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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
epulis granulomatosa is seen in
pyogenic granuloma=lobular capillary hemangioma= pregnancy tumor
26
epulis granulomatosa
- hyperplastic granulation tissue arising in healing extraction socket - reaction to bony sequestra in socket
27
pyogenic granuloma=lobular capillary hemangioma= pregnancy tumor clinical features histopathologic features
- vascular proliferation of granulation tissue | - endothelium lined channels engorged with RBCs
28
peripheral giant cell granuloma
soft tissue counterpart of central giant cell granuloma
29
peripheral giant cell granuloma occurs
on gingiva only
30
color of peripheral giant cell granuloma
more blue-purple than pyogenic granuloma
31
peripheral giant cell granuloma peak age and sex
40-60 years, slight female predilection
32
peripheral giant cell granuloma radiographic features
- cupping resorption of bone may be seen | - if unclear whether lesion originated in bone or soft tissue, patient must be worked up for hyperparathyroidism
33
peripheral giant cell granuloma radiographic features-if unclear whether lesion originated in bone or soft tissue, patient must be worked up for
hyperparathyroidism
34
peripheral giant cell granuloma histopathology
- multinucleated giant cells with up to several dozen nuclei - background of plump ovoid spindle shaped mesenchymal cells with mitoses - hemorrhage + hemosiderin
35
peripheral giant cell granuloma histopathology-overlying mucosa ulcerated
50% of cases
36
peripheral giant cell granuloma recur?
10-18% recur and must be re-excised
37
peripheral giant cell granuloma r/o/
osteoglastic brown tumors of hyperparathyroidism
38
peripheral ossifying fibroma not to be mistaken for
peripheral odontogenic fibroma or central ossifying fibroma
39
peripheral ossifying fibroma occurs on
gingiva only
40
peripheral ossifying fibroma color
red-pink - frequently ulcerated - usually
41
peripheral ossifying fibroma occurs in
teens + young adults - female predilection 2:1 - maxilla - anterior - rare migration and loosening of teeth
42
peripheral ossifying fibroma histopathology
fibrous proliferation w/ formation of mineralized product
43
lipoma
benign tumor of adipose tissue
44
#1 most common mesenchymal neoplasm
lipoma - most occur on trunk or extremities - rarely in oral cavity - more common in obese, but metabolized independently of normal body fat
45
lipoma clinical features
- pink or yellow in color - 50% of intra oral cases in buccal vestibule or buccal mucosa - soft, smooth-surfaced nodules usually
46
lipoma
- female predilection - most patients older than age 40 - oral lipomas with equal gender
47
granular cell tumor predilection
oral cavity - uncommon benign soft tissue neoplasm - neural differentiation
48
granular cell tumor most common site
tongue
49
granular cell tumor sex predilection
female 2:1 | -usually pink, rarely yellow
50
granular cell tumor histopathologic features
- abundant pale, eosinophilic granular cytoplasm | - half of all cases show
51
granular cell tumor -half of all cases show
pseudoepitheliomatous hyperplasia
52
congenital epulis
-rare soft tissue tumor occuring on alveolar ridge of newborns
53
congenital epulis resemble
granular cell tumor
54
congenital epulis preilection
females 90% | maxillary 2-3x
55
congenital epulis histopathology
resemble granular cell tumors | -NO psuedoepitheliomatous hyperplasia
56
congenital epulis recurs?
NEVER
57
neurofibroma
most common peripheral nerve tumor
58
neurofibroma histopathology
interlacing bundles of spindle cells - wavy nuclei - delicate collagen bundles and variable myxoid matrix - mast cells
59
neurofibroma r/o
neurofibromatosis
60
neurofibroma recurs
rarely
61
how many neurofibromatosis forms
8 forms
62
most common form of how neurofibromatosis
85-97 % type 1
63
type 1 neurofibromatosis
recklinghausen disease
64
type 1 neurofibromatosis
autosomal dominant
65
type 1 neurofibromatosis mapped to chromosome
chromosome 17
66
neurofibromatosis
multiple nuerofibromas, especially on skin, develops at puberty
67
neurofibromatosis oral manifestations
72-92% of cases | -50% show enlarged fungiform papillae
68
neurofibromatosis pigmentation
cafe au lait pigmentation -smooth edged macules develop within 1st year of life 1mm
69
neurofibromatosis crowe sign
axillary freckling
70
neurofibromatosis lisch nodules
brown pigmentation on iris
71
neurofibromatosis malignant peripheral nerve sheath tumors
-5 year survival 15%
72
associated withneurofibromatosis
``` cns tumors pheochromocytoma leukemia rhabdomyosarcoma wilm's tumor ```
73
schwannoma most common oral site
tongue
74
schwannoma
slow growing benign tumor | 25-48% of cases in head and neck
75
histopathology of schwannoma
- encapsulated tumor | - 2 patterns in variable ratio
76
2 histopathological patterns of schannoma
antoni A pattern | antoni B pattern
77
antoni A pattern
- streaming fascicles of spindle shaped schwann cells | - palisaded arrangement around acellular eosinophilic verocay bodies
78
antoni B pattern
- less cellular and organized | - random spindle cells in loose myxomatous stroma
79
neuromas
considered reactive, not neoplastic | -solitary circumscribed neuroma (palisaded encapsulated neuroma)+ traumatic neuroma
80
traumatic neuroma
proliferation of neural tissue after transection or other damage of a nerve bundle
81
traumatic neuroma
middle aged adults female predilection 24-33% associated with pain
82
traumatic neuroma omost common in
mental foramen area, tongue, lower lip, associated with trauma
83
histopathology of traumatic neuroma
mature, myelinated nerve bundles within fibrous CT stroma
84
multiple endocrine neoplasia
- group of rare conditions - autosomal dominant - multiple tumors and hyperplasias of endocrine organs
85
Men type 1
wermer syndrome
86
MEN type 1 = wermer syndrome mutation of
MEN 1 gene
87
MEN type 1 = wermer syndrome tumors/hyperplasias
parathyroid /pituitary gland adrenal cortex pancreas
88
MEN TYPE 2
- familial medullary thryoid carcinoma syndrome - MEN type 2A - MEN type 2B
89
MEN Type 2A: what percent develops medullary carcinoma of the thyroid (MTC)
95%
90
MEN Type 2A: what percent develop pheochromocytomas of adrenal medullla
50%
91
MEN Type 2A: what percent developparathyroid hyperplasia or adenoma
20-30%
92
MEN type 2B
mutation of RET protooncogene in 95% | - same findings in type 2a PLUS multiple mucosal neuromas
93
MEN type 2B
marfanoid body build | -mucosal neuromas on eyelid, conjunctiva, or cornea
94
MEN type 2B oral neuromas often first sign of diseas
painless papules on lips and anterior tongue
95
MEN type 2B pheochromocytomas of adrenal glands in %?
50% of patients
96
MEN type 2B medullary carcinoma of thyroid **
almost all patients -aggressive tumor with propensity for metastasis -
97
MEN type 2B medullary carcinoma of thyroid **; without prophylactic thyroidectomy before age 1
most patients will develop distant spread during childhood or adolescence
98
MEN type 2B : MTC associated with elevated
serum or urinary levels of calcitonin
99
pheochromocytomas of MEN type 2B associated with
urinary vanillylmandelic acid (VMA) and increased epinephrine: norepinephrine
100
vascular anomalies- tumors
- hemangioma of infancy - congenital hemangioma - kaposiform hemangioendothelioma - tufted angioma
101
vascular anomalies- simple malformations
- capillary - venous - lymphatic - arteriovenous
102
hemangioma of infancy (vascular anomalies)
most will resolve on their own
103
most common tumor of children (4-5% of 1 year olds)
hemangioma of infancy
104
hemangioma of infancy female predilection
3-5:1
105
hemangioma of infancy percent in head and neck
60%
106
how many hemangioma of infancies are solitary
80%
107
hemangioma of infancy proliferate for 6-10 months before
involution
108
congenital hemangioma (vascular anomalies)
- rapidly involuting variant (RICH) | - noninvoluting variant (NICH)
109
vascular malformations (vascualr anomalies)
persistent lesions present at birth
110
intrabony vascular malformations
- venous or arteriovenous malformations - jaw lesions usually occur by age 30 - 3:1 mandible predilection
111
lymphatic malformation
- 50-75% in head and neck region - most common on anterior tongue - pebbly surface
112
lymphatic malformation histopathology
- proliferation of lymphatic vessels | - valvular structures may be noted within the lesion
113
pebbly
lymphangioma

oral pathology 2 (3 decks)

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