty

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18
Q

Histology of pyogenic granuloma

A

Inflammatory cell infiltrate usually prominent under ulcerations
Vascular proliferation and an oedematous cellular fibrous stroma

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19
Q

Describe the presentation of giant cell epulis

A
  • Gingival margin between teeth anterior to molars
  • Round and soft swelling
    Dark red, blue or purple
  • Usually singular
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20
Q

Histology of giant cell epulis

A

Multiple multinucleate cells lying in a vascular stroma below the superficial epithelium
Highly vascular and haemosiderin present

21
Q

Tx of giant cell epulis

A

Excision along with the gingival base

Underlying bone curetted

22
Q

What is a papilloma

A

Benign nodule most probably caused due to human papillomavirus (HPV)

23
Q

Describe the presentation of papilloma

A
  • Spiky exophytic or round cauliflower shapes
  • May have a white surface due to keratinisation
  • Can be multiple
  • Any aspect of the mucosa but common on dorsal tongue
24
Q

Epidemiology of papilloma

A

Children and immunocompromised (HIV)

25
Q

Histology of squamous papilloma

A

Stratified squamous epithelium with a vascular connective tissue core
Most are keratinised giving a white surface

26
Q

Are papillomas premalignant?

A

No

27
Q

Tx of papilloma

A

Local excision

V difficult if extensive lesions

28
Q

What are the two types of nerve sheath tumours?

A

Schwannomas

Neurofibromas

29
Q

What are nerve sheath tumours?

A

Benign neoplasms of supporting tissues of the nerves

30
Q

What are schwannomas?

A

Benign neoplasms arising from schwann cells (S100 positive)

31
Q

What are neurofibromas?

A

Uncommon benign tumour arising from the nerve sheath, forming a smooth, painless lump located intraorally, on the skin or GI tract

32
Q

What is it called when there are multiple neurofibromas?

A

Neurofibromatosis

33
Q

Describe the presentation of granular cell tumours

A

Asymptomatic
Smooth swelling
Common on the tongue (can occur anywhere on the mucosa, skin or GI tract)

34
Q

Histology of granular cell tumours

A

Large granular cells originating from Schwann cells (S100 positive)
Merge with muscle

35
Q

Tx of granular cell tumours

A

Simple excision

36
Q

Why are granular cell tumours often mistaken for carcinoma?

A

Histology shows hyperplasia of the epithelium

37
Q

What is a haemangioma?

A

Haemartoma of blood vessels (vascular malformation)

38
Q

Describe the presentation of haemangiomas

A
  • Localised (can be diffuse) often on the lip or tongue

- Flat or nodular, purple which blanch on pressure

39
Q

Histology of haemangiomas

A

Highly vascular

Can be capillary or cavernous vessels, or both

40
Q

What is Sturge-Weber syndrome?

A

Haemagiomas occuring on the meninges, causing epilepsy and a mental defect

41
Q

Tx of haemangiomas

A

Excsision is avoided due to risk of excessive bleeding

Cryosurgery may be carried out instead

42
Q

What is a lymphangioma

A

Haemartoma of lymphatic vessels

43
Q

Describe the presentation of lymphangiomas

A

Pale or transluscent
Smooth or nodular elevations
Can suddenly swell and becomme dark-purple and symptomatic
Macroglossia or enlargement of the tongue

44
Q

Why may a lymphangioma become purple?

A

Due to bleeding into the lymphatic space

45
Q

Histology of lymphangiomas

A

Thin walls and vascular spaces with amorphous material (due to fixated lymph)
Special strains may show the lymphatic endothelial cells

46
Q

Tx of lymphangiomas

A

Excise if localised

Staged surgery if diffuse

47
Q

What is a lipoma?

A

Benign neoplasm of adipose tissue due to encapsulated lobules of mature fat cells
Rare in the oral cavity

48
Q

Presentation of lipoma

A

Yellow tinted lesion, may be pedunculated
Occur on areas not prone to trauma
Slow growth

Oral Disease - Soft tissue (12 decks)

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