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Oral Disease > Benign Neoplasms and Reactive Lesions > Flashcards

Benign Neoplasms and Reactive Lesions Flashcards

1
Q

Summarise Localised- epulides (5)

A
  • Fibrous hyperplasia (fibro-epithelial polyp)
  • Pyogenic granuloma
  • Peripheral giant cell granuloma
  • Gingival cysts
  • Bohns nodules
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2
Q

List Generalised swellings of gingival tissues (6)

A
  • Chronic hyperplastic gingivitis
  • Leukaemic infiltration
  • Endocrine related (puberty, pregnancy)
  • Crohn’s disease
  • Gingival fibromatosis
  • Drug induced hyperplasia
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3
Q
A

Pedunculated or sessile

  • Same colour as normal mucosa
  • Firm
  • Painless unless traumatised
  • Caused by trauma
  • Overgrowth of fibrous connective tissue
  • Covered by hyperkeratinised stratified squamous epithelium
  • Management: excision. Get rid of cause.
  • Send for histopathological examination
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4
Q

Summarise the aetiology and clinical appearance of Pyogenic granuloma (6)

A
  • Red/blue/purple vascular growth
  • Sessile or pedunculated
  • Rapid growth
  • Soft, bleeds easily
  • Usually < 40 years
  • Common in pregnancy/puberty (pregnancy epulis)
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5
Q

Summarise the causes of a Pyogenic granuloma (4)

A
  • Trauma e.g plaque, calculus, denture, orthodontic appliance
  • In pregnancy/puberty hormonal induced exuberant response to above
  • Overgrowth of very vascular granulation tissue (endothelial cells & fibroblasts)
  • Explains the red colour seen clinically
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6
Q

Summarise the management of a Pyogenic granuloma (4)

A
  • Excision and remove cause
  • If pt. pregnant improve oral hygiene and excise but may recur.
  • Lesions may mature into dense fibrous tissue (fibrous epulis)
  • Also found at other sites in oral mucosa
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7
Q

Give differential diagnoses for fibrous epulis, how do you establish a definitive diagnosis? What should you exclude? (5)

A
  • Firm, mucosa coloured: fibrous epulis
  • Soft, red, red/blue: pyogenic granuloma, giant cell granuloma.
  • If patient pregnant/puberty then more likely pyogenic granuloma.
  • Definitive diagnosis by excisional biopsy.
  • Remember to exclude an abscess from tooth or gum- red/yellow/soft/fluctuant.
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8
Q

What can cause generalised gingival swellings? (7)

A
  • Hereditary: Gingival fibromatosis
  • Inflammatory: Chronic hyperplastic gingivitis
  • Hormonal: Endocrine related (puberty, pregnancy)
  • Diet related: Scurvy
  • Drug related: Drug induced hyperplasia
  • Neoplastic: Leukaemic infiltration; Wegners granulomatosis
  • Associated with GI tract disease: Crohn’s disease
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9
Q

Summarise a gingival fibromatosis (5)

A
  • Hereditary
  • Lifelong
  • Pale pink, firm overgrowth
  • May cover and submerge teeth
  • May regrow after removal
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10
Q

Describe the clinical appearance and associated of Chronic Hyperplastic Gingivitis (2)

A
  • Associated with poor oral hygiene

- Erythematous gingivae, bleed on probing

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11
Q

What is Hormonal related gingival hyperplasia associated with and how does it appear? (3)

A
  • Puberty and pregnancy
  • Exuberant response to plaque
  • Red, erythematous, bleeds easily on probing
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12
Q

Describe Diet related: Gingival hyperplasia in scurvy (5)

A
  • Diet poor in vitamin C
  • Failure to synthesise collagen
  • Loss of teeth
  • Inflammatory type hyperplasia
  • Very rare in UK
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13
Q

Describe the clinical appearance of Neoplastic: Gingival hyperplasia associated with leukaemia, what is in response to and associated with? (5)

A
  • Red, swollen gingivae
  • May exude pus
  • Ulceration
  • Response in excess of amount of plaque
  • May be associated with petechial haemorrhages, tiredness
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14
Q

Describe Drug induced gingival hyperplasia, what is it associated with? What is the management? (6)

A
  • Associated with cyclosporin (immunosupressant), nifedipine (antihypertensive) and phenytoin (anticonvulsant)
  • Gingivae pale, lobulated surface, little inflammation
  • Dense fibrous tissue
  • Little inflammation
  • Long epithelial rete ridges
  • Management: surgical reduction, improve oral hygiene, change drug regime if possible.
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15
Q

Describe Differential Diagnoses for Generalised Gingival Hyperplasia, associated with specific symptoms (3)

A
  • Pale, un-inflamed gingivae: gingival fibromatosis or drug induced. Distinguish on duration and drug history
  • Red, inflamed gingivae: inflammatory hyperplasia or hormonal induced. Distinguish by history
  • Red, inflamed, pus, ulceration: leukaemia. Further investigations
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16
Q

Broadly summarise Swellings affecting the oral mucosa (3)

A
  • These may be derived from any of the tissues in the oral mucosa
  • Most are reactive or inflammatory in nature
  • A few are benign neoplasms or developmental
17
Q

Summarise Squamous cell papilloma and its management (8)

A
  • Benign neoplasm but some be viral- HPV.
  • White cauliflower like growth
  • Pedunculated or sessile
  • Common on palate
  • Overgrowth of epithelium which is hyperkeratinised- hence white colour
  • Surface thrown into fronds
  • Vascular connective tissue core
  • Management: excision with a margin
18
Q

Summarise Fibrous Hyperplasia- fibro-epithelial polyp (3)

A
  • Continued trauma
  • Common on cheeks, tongue, lip
  • Mucosal coloured, firm nodule
19
Q

Summarise Pyogenic granuloma (4)

A
  • Caused by trauma
  • Red/red-white
  • Overgrowth of vascular granulation tissue
  • Usually ulcerated
20
Q

Summarise Lipoma and its management (6)

A
  • Benign neoplasm
  • Composed of fat
  • Yellow/pink
  • Smooth surface
  • Common
  • Management: excision
21
Q

Summarise Haemangioma clinical appearance (5)

A
  • Hamartoma
  • Excess blood vessels
  • Blue/blue-purple colour
  • Localised or diffuse
  • May bleed excessively. Care!
22
Q

Summarise Lymphangioma (2)

A
  • Similar to haemangioma but an overgrowth of lymphatic vessels
  • Paler colour clinically
23
Q

Summarise Neural tumour (5)

A
  • Neurofibroma or neurilemmoma.
  • More deep seated
  • Relatively rare
  • Firm
  • Mucosal coloured
24
Q

Summarise Granular cell tumour (2)

A
  • Common on tongue

- Neural origin

25
Q

Give Differential diagnoses of mucosal swellings specific to symptoms/clinical features (6)

A
  • Cauliflower-like and white- squamous cell papilloma
  • Smooth, mucosal coloured, related to denture, or other source of trauma- fibrous hyperplasia.
  • Smooth, yellow- lipoma
  • Red/red-white, related to trauma -pyogenic granuloma
  • Red/blue- haemangioma, mucocoele
  • Deep seated/ normal mucosa- neuroma, neural tumour, salivary gland tumour

Oral Disease (9 decks)

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