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oral pathology 2 > Benign soft Tissue Tumors > Flashcards

Benign soft Tissue Tumors Flashcards

1
Q

reactive benign soft tissue tumors

A

fibroma

+ reactive gingival nodules

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2
Q

reactive gingival nodules

A
  1. pyogenic granuloma
    2 peripheral giant cell granuloma
    3 peripheral ossifying fiborma
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3
Q

neoplastic benign soft tissue tumors

A 
lipomatous
neural
vascular
muscular (rhabdomyoma + leiomyoma)
myofibroblastic (myofibroma)
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4
Q

fibroma

A

reactive hyperplasia of fibrous CT

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5
Q

a fibroma is a response to

A

local trauma or irritation

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6
Q

what is themost common tumor of the oral cavity

A

fibroma

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7
Q

is a fibroma a true neoplasm?

A

no

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8
Q

most common location of a fibroma

A

buccal mucosa

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9
Q

clinical features of fibroma

A

typically sessile, smooth surface nodule, may be whitish from hyperkeratosis but usually normal in color

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10
Q

most common age for fibromas

A

30-60

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11
Q

fibroma

A

asypmtomatic + female predilection

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12
Q

histopathology of fibromas

A

unencapsulated

-nodular mass of densely collagenized fibrous CT covered by stratified squamous epithelium

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13
Q

do fibromas recur?

A

rarely

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14
Q

what should we r/o with fibroms

A

neoplasia

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15
Q

giant cell fibroma clinical features

A
  • asymptomatic nodule
  • papillary
  • younger patients than those with fibromas
  • female predilection
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16
Q

50% giant cell fibromas occur on

A

gingiva

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17
Q

retrocuspid papilla

A
  • giant cell fibroma
  • bilateral often
  • pink papule
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18
Q

retrocuspid papilla lingual to

A

mandibular canines

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19
Q

histology of giant cell fibroma

A
  • large stellate fibroblasts w/ several nuclei
  • rete ridges narrow and elongated
  • vascular fibrous CT
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20
Q

pyogenic granuloma (reactive gingival nodules)

A

lobular capillary hemangioma

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21
Q

pyogenic granuloma poorly names

A

neither pyogenic nor granuloma

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22
Q

pyogenic granuloma=lobular capillary hemangioma= pregnancy tumor

A

may be seen in pregnant women

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23
Q

pyogenic granuloma=lobular capillary hemangioma= pregnancy tumor

A
  • smooth or lobulated mass
  • pedunculated or sessile
  • red-pink-purple
  • often ulcerated
  • newer lesions more vascular, older lesions collagenized
  • painless mass may bleed easily
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24
Q

pyogenic granuloma=lobular capillary hemangioma= pregnancy tumor clinical features

A
  • 75%-85% on gingiva
  • maxilla>mandible
  • anterior> posterior
  • facial > lingual
  • more common in young patients
  • female predilection
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25
Q

epulis granulomatosa is seen in

A

pyogenic granuloma=lobular capillary hemangioma= pregnancy tumor

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26
Q

epulis granulomatosa

A
  • hyperplastic granulation tissue arising in healing extraction socket
  • reaction to bony sequestra in socket
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27
Q

pyogenic granuloma=lobular capillary hemangioma= pregnancy tumor clinical features histopathologic features

A
  • vascular proliferation of granulation tissue

- endothelium lined channels engorged with RBCs

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28
Q

peripheral giant cell granuloma

A

soft tissue counterpart of central giant cell granuloma

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29
Q

peripheral giant cell granuloma occurs

A

on gingiva only

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30
Q

color of peripheral giant cell granuloma

A

more blue-purple than pyogenic granuloma

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31
Q

peripheral giant cell granuloma peak age and sex

A

40-60 years, slight female predilection

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32
Q

peripheral giant cell granuloma radiographic features

A
  • cupping resorption of bone may be seen

- if unclear whether lesion originated in bone or soft tissue, patient must be worked up for hyperparathyroidism

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33
Q

peripheral giant cell granuloma radiographic features-if unclear whether lesion originated in bone or soft tissue, patient must be worked up for

A

hyperparathyroidism

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34
Q

peripheral giant cell granuloma histopathology

A
  • multinucleated giant cells with up to several dozen nuclei
  • background of plump ovoid spindle shaped mesenchymal cells with mitoses
  • hemorrhage + hemosiderin
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35
Q

peripheral giant cell granuloma histopathology-overlying mucosa ulcerated

A

50% of cases

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36
Q

peripheral giant cell granuloma recur?

A

10-18% recur and must be re-excised

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37
Q

peripheral giant cell granuloma r/o/

A

osteoglastic brown tumors of hyperparathyroidism

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38
Q

peripheral ossifying fibroma not to be mistaken for

A

peripheral odontogenic fibroma or central ossifying fibroma

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39
Q

peripheral ossifying fibroma occurs on

A

gingiva only

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40
Q

peripheral ossifying fibroma color

A

red-pink

  • frequently ulcerated
  • usually
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41
Q

peripheral ossifying fibroma occurs in

A

teens + young adults

  • female predilection 2:1
  • maxilla
  • anterior
  • rare migration and loosening of teeth
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42
Q

peripheral ossifying fibroma histopathology

A

fibrous proliferation w/ formation of mineralized product

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43
Q

lipoma

A

benign tumor of adipose tissue

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44
Q

1 most common mesenchymal neoplasm

A

lipoma

  • most occur on trunk or extremities
  • rarely in oral cavity
  • more common in obese, but metabolized independently of normal body fat
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45
Q

lipoma clinical features

A
  • pink or yellow in color
  • 50% of intra oral cases in buccal vestibule or buccal mucosa
  • soft, smooth-surfaced nodules usually
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46
Q

lipoma

A
  • female predilection
  • most patients older than age 40
  • oral lipomas with equal gender
47
Q

granular cell tumor predilection

A

oral cavity

  • uncommon benign soft tissue neoplasm
  • neural differentiation
48
Q

granular cell tumor most common site

A

tongue

49
Q

granular cell tumor sex predilection

A

female 2:1

-usually pink, rarely yellow

50
Q

granular cell tumor histopathologic features

A
  • abundant pale, eosinophilic granular cytoplasm

- half of all cases show

51
Q

granular cell tumor -half of all cases show

A

pseudoepitheliomatous hyperplasia

52
Q

congenital epulis

A

-rare soft tissue tumor occuring on alveolar ridge of newborns

53
Q

congenital epulis resemble

A

granular cell tumor

54
Q

congenital epulis preilection

A

females 90%

maxillary 2-3x

55
Q

congenital epulis histopathology

A

resemble granular cell tumors

-NO psuedoepitheliomatous hyperplasia

56
Q

congenital epulis recurs?

A

NEVER

57
Q

neurofibroma

A

most common peripheral nerve tumor

58
Q

neurofibroma histopathology

A

interlacing bundles of spindle cells

  • wavy nuclei
  • delicate collagen bundles and variable myxoid matrix
  • mast cells
59
Q

neurofibroma r/o

A

neurofibromatosis

60
Q

neurofibroma recurs

A

rarely

61
Q

how many neurofibromatosis forms

A

8 forms

62
Q

most common form of how neurofibromatosis

A

85-97 % type 1

63
Q

type 1 neurofibromatosis

A

recklinghausen disease

64
Q

type 1 neurofibromatosis

A

autosomal dominant

65
Q

type 1 neurofibromatosis mapped to chromosome

A

chromosome 17

66
Q

neurofibromatosis

A

multiple nuerofibromas, especially on skin, develops at puberty

67
Q

neurofibromatosis oral manifestations

A

72-92% of cases

-50% show enlarged fungiform papillae

68
Q

neurofibromatosis pigmentation

A

cafe au lait pigmentation
-smooth edged macules develop within 1st year of life
1mm

69
Q

neurofibromatosis crowe sign

A

axillary freckling

70
Q

neurofibromatosis lisch nodules

A

brown pigmentation on iris

71
Q

neurofibromatosis malignant peripheral nerve sheath tumors

A

-5 year survival 15%

72
Q

associated withneurofibromatosis

A 
cns tumors
pheochromocytoma
leukemia
rhabdomyosarcoma
wilm's tumor
73
Q

schwannoma most common oral site

A

tongue

74
Q

schwannoma

A

slow growing benign tumor

25-48% of cases in head and neck

75
Q

histopathology of schwannoma

A
  • encapsulated tumor

- 2 patterns in variable ratio

76
Q

2 histopathological patterns of schannoma

A

antoni A pattern

antoni B pattern

77
Q

antoni A pattern

A
  • streaming fascicles of spindle shaped schwann cells

- palisaded arrangement around acellular eosinophilic verocay bodies

78
Q

antoni B pattern

A
  • less cellular and organized

- random spindle cells in loose myxomatous stroma

79
Q

neuromas

A

considered reactive, not neoplastic

-solitary circumscribed neuroma (palisaded encapsulated neuroma)+ traumatic neuroma

80
Q

traumatic neuroma

A

proliferation of neural tissue after transection or other damage of a nerve bundle

81
Q

traumatic neuroma

A

middle aged adults
female predilection
24-33% associated with pain

82
Q

traumatic neuroma omost common in

A

mental foramen area, tongue, lower lip, associated with trauma

83
Q

histopathology of traumatic neuroma

A

mature, myelinated nerve bundles within fibrous CT stroma

84
Q

multiple endocrine neoplasia

A
  • group of rare conditions
  • autosomal dominant
  • multiple tumors and hyperplasias of endocrine organs
85
Q

Men type 1

A

wermer syndrome

86
Q

MEN type 1 = wermer syndrome mutation of

A

MEN 1 gene

87
Q

MEN type 1 = wermer syndrome tumors/hyperplasias

A

parathyroid /pituitary gland
adrenal cortex
pancreas

88
Q

MEN TYPE 2

A
  • familial medullary thryoid carcinoma syndrome
  • MEN type 2A
  • MEN type 2B
89
Q

MEN Type 2A: what percent develops medullary carcinoma of the thyroid (MTC)

A

95%

90
Q

MEN Type 2A: what percent develop pheochromocytomas of adrenal medullla

A

50%

91
Q

MEN Type 2A: what percent developparathyroid hyperplasia or adenoma

A

20-30%

92
Q

MEN type 2B

A

mutation of RET protooncogene in 95%

- same findings in type 2a PLUS multiple mucosal neuromas

93
Q

MEN type 2B

A

marfanoid body build

-mucosal neuromas on eyelid, conjunctiva, or cornea

94
Q

MEN type 2B oral neuromas often first sign of diseas

A

painless papules on lips and anterior tongue

95
Q

MEN type 2B pheochromocytomas of adrenal glands in %?

A

50% of patients

96
Q

MEN type 2B medullary carcinoma of thyroid **

A

almost all patients
-aggressive tumor with propensity for metastasis
-

97
Q

MEN type 2B medullary carcinoma of thyroid **; without prophylactic thyroidectomy before age 1

A

most patients will develop distant spread during childhood or adolescence

98
Q

MEN type 2B : MTC associated with elevated

A

serum or urinary levels of calcitonin

99
Q

pheochromocytomas of MEN type 2B associated with

A

urinary vanillylmandelic acid (VMA) and increased epinephrine: norepinephrine

100
Q

vascular anomalies- tumors

A
  • hemangioma of infancy
  • congenital hemangioma
  • kaposiform hemangioendothelioma
  • tufted angioma
101
Q

vascular anomalies- simple malformations

A
  • capillary
  • venous
  • lymphatic
  • arteriovenous
102
Q

hemangioma of infancy (vascular anomalies)

A

most will resolve on their own

103
Q

most common tumor of children (4-5% of 1 year olds)

A

hemangioma of infancy

104
Q

hemangioma of infancy female predilection

A

3-5:1

105
Q

hemangioma of infancy percent in head and neck

A

60%

106
Q

how many hemangioma of infancies are solitary

A

80%

107
Q

hemangioma of infancy proliferate for 6-10 months before

A

involution

108
Q

congenital hemangioma (vascular anomalies)

A
  • rapidly involuting variant (RICH)

- noninvoluting variant (NICH)

109
Q

vascular malformations (vascualr anomalies)

A

persistent lesions present at birth

110
Q

intrabony vascular malformations

A
  • venous or arteriovenous malformations
  • jaw lesions usually occur by age 30
  • 3:1 mandible predilection
111
Q

lymphatic malformation

A
  • 50-75% in head and neck region
  • most common on anterior tongue
  • pebbly surface
112
Q

lymphatic malformation histopathology

A
  • proliferation of lymphatic vessels

- valvular structures may be noted within the lesion

113
Q

pebbly

A

lymphangioma

oral pathology 2 (3 decks)

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